HC 100 Takeaway: Four Steps to Effectively Pilot Change

 In Expanding Services, Preparing for the Future

At Home Care 100 last week, Jeff Shaner, CEO of Aveanna Healthcare, shared his company’s journey into value-based care through negotiated deals with select state payers for pediatric home care services. It was great to watch him talk through these issues. Having worked with Jeff recently, I’ve always admired his passion for pushing the home-based care community forward.

From my perspective, Aveanna’s experience lays out a four-step blueprint for other providers to follow in crafting their own pathways’ innovations, like new payer engagements. The four-pronged approach draws on experiences similar to those I had the honor to lead when working in a Fortune 500 environment.


1: Segment

Step 1: Segment Your Opportunities

Not all payers are the same. Jeff and his team recognized this and rather than wasting their efforts on trying to hold the line with across-the-board rate or term changes, they focused their efforts on opportunities with the greatest mutual benefit. To know where to focus, you need three kinds of information:

  1. Performance data (both internal and that of your partner)
  2. Knowledge of what your high-priority potential partner values
  3. Insight from internal teams on operating conditions

Using this intelligence, segment your opportunities into three camps – potential partners, transactional players and targets for education. Focus strategies on the first and the third. Maintain the status quo with transactional players or even consider winding down engagements.


2: Incubate

Step 2: Incubate, Don’t Mainstream

We often see providers aim to hard launch new services or payer engagements simultaneously across their enterprise. Bolting new approaches onto your existing operating model is a recipe for frustration and futility. Instead, set up incubation teams that sit outside your core business.

Pilot teams that are incubating innovation need clear leadership and decision-making authority and direct lines of communication to the correct C-suite sponsor, if not the CEO. Often, organizations can be tempted to throw the whole leadership team at new ideas. When your entire leadership is focused both on the core business AND the success of the incubated concept, you’re splitting your focus and diluting decision making and ownership. Both delay progress and the core business will suffer. Establish a small group of leaders to provide ongoing oversight of the initiative. Consider using a Lean Six Sigma phase gate or Agile methodology to structure and assess incubated initiatives as they mature to ensure time and money is well invested.


3: Share

Step 3: Celebrate Wins and Share the Wealth

The real magic in the strategy Jeff and the Aveanna team are deploying is how they’re leveraging payer partnerships to grow opportunities for caregivers. Value-based engagements often include service level or outcomes goals with performance-based bonuses. Aveanna is using these engagements to provide higher-wage opportunities for caregivers in participating markets. Skin in the game works at all levels!

At the same time, over the past two years, Aveanna leaders have taken a hard look at the infrastructure of their employee experience, streamlining processes and localizing roles to remove barriers to decision making, success and individual growth. Transcend had the honor of helping to support some of that work as a partner with Aveanna.

Incubated initiatives also provide opportunities for growth for mid-level leaders. Aveanna is embracing this opportunity to develop the next generation of organizational leaders.


4: Manage

Step 4: Manage Expectations and the Speed of Scaling Up

Perhaps the hardest part of innovating is managing stakeholder expectations. As incubated concepts are successful, leaders and investors can be tempted to scale the model too quickly for the firm to manage. It also can be tempting to have multiple siloed innovations or pilots going live simultaneously. Often, staff don’t see or understand their role in this and can become disillusioned, or not understand which new project is a priority and suffer fatigue.

An agile and cadenced scale plan – supported by a clear stakeholder communications plan – is essential and should be a part of the core oversight team’s work.

You can expect Transcend to be discussing these issues of innovation and change management all year – as my colleague and Transcend Chief Strategy Officer Tony Kudner mentioned in The Transcend Top Six, change ain’t done. We’re responding to the changes we’re seeing in the community by building our practice to support change management and better understanding of new payer models and innovation. In fact, look for our first 2024 Insights research to be published in the coming weeks, with some comprehensive views on how value-based care is impacting our community.

If you need help framing change, building communications plans or developing your strategic roadmap, Transcend can help. Drop us a line at hello@transcend-strategy.com to start a conversation about how to seize your Growth Readiness Opportunities.

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