GHP Home >> Open Mike
Open Mike - 2011

Sometimes growth don't feel like it should
January 28, 2011

You may have heard that Group Health’s Executive Leadership Team recently built the 2011-2015 Strategic Plan. It came together with input from hundreds of people around Group Health Physicians and Group Health Cooperative, and is supported and endorsed by both organizations’ boards. It focuses on four areas:

  • Profitable growth with a target of 932,000 insured members by 2015
  • Affordability since we have a business reason and an obligation to bring costs down
  • Quality with a target to rank among the top 25 NCQA accredited plans by 2015
  • Staff engagement because without you, these targets are impossible.

The plan notes “Our patients get the best care when they are cared for by Group Health Physicians in Group Health Medical Centers.” And when this is not possible, it points to achieving the “highest level of ‘integrated care’ by partnering with preferred partners.”

It is a very bold plan, projecting “strategies that drive growth in our group practice in order to provide cost-effective, high-quality care. Our goal is that the majority of all new members will receive their care with Group Health Medical Centers.”

You often hear us “executives” talking about the importance of profitable growth, but it might not always feel like a good thing to you as you do your work every day. Certainly growth itself can mean more work for front line clinicians and clinical teams, and that can be painful. We know that taking on new patients—and engaging them in their own good health—takes time. But it’s what’s unique and important about our kind of medicine.

We can mitigate the pain of growth somewhat by getting ready for it with enough staff and space to welcome new patients. Still, growth can be hard on our front lines. So why is it a good idea? Here are some key business and strategic reasons to pursue profitable growth.

The world is rapidly changing around us. Washington added nearly 1 million new residents over the last decade, becoming the 13th largest state. Without growth, our market share—the portion of the total available health care market that we serve—declines. This decreases Group Health’s standing in the region and undermines our ability to negotiate effectively with hospitals, other providers, and health plans.

More coverage for each other, more time to learn. When we grow we can add more staff and more specialties, increasing our ability to cover for each other and meet sub-specialization needs. Related to this, with growth comes more opportunity for front line staff to take on new roles related to administration, education, or research. It helps development of knowledge, skills, innovation, and personal growth to be living, vibrant qualities in our work.

A volume of patients to attract the best of the best. Market relevance (often confirmed by growth) is in fact what keeps our jobs secure and is a measure of long term success. Growth is even more vital for our Consultative Specialty group. We need the referral base and patient volumes to attract and retain the highest quality specialists and subspecialists.

Fixed costs are spread more broadly. This makes a business model more financially sustainable in the long term. For our health plan and medical group alike, spreading infrastructure costs over a larger number of members means the cost of care per member is more stable over time.

We bring Group Health medicine to more communities. Growing also means spreading our influence to more people, living our founders’ mission to “serve the greatest number.” In doing this we help more people live better, healthier lives and relieve pain and suffering. Group Health has an obligation to be part of the solution. We CAN provide affordable, high quality health care. Being part of “what works” and seeing it thrive and grow is something we can all be proud of.

Our success in profitable growth is also part of leaving the organization in a better position than when we joined it. This is our responsibility to those who will follow us here.

Growth has to be profitable to do good in the long term. In the short term, growth can be painful for front line clinical people, and it means some tough decisions about structuring the business for its best future. But it’s a great dilemma to have.


Open Mike Articles
  • 2012  
  • |  2011  
  • |  2010  
The Path To The Best Care At Lower Cost   12/01/2012
The US spends $2.7 trillion on health care every year. If our collective wallets feel lighter, that’s because $304 billion comes out of our own pockets. How can these kinds of costs be brought under control, without sacrificing quality of care?

Certainty   09/04/2012
Sustaining momentum in uncertain times can be hard, but one way to keep it up is to celebrate progress. I’m really proud to call your attention to a study published in Health Affairs today.

Affordable Care Act ruling brings stronger imperative to transform health care  07/11/2012
As important as the Supreme Court Ruling is for the future of health care, it’s really just one step in a process that started before the Affordable Care Act passed and will continue for a long time to come.

Only connect 05/16/2012
This spring I spent five weeks in clinical immersion all over our system. I had 34 small-group discussions with 172 different clinicians. In March, I shared some early insights at the half-way point. Now I want to wrap up everything I heard.

What if? 04/11/2012
What if the “new normal” doesn’t feel normal at all, for many years? I try to remind myself and others that the current turmoil in health care is driven by market forces—not politics—and can only be solved by directly addressing the market. Our “new normal” is all about reaching across silos to work with partners in new ways.

Business problem? Diagnose it.
I’m about halfway through my 2012 clinical immersion. When I tried this last year it was new for all of us, and it felt right to start our conversations around values. This year I'm trying to dig a little deeper.

What will your legacy be?  02/24/2012
What a night! It felt terrific to see over 700 clinicians and special guests at the GHP Annual Meeting on February 15. “A Legacy of Leadership” was our theme for the evening, touching on our shared past, present, and future.

Performance matters  10/19/2011
Only nine Medicare Advantage plans in the country earned 5 stars overall, and Group Health Cooperative’s Medicare Advantage plan is one of them!

Looking back, and ahead: reflections on my first three years  9/17/2011
The last three years have passed quickly, largely because I’ve had such an amazing group of people to work with. What you’re capable of no longer surprises me. It inspires me.

Our people are our culture, and we’re constantly evolving  8/17/2011
One thing I’ve noticed since my last Q&A on Group Health culture with Scott Armstrong is that conversations like ours are spreading.

More than elbow room  7/6/2011
Growth is a good problem to have in turbulent economic times. But as I’ve heard in medical staff business meetings and conversations, growth is hard on daily life at work.

Erikson and Soman on partnership and growth  6/15/2011
Sustaining growth isn’t about Michael and I being leaders; it’s about teams of seasoned, excellent colleagues and leaders and clinical teams. We both have tremendous confidence in them.

The good, the bad and everything in between  5/11/2011
I went all over the state in March, talking with small groups of GHP physicians and other clinicians about critical issues. 

Why are we here?  3/23/2011
Easily eight out of ten of you mention that our philosophy of medicine—the way we practice—drew you here. And paired with the people and relationships in your workplaces, it’s a major thing that keeps you here.

Culture at Group Health: 7 questions for Scott & Michael  3/9/2011
Scott and I kicked off some fresh thinking about culture and respect for people at our Leadership Conference about five weeks ago. Recently, we sat down to check in with each other about it.

Put some passion in your workplace 2/17/2011
What satisfies you, motivates you, or makes you want to tell your friends and family about your day? Do you know how your co-workers would answer these questions? Talk to each other to learn from each other.

What will it take? You.  12/1/2010
About 350 leaders from the Group Practice and throughout Group Health gathered for the Group Practice Annual Fall Forum on November 12.

Demystifying clinical integration
Clinical integration is the key, so let’s define what that phrase means.

Step back and take it all in. You’re making great things happen.  10/21/2010
In the last issue of Open Mike we had just learned that we had won the 2010 Acclaim Award from the American Medical Group Association.

Group Health sees a big jump in NCQA private plan rankings  9/22/2010
Group Health is one of the highest rated health plans and among the top 50 in the nation, according to the National Committee for Quality Assurance (NCQA).

Innovation is where we shine  9/8/2010
I am very excited to share that the American Medical Group Association (AMGA) has honored our work with its 2010 Acclaim Award.

Notes from the Colorado Health Symposium  8/11/2010
During the last week of July I traveled to the Colorado Health Foundation’s annual symposium in Keystone, CO.

Measuring up  7/28/2010
Quality. Ask a hundred people to define it, and you’ll get a hundred answers.

The risk and opportunity of Accountable Care Organizations
Shared values, physician-led care models, and aligned incentives can bridge the distance between organizations in the world of accountable care.

Let’s start a conversation about our workplace  4/4/2010
People are our most important resource, our “secret sauce.”

Decreasing “unwarranted” variation in clinical care  3/24/2010
As you read this, we are in the midst of unprecedented reform to our national health care system.

Making the transition from “I” to “we”
Last night the Group Health Permanente Annual Meeting left me feeling inspired and confident.

Looking ahead to 2010  1/13/2010
First, for 2010, our goal is as follows: We will lead the top delivery system in the state.

Other GHP Leadership Publications