What Wayne Gretzky Can Teach Healthcare About Transitioning to Pay-for-Performance

Hockey great Wayne Gretzky played 20 years in the National Hockey League, earning his place as one of the most talented and celebrated athletes in the sport in the late 1970s through 1990s. I lived just outside St. Louis in 1996, his one and only season with the team. When he was traded from the Kings, the excitement for his arrival was electric.

Wayne Gretzky had incredible physical talent, but like any superstar athlete, what separated him from the rest of the very talented professional athletes he played against was a mental and intellectual edge.

One of his most famous quotes (I remember a high school friend with this exact poster hanging on his wall) is this: "I skate to where the puck is going to be, not where it has been."

The way he played the game wasn't to race over to where he saw the puck, but to anticipate where the puck would be next, and go there. The approach certainly served him well.

Gretzy's quote recently came up in a conversation I had with Kenneth Kaufman, managing director and chair of healthcare consulting firm KaufmanHall. Kaufman mentioned it as we were talking about hospitals' difficulty in transitioning to value-based payment models.

Specifically, we talked about how so many health system executives and boards are looking for guidance in timing the jump from fee-for-service to a new model (an issue that I previously wrote about here). That approach (i.e., 'timing' the transition) misses the point, he said. 

If Wayne Gretzky were a healthcare consultant, he would agree.

"At the moment, I would say that organized legacy providers are moving too slowly. A lot of organizations are quite cautious. This is not a first mover industry," said Kaufman.
Ninety-five percent of hospital systems today are not skating to where the puck is going. They may be thinking about it, analyzing it, and forming committees to explore it, but they aren't really moving. If we were to extend the hockey metaphor, they'd be the player frozen on the ice — staring at the puck and waiting for it to move first.

After all, following is easier than anticipating.

However, as I'm sure Wayne Gretzky would attest, you don't become the best by letting something, or someone, else lead you. Instead, take the lead, and take the risk.

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