1. As I watch Milwaukee-based Aurora Health Care and Downers Grove, Ill.-based Advocate Health Care merge, and Asheville, N.C.-based Mission Health agree to terms with Nashville, Tenn.-based Hospital Corporation of America, it reminds me of the Netflix series "Orange is the New Black."
In this case, $10 billion or so in revenues is the new $1 billion-plus. Systems seek scale as a buffer against change and to have greater resources to compete. Whether it's good or bad, and the right or wrong strategy, there are some movements in that direction.
2. Many systems in the face of rapid noise or threats from the external non-healthcare world are in a state of hardcore blocking and tackling to make them anti-fragile. Rather than new expansive growth initiatives, many seem to be focused on making sure they have their houses in order on several fronts to be able to withstand and respond to a variety of external pressures.