Empowering Employee Performance

Group of business people

In a rigid bureaucracy, whether in the government or the private sector, employee capability can become “dead capital” – an enormous, dynamic resource, effectively stifled by the organization. Successful performance management liberates that “captive” creativity, enthusiasm and dedication as a force multiplier for organizational success.

Fine as far as it goes, but how does this work in actual implementation?

Let’s begin with an example based on an axiom; workers are as different in their personalities as they are in their skill sets.  Between one third and one half of the American population are introverts, people who perform best on their own, and whose quality of work can actually decline in team-related gatherings, which saps an introvert’s energy and distracts their attention.

The “cubicle-ization” of the American workplace, eliminating offices in favor of mass, open floor plans, has been a disaster for introverted employees who require privacy and quiet to perform at their best.

Enter Susan Cain, author of “Quiet: The Power of Introverts in a World That Can’t Stop Talking,” a book which became a best seller in 2012. Cain has collaborated with the design firm Steelcase to develop a workplace alternative. The Cain-Steelcase design, represents five unique work rooms that are modular, and can be dropped in within today’s ubiquitous open floor plans.

While designed for introverts, the rooms provide value for extroverts and others of no designation. Of 39,000 North American workers surveyed, 95% reported the need for quiet spaces that allow for confidential conversations, ranging from a call to a doctor, to a conference call with a key client.

The Cain-Steelcase collaboration is an example of “actionable research” – transforming critical data and conclusions into tangible improvements in the workplace that unlock the “captive value” in employees, creating a new threshold for performance enhancement.

Performance leaders in organizations will quickly see the possibilities that these marginal investments will have in sustainable productivity. It is that paradigm of performance leadership and empowered employees that re-writes the narrative work success.

By | June 20, 2014 | | 0 Comments

“Fresh Thinking” to Improve Performance Capability


Executives know that they must improve performance capability to improve performance results. But recent public sector initiatives focused on improved performance have been anything but encouraging.

Technology has been a de facto silver bullet for government managers, holding the promise of greater capability and operational efficiency.  But the technology silo rarely produces advertised results. In the latest example, the General Accounting Office (GAO) has identified at least $10 billion in federal information technology contracts that are at risk of failure. 

$10 billion. That’s almost equal to the amount of money the Feds lost in the GM bailout from 2008, which caused such public controversy. But this report and its results send barely a ripple through the news.

Then you have the Health and Human Services and Veterans Affairs where management, technology and policy failed spectacularly, leading to embarrassment, delays and even, potentially, loss of life, respectively.

We clearly need to address these shortcomings more seriously. We need a new path to secure better, more responsive results, and that begins with fresh thinking.

Performance capability is a combination of employee readiness, operational resources, and structural design. Each has its unique complexity, which dynamically impacts the other elements. If executives neglect performance capability, they risk embedding systemic operational weaknesses throughout the organization.

What to do?  Executives have three basic options to enhance performance capability.

The first option is to redesign the work. We are all familiar with this in one form or another.

 Redesign can be simple, such as a new directive, but these impacts can fade quickly, as enduring cultural influences remain fixed. Redesign can also be grand, incorporating completely new concepts for processing work or new organizational reporting. The grand redesign is a high risk/high reward proposition. The payoff for successful implementation is an energized, high performing organization. The risks, primarily but not wholly generated by employees, include uncertainty, lack of awareness underlying the purpose of change and organizational culture clashes. Every redesign inherently picks winners and losers, and the inadequately explained organizational shift empowers those with the most to lose in the design, impeding optimal results.

The second option is new technology. We have already seen how this can go terribly wrong in the examples outlined above.

Clearly, technology is a double two-edged sword.

Technology has the power to accelerate access to vast information and organize an incredible variety of functional applications, but this invariably comes with negative effects. Indeed, today’s standard design/procurement cycle for technology deployment has a seriously counter-productive impact on work.

The larger, more expensive and complex a technology fix becomes, the more likely it is that the technology, not the problem it was designed to remedy, will become the focus of employee efforts. The result is a poor fit of technology that creates unnecessary burdens on employees, where staff are trying to comply with the tool rather than creating better outcomes. A poor fit can also exasperate operational and organizational weaknesses by putting too much faith into static machinery, rather than seeking adaptive capabilities. To be successful, technology must be adaptive to work design, not the other way around.

 The third option is new knowledge.

Training is always relevant to work performance, but the value of the retained knowledge is always in question. Valuable knowledge is acquired in many ways, including skill-based training, work-embedded training, work-based coaching, and work-related analytics. Each of these is valuable, but pose the risk of not sustaining value or becoming misaligned with business goals.

Skill-based training is not necessarily applied to the work. Work-embedded training can reinforce a weak work design. Work-based coaching can be off the organizational goals. Analytics can distort and drive unwanted behaviors. Valuable knowledge is when employees and executives are prepared to change work capacity together.

In sum,  for each approach there is a significant downside. But what if, as part of our fresh thinking, we were to incorporate the best features of design, technology and knowledge into a discipline of its own, where the mutually reinforcing elements empowered change from the bottom up while also limiting risk?

That creates a fourth option; performance engineering for executives.

Performance engineering is a “trans-disciplinary” method of fitting design, technology, and knowledge together so that the changing and complex elements of performance capability are measurable, and readily available for analysis. Recursive analyses of elements allows employees and executives the opportunity to test feasible change, and create a rigorous culture with the potential for performance improvement. Instead of looking to one element to solve an organizational problem, performance engineering incorporates each, creating maximum value with minimal risk. It is fast, adaptable, scalable and affordable to almost any organization, in or outside the government.

We cannot end organizational challenges. But we can improve the manner in which we address them, which is fast, flexible and cost-effective, and which unlocks the captive value of employees while promoting rigor, efficiency and accountability.

For discerning executives, Performance Engineering is the answer.

By | June 17, 2014 | | 0 Comments

How to Grow the Pie

Financial graphs analysis

Issuing its first revision to first quarter Gross Domestic Product (GDP) for 2014, the Bureau of Economic Analysis (BEA) has reported that the US economy contracted by one percent in the first three months of the year; the first such contraction since 2011. Despite truly extraordinary efforts by the Federal Reserve since 2008, and more than $1 trillion in spending by the federal government since 2009, the economic recovery that officially began in June 2009 has been halting and anemic, significantly under-performing all post-recession recoveries since WWII.

Is this the “new normal”? Do we face – or more importantly, are we bequeathing to our children – a world of stagnation where individual gains are only derived from redistributing the existing pie?

To answer the question, meet Robert Solow.

An MIT professor, and later, a Nobel Prize winner, Solow published a paper in 1957 that analyzed American labor productivity gains. Those gains are the core component of per capita GDP growth, which directly relates to expanded wealth and improved living standards.

Solow research determined that less than 13 percent of growth in output per worker could be accounted for in increased use of capital (land, equipment, et. al.). The overwhelming majority of the increase, nearly 88 percent, was attributable to “technical change” or innovation.

As Jim Manzi, former CEO of Lotus Development notes in a recent article in National Affairs, “The root of American economic success has not been luck or land or conquest but innovation.”

Despite our subpar economic performance, as a nation we remain in a dynamic era where innovation radically reduces costs, spurring additional innovation, in an almost virtuous cycle, that is a natural wellspring for growth.

Consider the computer revolution. In 1990, one million transistors cost $527.00. Today, a million transistors costs five cents.

Or consider storage capacity.  In 1990 it cost $569.00 to store a gigabyte of data.  Today, the same data can be stored for two cents.

The birth of ubiquitous IT, which revolutionized the marketplace for business and consumers at the end of the 20th century, has in turn, been the basis of a second, potentially more consequential revolution. The competition and subsequent innovation that triggered the radical drop in marginal costs for hardware and storage has catalyzed a new market of low-cost, specialized analytic tools, which, when combined with low cost data storage, provide unprecedented insight into business operations, promoting efficiency, transparency and accountability in near real-time.

Applied automation is now automatic, analytic and actionable.

But technology tells only one part of the innovation story. Human interaction, in a mutual problem-solving approach, remains indispensable to the sustained innovation process.

The innovations that have driven the greatest economic value have come…almost without exception, from iterative collaboration with our customers to find new solutions to difficult problems in the course of business,” said Jim Manzi.

We could not agree more.

What was true then remains true today. Combine Manzi’s work paradigm with the revolution in technology and you have a robust kit of processes, practices and tools that enhance employee engagement, nurture performance leadership in executives, while developing a  rigorous culture that is dynamic, flexible, responsive, transparent and accountable.

Empowered by people, designed for success.

This is the latent potential in our economy. If we can recognize and harness the rapidly evolving value in the marketplace and apply it to both business and government, a strong and growing economy will be only one of the benefits.


By | June 2, 2014 | | 0 Comments

Healthcare Executives and Patient Agency


Nearly 1/5th of US GDP is dedicated to healthcare expenditures.

Healthcare spending, and its long-term affordability, drives public policy debate, with academics and government agencies annually proposing new plans as part of an agenda to control costs and improve health outcomes.  The proposals fit nicely within concepts that seem to promote advantages for patients. An example is the upcoming event, Patient- and Family-Centered Care for Adults with Chronic Conditions, by the U.S. Agency of Healthcare Research and Quality.

Among the many events that seek to address the health care debate, the AHRQ is particularly promising as it examines real examples of patient experiences. However, AHRQ’s efforts could be significantly enhanced if the format and outcomes include direct conversations with healthcare executives – the officials who manage the designs of operations and organizations that affect patients.

At heart, healthcare executives have a unique role in society. They shape the organizational behavior of a diverse industry, including doctors, nurses, pharmacists, technicians, and other that we contact through our medical lives. It is an organizational behavior that informs us, the patients, what we can expect and control in clinical and overall health experiences.

That expectation and control is our “patient agency,” the ability of a patient to evaluate, decide, and act on healthcare matters according to personal preferences. It includes control over (1) visible and understandable information, (2) flexible and efficacious processes, and (3) effective and authoritative decision-making.

Patient agency is critical to the success of healthcare outcomes – and quality healthcare overall, given its direct influence on successful treatment and prevention of the most prevalent health problems, namely chronic diseases and behavior-driven conditions.

And healthcare executives can directly affect patient agency. In fact, that might be where our public policy and plans should begin—where health is foundational to an individual experience—patient agency and the healthcare executive.

What is the scientific research supporting this conversation?

There are numerous examples, some noted below, that demonstrate how the patient is the legitimate leader of her or his health and medical interactions. There is substantial evidence demonstrating the value of patient agency both in the demand for healthcare and the outcomes of treatment.

Patient agency drives healthcare outcomes:

  •  Greater sense of control enhances patient’s resiliency (Diesnstbier, 1989; Herbert and Cohen, 1993; Sieber et al., 1992; Wiedenfeld et al., 1990).
  • Disengaged cancer patients tend to have unfavorable outcomes (DiClemente and Temoshok, 1985; Greer, Morris, and Pettingale, 1979; Pettingale et al., 1985).
  •  Pain control training produces better dosage schedules and less pain at follow-up (Rimer, Levy, and Keintz, 1987).
  • Cardiac patients who can control visits and their timing demonstrated lower mean heart rate and diastolic blood pressure (Lazure and Baun, 1995).

Patient agency is useful in managing service utilization:

  •  Preparatory information is associated with shorter hospital stays, reduced morbidity, and reduced need for analgesics (Eisendrath, 1987).
  •  Video presentations on back surgery improved patients’ knowledge about options and reduced the demand for surgery (Deyo et al., 2000; Phelan, 2001).
  •  Under severe conditions (ovarian cancer), greater understanding of information is a strong determinant of treatment choices (Elit, Levine, and Gafni, 1996).
  •  Patient-controlled analgesia devices maintain effective concentrations (Hull and Sibbald, 1981) while keeping constant rates (Austin, Stapleton, and Mather, 1980).

Patient agency is reinforced by thoughtful clinical communications:

  •  Patients’ medical comprehension is dependent on clarity and specificity of the content (Hall, Roter, and Katz, 1988), and manner of delivery (Larsen and Smith, 1981).
  •  Patient’s medical objectivity is appropriate, given age (Stiggelbout et al., 1996; Yellen, Cella, and Leslie, 1994) and responsibilities (Yellen and Cella, 1995).
  •  Patients are consistent in medical decisions (Cassileth, Seidman, and Soloway, 1989; Danis et al., 1994; Everhart and Pearlman, 1990; Slevin, Stubbs, and Plat, 1990).
  •  Patient’s can communicate preferences when multiple trade-offs characterize complicated treatment decisions (Brundage et al., 1998).

A classic study on patient agency was completed at the U.S. Department of Veterans Affairs. VA researchers experimented with how they could affect patient agency through innovative techniques (Greenfield et al., 1985). They found that both veterans and programs could benefit significantly from designs that reinforce patient agency development. The examination was of a 20-minute pre-visit coaching program. The study demonstrated sustained and significant benefits in patient agency and physical health, without additional clinical time. In their conclusions, they contended that without well-developed patient agency, veterans “may not acquire the knowledge, skill, and more importantly the confidence and sense of control they need in the management of chronic disease” (p. 456). The study also illustrated that reinforced patient agency could help manage unnecessary use of healthcare services and improve veterans’ ability to prevent acute health problems.

Patient agency is developed in a person, and reinforced by local experiences. It is the foundational aspect of health outcomes, and largely shaped by the experiences designed by local healthcare executives.

We need to shift our attention away from the grand plans for healthcare and look to the value of the local leadership – leadership in personal health and healthcare services. Our common national objectives, lower cost, quality care, better outcomes begin with patients, not bureaucrats.  We need to align our reform processes accordingly.

By | May 22, 2014 | | 0 Comments

Unlocking the “Captive Value” in Government

the word bureaucracy

When we consider the nature of optimal work, almost everyone agrees on the one model to avoid – government.

The stories and experiences are part of our collective national legend. Scandalous layers of bureaucracy, soul-draining procedures, wasteful duplication and serial cost overruns, as well as mind-numbing regulations that are as dense as a triple canopy jungle. Work guided by process instead of purpose, seemingly impervious to improvement or reason, driven by the lowest common denominator.

It is no small wonder that Gallup consistently finds citizen trust in government at an all-time low, while a recent Harvard Institute of Politics finds particularly low trust levels among the newest generation of voters, Millennials.

Interestingly, the citizenry is not alone.

What is less apparent, but more meaningful, is that individual federal workers intuitively understand the need for innovation to improve the delivery of government services, and the vast majority are committed to do so. However those same workers do not believe that management encourages or rewards government workers for having this vital sense of initiative.

The Partnership for Public Service, in conjunction with private sector firms, examined the issue of innovation in government and the elements that foster and drive innovation in the public-sector space.  According to the survey, 90 percent of government employees reported that they were always looking for better ways to do their jobs. However, only 55 percent felt that they were encouraged to be innovative, and only 33 percent believed that their agency would reward creativity and innovation.

Far removed from our common stereotype, federal workers are in fact motivated to improve the way they do their work, but simply do not feel that there is priority or benefit from management in doing so.

This represents a failure of executive vision; a lack of performance leadership by federal managers, writ large, which has left untapped the enormous “captive value” of the federal workforce. At a time of large-scale, public sector austerity, this value can serve as a “no cost” force multiplier across the federal government, liberating a wellspring of creativity and inspiration that has the power to transform outcomes.

The survey is a warning to the upper echelons of the federal government, and particularly to our political appointees, charged with charting a long-term course for effective, accountable government.

Program by program, the federal government must embrace performance engineering as a tool to foster performance leadership among executives, to connect management to employees through clear vision, goals and methods, and to embrace a culture of rigor as a cornerstone of program, process and practice evaluation so that organizations can constantly evolve, intelligently.

The raw talent and ambition exists. We need a concerted effort to “humanize” work, to un-cap that latent potential. This is necessary not simply to attract and retain the best and brightest in our federal workforce – which is essential - but more importantly as part of a concerted effort to restore citizen confidence in our public institutions.

By | May 14, 2014 | | 0 Comments

The Innovation Trap


Innovators don’t plan for obsolescence.

Self-evident, but paradoxical.

For no matter how disruptive an innovation is to the marketplace, the seeds of its obsolescence are already an integral component, embedded within the very processes that drive growth.

It is the dilemma of market acceptance.

Successful innovators first crack the market, and then own it. However, in the process, priorities necessarily change. The initial focus on market acceptance evolves into a sustained effort to protecting market share, clients and customers. Internally, a culture that had previously embraced risk, flexibility, dynamism, begins to atrophy through bureaucracy, inertia and risk-aversion.

Consider Kodak. Once globally synonymous with photography, Kodak’s comprehensive failure to adapt its business model as new technology fundamentally changed the market led to bankruptcy. Or Blackberry, which pioneered the market for the smartphone. Once ubiquitous, Blackberry’s determination to sustain its legacy business proved its undoing at the hands of innovative rivals.

For established innovators looking to maintain their edge, the risks of a failing performance culture have only gotten worse, as new technologies and shared service paradigms have driven the threshold costs of starting a credible business – and new competition – to unheard of lows. Collaborative communities, such as Odesk, allow new companies to outsource specialty work at competitive prices. Cloud computing offers the start up an entire data infrastructure that is scalable with the expansion of business.  Communal work arrangements provide office space for incubators. And the explosion of VCs and variants, has made investment capital accessible to the individuals with good ideas.

The differentiator for successful innovators is an understanding of what can be controlled and changed. Maintaining a sustainable edge in this new and challenging business landscape requires matching the dynamic realities of the market with a rigorous organizational culture. To empower employees and unleash their captive value. To amplify the leadership of executives who can articulate a clear, concise and understandable message that engenders a culture of team work, best practices and problem-solving. To create an internal consciousness within the organization were individual initiative is collectively valued and recognized. Where the rigor of sustained performance improvement is the baseline for minimally acceptable conduct. Where the nature of work is humanized, not commoditized.

Google, Facebook, Amazon and Twitter – the popular innovators of our day, are all less than 15 years old. They displace other, well known firms that were once household names for decades, but who could not keep pace with the market. The trend will only continue, as the cycle of innovation becomes more compressed and the field of competition grows larger and more intense.

We cannot stop change, only adapt to it. A rigorous performance culture is the key to that success.












By | May 6, 2014 | | 0 Comments

The Needless Costs of Bureaucracy

Piles of files

If you are looking for a “poster child” of government waste and inefficiency, one need not look further that Boyers, Pennsylvania.

There, in an old limestone mine – 230 feet below the surface – staff from the Office of Personnel Management (OPM) toil each day, processing the retirement requests for the federal workforce; on average about 100,000 packages per year.

While the location for OPM’s work is unusual, that alone does not explain the significance of this particular operation.

All of the claims are processed by hand.

That’s right, the federal government’s entire retirement system is a massive paperwork activity, more reminiscent of the War Department during WWII than of a 21st century organization.

OPM employs 600 people who work the claims each day, walking back and forth to 28,000 file cabinets that hold all the records. Taken by itself, this might not seem like much more than a freakish anomaly, but the Boyers operation is symptomatic of the unnecessary excesses of government bureaucracy and the costs it imposes.

OPM’s spends $55 million on the paper-driven retirement process each year. And it’s getting more expensive. The cost per claim has increased from $82 to $108 over the past five years.

The cost in terms of delay for this manual process is also significant. It takes an average of 61 days for OPM to issue a benefit check after initial receipt of the retirement package. If you are a federal retiree, you need to plan ahead for two months or more without income.

This is simply unacceptable.  At the state level, where technology automation has been readily adopted, benefits processing is far more rapid.  In Florida, the average claim takes 47 days.  In Texas, it is only two days.

But automation at the OPM site has been at the heart of the problem. The OPM facility is resistant to the very change that would make the operation more efficient, accountable and transparent. Over a period of years, OPM has made failed technology investments at the Boyers facility topping $100 million. Sadly this is not an uncommon problem in the government, where the bureaucratic IT culture survives, despite the market alternative of performance engineering.

OPM’s response to its technology failure was to hire more bodies and rearrange the paperwork process so that it moved more quickly. While this may meet immediate processing goals, it is no model for a long-term solution; doubling down on inefficiency.

We are living in an age of breathtaking technological achievement and innovation. Computing power, advanced analytics and storage capacity increase by orders of magnitude, as the costs for these technologies drop geometrically. Enormous organizational power, delivered through a diverse set of flexible, Commercial Off the Shelf (COTS) products, is now available to commercial customers and regular consumers.  There is no adequate reason why the government does not availed itself of a timely opportunity to achieve economies of scale, improve performance, efficiency, accountability and transparency with these tools. When combined with a discipline that is specifically designed to address the challenges of bureaucracy and the risks in technology deployment – such as Aplin’s PASS performance engineering – real  change and innovation is possible.

OPM’s retirement processing would be a good place to start.

By | April 30, 2014 | | 0 Comments

The Differentiator Between Good and Great


What is the nature of “enabled success?”

Looking at businesses as they grapple with a rapidly changing landscape, there is no shortage of organizational approaches that are as different as they are unique. But are they right? Despite the proliferation of theories and methods, research continues to confirm that as a foundation, employee engagement and performance leadership are the core of an organizational design built to succeed.

The latest evidence comes from detailed research by Gallup, laid out in a recent article, “Seven Things Great Employers Do (That Others Don’t).” The first factor? Having involved leaders who want to improve.

Leaders’ own attitudes, beliefs and behaviors have powerful trickle-down effects on their organizations’ cultures. Leaders of great workplaces don’t just talk about what they want to see in management ranks – they model it and keep practicing to get better at it every day with their own teams.”

At Aplin, we call this “amplifying executive leadership,” and it lies at the heart of our PASS performance engineering discipline, where our vigorous designs and scientific discipline combine to enhance executive insight and capability to tangibly improve organizational performance.

In its research, Gallup noted that, “Many [companies] make the mistake of prioritizing the easy, shiny stuff – hip office space, remote work arrangements and inventive benefits – over the elements that will strengthen emotional ties and connect employees more deeply to their managers, team and companies…[A] job has the potential to be at the part of a great life, but only if its holder is engaged at work.”

At Aplin, we could not agree more. The natural tendency of growing organizations is to place ever more significant barriers between people: management to employees; departments to departments; staff to staff.  This organizational static serves to inhibit rather than enhance work, and impacts its relative value by both management and employees. The key is to establish, maintain and deepen communication between all staff. Aplin’s focus on “humanizing” work unlocks the “captive value” in human capital, releasing the full expression of capability that is present in every organization. It is an institutional force multiplier that assures results.

If these are the kind or results your organization seeks, let’s talk about how Aplin can work with you to enable success.  Read Gallup’s article here: www.businessjournal.gallup.com






By | April 28, 2014 | | 0 Comments

The Evolving Work Place and Performance


Executives seeking insight into the complex paradigm of optimal employee performance might take time to ponder the contributions of Robert Propst to modern work.

 An American inventor, Propst designed the “Action Office II” in the 1960s, creating a “work station” surrounded with three walls made of inexpensive, disposable materials, which could be flexibly arranged into any space and any configuration desired.

Said another way, Robert Propst created the cubicle.

Today, 40 million Americans make a living in some sort of cubicle.  Roughly 93 percent of those workers would rather be working somewhere else.

This and other fascinating facts can be found in a new book, “Cubed: A Secret History of the Workplace,”  by Nikil Saval. More than just a history of our work space, Saval lays out a crucial, yet unexamined dimension contributing to worker satisfaction and superior performance.

The origins of office work were hopeful enough. “Counting Houses” as they were known in the late 19th and early 20th centuries were dank, cramped designs that could have 10 or more people working in only 25 square feet. However, partners worked side-by-side with clerks in these offices, and it was this close proximity of managers to employees – with decisions made openly in real time – which created an esprit de corps and sense of purpose among staff that contributed to better performance.

Propst’s handiwork in the late middle of the last century was an intellectual high water mark for the commoditization of employees that evolved in the 20th century, highlighting the structural acrimony between labor and management on a host of issues, including a large-scale failure of employees to impress upon management the need for consultation with staff when making design and human resources decisions that affect employee lives.

All is not lost however.

Saval sees a brighter future, made possible by advances in technology that free employees from the tyranny of location. As such, he predicts that the old career path, from cubicle to corner office. is “coming to a close,” with a new, as yet unformed construct taking its place. A critic of organizations that insist on hierarchy, Saval states that “It remains for office workers to make this [new] freedom meaningful…to make workplaces truly their own.”

For executives looking to the future, the message could not be clearer. Maximum performance is driven by employee engagement, which is heavily influenced by the organization of the workspace and their proximity to decision-making. In the evolution of the workspace, technology can free the employee from a desk, but it is the empowered employee working under amplified leadership of executives – the foundation of the Performance Architecture Science System (PASS) – that brings human capital, technology and the workspace together to produce superior performance.

By | April 22, 2014 | | 0 Comments

“Analysis”: the Consciousness of Success



The zero sum game of “more versus less” is alive and well in our nation’s capital, where Congress and the President remain gripped in a furious fight over the course of federal spending.  All the while we keep missing the most important question, “how.”

Over the last five years, we have seen both sides play out. Large increases in federal spending after the Great Recession later led to widespread charges of waste, fraud and abuse. Similarly, the “sequester,” put in place by Congress to contain Federal spending, foolishly cut programs across-the-board without any consideration for context and priority, and was ultimately deemed to be similarly unworkable.

It is not that we haven’t been trying hard to resolve our national fiscal issues but rather that we have been asking the wrong question to reach that goal. The real question is “how.”

The best example of this comes from the Department of Health and Human Services (HHS) which this week, for the first time, released doctor-specific information about Medicare payments from 2012 forward. Medicare provides medical coverage to the disabled and citizens over 65 on a fee-for-service model, processing over one billion claims per year. According to the Kaiser Family Foundation, Medicare spending is projected to double to more than $1 trillion by 2023, creating significant pressure on the federal budget and forcing difficult and unpleasant choices on spending and taxation.

The release of the Medicare data confirms a tangible third path for policy-makers as the nation faces these choices – the ability to ask the “actionable how.” Journalists were the first to intuitively understand this, jumping into the Medicare numbers with ad hoc analyses of raw data that provided a striking portrait of Medicare spending.

 Fact: Just two percent of Medicare’s 880,000 physicians accounted for nearly 25 percent of the payments.

Now, imagine what a sustained and deeply comprehensive analysis of the billions of records in Medicare could provide in terms of insight. Expand even further and apply that concept across the federal government and consider the possibilities for informed choice.

Modern technology has provided highly capable, low cost, commercially available, analytical tools that can not only deliver a vivid, real-time picture of resource deployment for senior executives, but as a result, help establish a fresh baseline that can serve to reform practices and procedures, improve service delivery and expand transparency while lowering costs.

This is the foundation of a “third path” to evaluate our fiscal challenges – one that holds the promise not simply to resolve stubborn political problems, but to effectively focus government services and repair public confidence in the wise use of its tax dollars.


By | April 18, 2014 | | 0 Comments