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Sunday, January 30, 2011

Ask Not What your Mentor Can do for You

For the last few years, I have signed up to be a mentor for my MBA program's Social Impact Movement club and Health Care Management program. The most surprising part is that when students were faced with lists of mentors who were venture capitalists, social venture capitalists, and other titans of industry, two were swayed enough by my credentials of working in a non-profits (including a commune), to select me. Unfortunately, being selected was the highlight of my mentor experience.

I had one conversation with each of them and they were eager, pleasant, and polite. I probably spent 5 minutes more than what was tolerable with my diatribes and philosophy of the world. One wanted to know how to connect to the non-profit community while working for a corporation. The other wanted to know how to transition into the payer/provider side of health care after her indentured servitude (or sponsorship from her consulting firm) ended. Like all mentees, they both wanted contacts so I dusted off my network to give them contacts. That was the end of the relationship. I never heard if they called my contacts, any results, or even a thank you when I sent additional information. It was about transactional as cutting in front of someone while boarding a plane.

I don't expect to get on my mentee's holiday card list or even be Facebook friends (although connecting through Linked In would be a nice touch and appropriate). I know that being 10 years older than them is practically the same as being a senior who eats dinner at 5:00 in Generation Y years. However, I do expect communication and acknowledgment that is on par with Amazon when I place an order. At least Amazon thanks me for my order and lets me know when it's about to arrive. With the importance of mentors becoming as popular an accessory as a case for your smart phone and Google search results on the importance of mentors returning 7.9 million hits, one should know how to be a good mentee.

Most mentees know about being respectful of time and being professional. What mentees do not do well is turn the mentorship into a relationship. Most who network are also too transactional. When given a contact by a mentor, let the mentor know the results of the interaction. It will help the mentor's network as they will know who to tap into or equally important, not to tap into in the future. Complete the deal and follow-up with mentors after completing a job search or graduation. It's about the relationship and not turning a mentor relationship into just a 20 minute phone call.

If mentees don't become better at being mentees, mentors like myself will lose interest. We would rather spend that 20 minutes with someone whom we have a relationship or at least the chance to build one.

Monday, January 24, 2011

A Ranking that Differentiates MBA programs for Employers

I was reviewing the latest MBA ranking- no not the Business Week ranking. No not the US News and World Report MBA ranking. No, don't worry it's not the Wall Street Journal ranking which you hate because it ranked your school 57th. No, not the Financial Times ranking which yes ranked London Business School #1 and yes I know that you think that Insead is clearly the top European business school. No, not Jacksonville Jaguar running back Maurice Jones-Drew Fantasy Football and top MBA ranking. Yes, I'm glad that it's not the Jones-Drew ranking because no one trusts guys with hyphenated last names.

Let me start again. I was looking at some random MBA ranking published by QS. I don't know what QS stands for and I only found it because a student of Bainbridge Graduate Institute (BGI) complained about its Corporate Social Responsibility ranking. I only know what BGI is because a Facebook friend who sought my advice on MBA programs attends BGI and posted about it.

You also know that it's a very inauspicious start to a blog post when it's the 3rd paragraph and you are still rambling. And writing in the second person. The point that I was making was that while I don't know what QS stands for, their ranking unintentionally has some interesting results. The ranking is devised through surveying major employers of MBA's and scoring their responses on an curve. Based on the spread of the curve between the various places, one can tell which specialties provide significant differentiation for MBA programs.

I am applying the same methodology from a Net Promoter Survey that a market research firm did on the Medicare Advantage industry. Through their methodology, they can tell what features provide a health plan a true opportunity for differentiation. For example, most Medicare Advantage enrollees think that their health plan's customer service is top notch even those who hate their plan. The scores cluster very close together meaning there is little to no opportunity for a plan to differentiate themselves through customer service. However, few members really think their Medicare Advantage plan has a good dental offering which provides an opportunity for differentiation.

My analysis of the QS MBA rankings by specialty is not as statistically robust as the market research firm. I applied the same methodology to come up with some expected and counter intuitive results which is what one wants to make analysis interesting and probably accurate. If the results are all expected than the analysis isn't very interesting. This is like most social psychology experiments that reveal gems like people tend to get angrier at football games when their favorite team is losing and reduced to playing its 3rd string quarterback whose name sounds like the the newest character in Glee. If the results are counter all counter intuitive, then they are probably wrong due to an incompetent research assistant.

After 5 mostly rambling paragraphs, here are the results. My methodology is that I looked at the number of schools that received a score of 100 and score of the top 10 schools and top 20 schools to see the spread. The number of schools that received a score of 100 was clustered closely around 4 or 5 programs. Average ranking of the 10th ranked school was 76 and average ranking of the 20th ranked school was 49. This is all done by specialization which are:

Entrepreneurship: Five programs received a score of 100, the 10th ranked school received a score of 77, and 20th ranked school received a score of 38. This distribution pretty much matches the average scores so there is only an average amount of differentiation a program can achieve by focusing on entrepreneurship. Entrepreneurship is a fairly nebulous field so is this expected.

Information Management: Two programs received a score of 100, the 10th ranked school received a score of 80, and 20th ranked school received a score of 37. Another average distribution except the fewest schools received a perfect score. Unless, you are a Harvard or MIT graduate which achieved the perfect score, there is an average opportunity for differentiation.

Five programs received a score of 100, the 10th ranked school received a score of 48, and 20th ranked school received a score of 31. This is more interesting as there is a clear opportunity for differentiation in Finance. There are only 7 schools that received a score above 58 (Wharton, Chicago, LBS, Stern, Harvard, Columbia, and Insead). Graduates of those schools will separate themselves from the hordes of other MBA's in the field of finance (with the fin in finance pronounced like a fish's fin instead of fine by graduates of those elite programs.)

International Management: Four programs received a score of 100, the 10th ranked school received a score of 79, and 20th ranked school received a score of 51. The distribution is above average in terms of how tightly it is clustered. This shows little differentiation opportunity and a cautionary tale. International Management used to be an area of focus for schools like Thunderbird as they hung their hats on breaking into the elite circles of MBA programs through International management. While Thunderbird was one of the four programs that received a 100, USC, Cambridge, and SDA Barconi were examples of schools with just an average reputation that were close behind. All of Thunderbird's focus still results it the school having a similar reputation as the fortified Thunderbird wine.

Strategy: Four programs received a score of 100, the 10th ranked school received a score of 73, and 20th ranked school received a score of 36. Considering that strategy is thought to be as nebulous as entrepreneurship only with more buzz words, I was surprised that there was this much opportunity for differentiation. This was the most counter intuitive example as George W Bush has almost destroyed this specialization by calling it stratergery.

Operations Management: Three programs received a score of 100, the 10th ranked school received a score of 89, and 20th ranked school received a score of 60. Operations management had the opposite story of strategy with a very tight distribution all the way to the 20th ranked program. There is little opportunity for differentiation probably became most employers have only met one MBA who majored in Operations management.

Innovation: Three programs received a score of 100, the 10th ranked school received a score of only 62, and 20th ranked school received a score of 42. While innovation is more buzz word than an actual specialization, it looks like employer believe a few schools do it well (MIT, Stanford, Harvard, Wharton, IE in Spain, London Business School, and NYU Stern).

Corporate Social Responsibility/Ethics: Fourteen programs received a score of 100, the 10th ranked school received a score of 100, and 20th ranked school received a score of 97. Despite all the talk, the MBA Oath, and general interest in the area, employers believe all the schools have the same capabilities. There is no current opportunity for differentiation which should be cause for concern for BGI or other programs which are trying to use this as a point of differentiation. Currently, employers believe there is a larger difference in students skills with a financial calculator then there skills in resolving an ethical dilemma. A BGI student blogs that the recent MBA's dubious role in the financial crisis should lower their schools' scores. However, the Notorious BGI student fails to explain what their program's students would do any differently. Would they get jobs at the SEC and better regulate the financial industry? Would they become CEO's and require their bankers to submit essays on their ethics? Would they even get jobs in the financial industry by touting their ethical skills? This survey suggests these skills would not impress future employers.

The results of this survey show the a stratergery of differentiating in Corporate Social Responsibility would have even a worse outcome than schools that placed all their chips on international management. There is little differentiation and what difference there is easy to replicate.

Thursday, January 20, 2011

The Rise and Fall and Mostly the Fall of the For Profit Hospital Industry

The For Profit Hospital industry, led by Hospital Corporation of America (HCA) and Tenet (which I liked to call Tenant based on how it treader providers), was the poster child for health care efficiency in the 1990's. HCA owned by former Senator Bill Frist and led by current Florida governor, Rick Scott, gobbled up as many hospitals in the mostly Southeast, California, and Great Plains as they could. Tenet was close behind. They boasted of their management talent, market clout, and economies of scale that would shake up the sleepy non-profit hospital industry and turn it into a real business.

The first experience with becoming a real business involved HCA being charged with the largest Medicare fraud case in US history and Tenet was charged with milking the Medicare Outlier Pool like a cow on growth hormones. Basically these foundations of capitalism figured out how to suck money out of government programs like a collapsed supernova sucks light or the Green Bay Packers just plain suck.

The For Profit Hospital industry has made the news again which underscores the lack of change in the health care system. First, the Federation of American Hospitals, which is the association for the For Profit Hospital Industry, wrote a letter to Medicare about their position on the new Accountable Care Organizations (ACO). A principle of ACO's is that provider groups are assigned both patients and the dollars associated with managing their care. This provides incentives to provide the right care rather than the most profitable. The Federation of American Hospitals likes being assigned the dollars but wants to pick the patients that are assigned to them. This is cherry picking or called being "neither accountable, nor caring, nor organized". This creates the images of the same Redding, CA Tenet hospital that did open heart surgeries on anyone that they could sedate long enough, assigning themselves all the wealthy retirees who need a knee surgery for the spring ski season. The chronically ill lower income patients can be assigned to the non-profit hospitals who lack their managerial talent to completely game the system.

It's gotten so bad for Tenet, that they made the news because they were the target of a takeover from another for profit hospital group called Community Health Systems, Inc. (CHS). CHS has accused the Tenet Board of Directors of not taking their shareholder interests into account but their own personal interests. That's kind of like a Hell's Angel accusing another biker of poor flossing habits.

The reason that the For Profit Hospital industry has such a poor track record was that their management talent and ability to turn around hospitals was mostly a myth. They were successful because they bought hospitals that had a monopoly in their current suburban or rural town or located in a wealthy area where everyone had great insurance. They successfully ran hospitals in one-hospital towns where they had no competition. They had to run them 20% more efficiently than their non-profit predecessors in order to make up for new taxes and required shareholder return. When they could not, that's when they started milking Medicare or forcing unnecessary psychiatric hospitalizations on patients. Whenever Tenet entered a competitive market as they did in Philadelphia with the purchase of 2 of the city's 5 academic medical centers, they did as poorly as everyone else.

The For Profit Industry has nowhere to go but go procreate with itself. All the lucrative hospitals with a local monopoly have been bought so there are no real new expansion opportunities. Which is probably why the latest For Profit hospital news stories provide better material for John Stewart and Stephen Colbert than for Harvard Business School case studies.

Wednesday, January 12, 2011

The Balance between ideal health reform solutions for the Insurance Industry and Consumers

A health reform solution that consumers and the insurance industry could agree on is as precarious and unstable as straddling 2 sides of a canyon. Everyone's groin starts to hurt after a while. Former insurance industry executive and blogging curmudgeon, Bob Laszewski, wrote a piece on what he saw as reform that could truly receive bipartisan support. What I saw is an example what best meets the needs of insurance companies and not those who purchase the plans. Here are Mr. Laszewki's arguments in contrast with my thoughts on actual consumer need. The reason that I am contrasting with consumer need is that the insurance company that figures out how to truly meet it will gain market share at the expense of others. Even the insurance industry needs to focus on its customers every once in a while.

1. Replace the individual mandate with a one-time open enrollment period: The individual mandate or requirement that individuals buy insurance is a contentious part of reform. However, if no one can be denied insurance, it's necessary to have everyone buy insurance in order to keep it affordable. Laszewski's solution is a one-time opportunity to buy insurance otherwise that individual could be denied insurance in the future. He calls it "freedom of choice and responsibility." I call it the status quo. Insurance companies love one time enrollment periods because they both bring in new customers as the same folks who always change their oil every 3 months will jump on the one time opportunity. Those folks who are too disorganized to maintain their health let alone their cars are more likely to miss the opportunity and be denied if they don't pass a health screen when they get around to applying for insurance.

The individual insurance market is very fluid. Most stay on a individual plan for a year at most before getting an opportunity for public or employer insurance. Therefore, a one-time opportunity will not be relevant to the vast majority who don't need individual insurance at that time period. For the average consumer, they want to be able to purchase health insurance when they need it not when insurance companies are willing to offer it. Health insurance has become the one industry that will refuse to sell their product to someone who has the money to buy it. That is not sustainable and needs to change or a new entrant will change it for the industry.

There is no real solution to balance affordability and access other than an individual mandate. United Healthcare developed the best alternative with an option, like a stock option, to buy insurance in the future without a health screen. While there probably isn't a true solution that consumers would embrace, Laszewski's solution mainly appeals to the insurance industry. The insurance industry's lobbying group, AHIP, has pretty effectively destroyed its reputation as a voice of reason or good ideas in health reform with ill-timed reports on cost or attacking ACO's to prevent the entrant of new competitors.

Eliminating mandated plans:
Health Reform will limit insurance carriers to only 4 plan designs that are sold in formal health care exchanges. These plan designs are cleverly named platinum, gold, silver, and bronze because calling them Tweedledee, Tweedledumb, Tweedledumber, and TweedleAngryInsuranceExecutive was probably too obvious. Laszewski wants their to be only one mandated design (the silver or Tweedledumber option) and allow insurance companies the latitude to design other plans to provide more consumer choice. Again, this is the status quo as most states already require an insurance company to offer one basic plan design.

When I talk to consumers, they do not want the current level of choice because it's overwhelming and confusing. They have to study the plans to figure out what features are included, what are not, and conduct a personal conjoint analysis to figure out what they should buy. Most just want to be able to buy one standardized health insurance and not need an owner's manual to figure out how to use it. Offering 4 designs gives this ability to buy a health insurance at 4 different prices. This "choice" that Laszewski reference is really insurance speak for benefit eliminations of services not widely used by the public (but heavily used by a few) to lower the price. However, the price can be lowered by making universal changes to all 4 plans that are clear and transparent to the consumer.

In closing: The rest of Lasewski's points were improvements in subsidies to buy insurance and change in tax policy that don't really divide insurance companies and consumers like those other 2 issues. The gap in consumer vs health insurance industry appeal of those 2 issues is why the first wave of health reform focused on the insurance industry. Subsequent waves will continue to focus on the insurance industry until we learn how to better listen to consumers. At least half of my assumptions on consumer interests are overturned when I survey them or talk with them on the phone. Talking with consumers is not nearly as painful as dealing with fall-out from getting it wrong. It's also much easier on the groin.

Generation X or Y, Do or Die

The blog title is inspired by Loudon Wainwright III's song from the album Strange Weirdos. However, Wainwright is a Boomer. When I first started blogging, I ran into Generation Y like a crash test dummy runs into a car windshield. Generation Y runs most of the blogging world like Hugo Chavez runs Venezuela. Dogmatically and the courts or rule of law are not needed to change rules.

Generation X lurks on the outside with occasional rushes towards the forefront. Results are often comparable to Chavez's opposition party tactics. Therefore, when I interacted with the blogging community, I did it sparingly and specifically.

These generation musings were triggered by the book The Ask by Sam Lipsyte. The reviews declared that this was the latest voice of Generation X. Since the main character was a recent father, I almost too strongly identified with him. Combined with a recent perusing of Generation Y blogs, this led to my further think about Generation X and Y and the generational rivalry.

I am not including the Boomers in this generational musing because enough has been written about the boomers. Even USA Today wrote a series about the Boomers and a probling, controversial story for them is generally, "US still eats more hamburgers than India." This boomer series was inspired by the first wave of boomers turning 65. Boomers turning 65 strikes me more as an Outlook calendar reminder than the trigger of a generational examination.

This Boomer retirement wave may be the assassination of the archduke that triggers the full fledged generational rivalry as X and Y compete for the corporate and business spoils that are left behind. Some write that there is a closer alliance between Generation Y and the Boomers since they are more team oriented and optimistic. Generation X's response is that it's on like Donkey Kong as we don't intend to be passed over again. However, this may all be irrelevant as Boomers may figure out a way to take the spoils with them to their graves and hold their positions and power for life just like Hugo Chavez.

Generation X and Y's philosophical leanings also place them on a collision course for rivalry. From reading Generation Y blogs, I see their gurus are Tim Ferris and writers of self-improvement books. They look to Seth Godin about following their passion. They love writing lists of what they plan to accomplish.

Generation X looks to the book/movie Fight Club and wishes to subvert the mainstream or John Hughes movie about nerdy underdogs finally receiving societal acceptance through unconventional methods. We're too cynical for failed cycles of self-improvement. Our New Years resolutions are snarky vows to update our hard drives or use fewer cue tips. We don't understand Generation Y's preacher-esque zeal for self-improvement and accomplishment and find their efforts come across, as well, too much preaching.

The rivalry is probably most intense among the older Y's and younger X's due to the freshman/sophomore dynamic. Sophomores feel their extra year warrants respect from freshman and that they should be treated differently by elders. However, sophomores are often really just older freshman who are still trying to figure out the same issues.

As an older Generation Xer, my contemplation through this post has made me realize that I am mainly just annoyed that Y's are littering on the internet and are terrible writers. Their web businesses that fill the internet like spores are typically affiliate marketing arrangements or "lifestyle design" which seems to be a way to justify writing about your navel gazing as a business. The true lack of any business model once traffic was achieved disillusioned me the about Generation Y's contributions to the internet.

Furthermore, their affiliate marketing or lifestyle design business models need to be driven by compelling content since they are mainly just writing about themselves. However, they kill their content with overusing awsome, awesomeness, sweet awesome goodness, or other words that don't really lend any descriptive value. I am waiting for awsomeful to catch on next. They declare ninja or rock star status for various abilities like networking or nose hair trimming. Unless it involves a throwing star or actual musical instruments, ninja or rock star are just another way of saying awesomeful. The Generation Y twitter driven writing style creates short blog entries with lots of ideas but no substance behind them. Titles of articles declare, "Everything that you know is wrong!" when the title should be: "I would like to suggest a slight shift in how we think about a new social media tool."

My Generation X co-workers and I talk about the challenges and how it's different working with Generation Y. One of my coworkers is managing 2 Y's and had the difficult experience of having to fire one of them. As we get older, the rivalry will fade and our different philosophies will complement work styles rather than be divisive. Until then, I will be more welcoming of Generation Y when they learn how to write awesomfuller and stops littering the internet with Amway schemes.
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