Start with why

Simon Sinek’s famous phrase has always resonated with me. Perhaps because understanding “why” gets to the root cause of a problem, one of the key questions we sought to answer in our latest research was, “Why do health care leaders integrate drivers of health (DOH) into their business models?”. 

Using the lens of Jobs to Be Done, we set out to discover what specific jobs arose in health care leaders’ lives that led them to incorporate DOH into their organizations. In addition to uncovering why they addressed DOH, we also discovered what it was about innovators’ business models that allowed them to improve health. You can read more detail on our findings here (detailed research), and here (summary). 

If you aren’t familiar with the concept of Jobs to Be Done, a job is the progress someone seeks in a given situation. It has two parts: the context or situation the individual finds themselves in, and the progress or goal they are seeking. When a job arises, individuals pull products and/or services into their lives to get that job done. Effectively, they “hire” those products or services to serve their job. If something comes along that does the job better, they will fire the old way, and hire the new one. Jobs uncover the causality behind people’s behaviors. So, in essence, we were seeking to understand what causal factors drove leaders to integrate DOH into their businesses. 

What did we find?

Health care leaders we interviewed had one of three jobs. This was the case whether they were leaders within potentially disruptive organizations, payviders, providers, free and charitable care organizations, or enabling organizations (i.e., technology companies that enable delivery of DOH services). The three jobs were as follows: 

  1. Job 1: When the current system is about reacting to illness, help me capture the market opportunity to keep people healthy and out of the hospital, so I can make a profit. 
  2. Job 2: When the current system is about reacting to illness, help me focus on people’s health, so I can help them treat the root causes of their problems and live better lives. 
  3. Job 3: When our financial future is evolving and the way we get paid is going to change, help me design a transition plan so I can remain financially viable and continue to serve the community. 

Of note, the context of the first two jobs was the same. That is, leaders with Jobs 1 and 2 found themselves in the same situation. Yet, the progress they sought was very different. One was motivated by the goal to make a profit. The other was driven by a mission to address the root causes of issues and improve lives. Also of note, Job 3 was held primarily by leaders in large health care systems whose existing business models were designed to excel in a fee-for-service (FFS) environment, not one incentivized to address DOH. 

A leader’s Job to Be Done informed their business model design 

The jobs that led health care executives to hire DOH, or to incorporate them into their business model, informed the business models they built. While no two business models were identical, leaders effectively addressing DOH to improve health and life outcomes had business models with similar foundational characteristics. Below is a summary of those similarities: 

  • Value proposition: Enable consumers and customers to achieve their goals
  • Resources: Harness a partnership ecosystem supported by an enabling technology platform
  • Processes: Hard-code an approach to creating trust
  • Profit formula/priorities: Reimagine revenue streams that are tied to new, consumer- and customer-focused measures of success

We found that leaders who incorporated these components into their business model design were more likely to impact DOH, leading to better health and life outcomes for the populations they served. Depending on the Job leaders had – either 1, 2, or 3 – they layered additional components on top of these foundational characteristics. 

Those with Job 3 had the most complex business model considerations 

In addition to the four foundational business model components listed above, we identified five more considerations for leaders who found themselves with Job 3. These are especially relevant for leaders in charge of FFS-driven models who are seeking to transition their approaches for the value-based future. 

Leaders with Job 3 were more likely to improve health outcomes when they also incorporated the following considerations into their business models: 

  • Resources: 
    • Establish DOH as a strategic priority endorsed by the board; 
    • Create clinical and social health leadership equality at the SVP level; and
    • Establish community engagement teams to serve as the boots on the ground. These teams engage with the community to implement programs, measure program impact, engage with individuals the programs serve, and vet and work with community and corporate partners.
  • Processes: Leverage the organization’s size and influence to lobby for policies and payment reform that incentivize keeping people healthy and addressing the root causes of systemic inequity. 
  • Profit Formula: Utilize balance sheet assets to invest in the community’s DOH needs, using interest from these loans as a source to fund internal DOH efforts.

Leaders with Job 3 are in a challenging position. Delivering on the value proposition associated with DOH (enabling people to achieve their health goals) does not align to the original value proposition of the FFS health care model (provide care as acute issues arise). As a result, these leaders will struggle to deliver on the new DOH value proposition from within an existing business model. 

Incorporating the suggestions outlined here can help leaders as they transition from an old business model to a new one. In the months ahead, we’ll be diving deeper into how leaders can go about this transformation in order to maintain viability, continue to serve their communities, and improve health and lives in the process. We look forward to sharing more soon.

If you are a health care leader who has integrated DOH into your business and care models, what drove you to do so? Does one of these jobs resonate with you? If so, or if not, I’d love to hear from you. You can reach me here.


  • Ann Somers Hogg
    Ann Somers Hogg

    Ann Somers Hogg is the director of health care at the Christensen Institute. She focuses on business model innovation and disruption in health care, including how to transform a sick care system to one that values and incentivizes total health.