How can Oak Street Health balance expanding its network of primary care centers versus maintaining quality of care at existing locations?

Introduction

Balancing Oak Street Health's network expansion with maintaining quality of care at existing locations is a critical trade-off that directly impacts the company's mission to rebuild healthcare as it should be. This scenario involves weighing the benefits of increased access and market share against the potential risks of compromising care quality and patient satisfaction. I'll approach this analysis by examining the business context, evaluating metrics, designing experiments, and providing a data-driven recommendation.

Step 1

Clarifying Questions (3 minutes)

• Business Context: I'm thinking Oak Street Health's revenue model is likely based on value-based care contracts. Could you confirm if this is the case, and if there are any specific revenue targets or growth expectations for the coming year?

Why it matters: Helps understand financial pressures driving expansion Expected answer: Confirmation of value-based model with aggressive growth targets Impact on approach: Would influence the balance between expansion and quality maintenance

• User Impact: Based on Oak Street Health's focus on Medicare patients, I'm assuming the primary user segment is adults 65 and older. Are there any specific sub-segments or health conditions we're particularly focused on?

Why it matters: Identifies key user needs and potential quality concerns Expected answer: Focus on chronic condition management in older adults Impact on approach: Would shape quality metrics and expansion strategy

• Technical Feasibility: Considering the importance of care coordination, I'm curious about Oak Street Health's current technical infrastructure. How scalable is the existing EMR and care management system?

Why it matters: Assesses ability to maintain quality during rapid expansion Expected answer: Moderately scalable system with some limitations Impact on approach: Might necessitate tech upgrades as part of expansion strategy

• Resource Allocation: Given the dual focus on expansion and quality, I'm wondering about the current staffing model. What's the ratio of care team members to patients, and how does this compare to industry standards?

Why it matters: Indicates current resource strain and capacity for growth Expected answer: Slightly better than industry average, but feeling stretched Impact on approach: Would influence hiring and training strategies in expansion plan

• Timeline Pressure: Considering the competitive landscape in primary care, I'm thinking there might be urgency to expand quickly. Are there any specific market opportunities or competitive pressures driving the timeline for expansion?

Why it matters: Helps balance speed of expansion with quality maintenance Expected answer: Some pressure to enter new markets before competitors Impact on approach: Would impact the aggressiveness of the expansion strategy