October has arrived which normally means cooler weather, shorter days and leaves turning those magical colors. "Not so fast", to quote Lee Corso on ESPN during the Saturday Game Day show. Most of Texas has experienced excessive rain fall in the spring, extended heat this summer met with lack of rain, drought conditions and most recent in North and Central Texas, flooding rains again; meaning I still have to mow the yard! Slow to come but I think fall is finally upon us!!

As we all know fall normally signifies football and I have noticed a trend that most conversations, business and personally start with something about our little league team, our college team and or our favorite pro team on what happened that weekend or what will happen in the next game (basic trash talking). I recall in my travels this summer seeing team shirts on fans 6-8 weeks out from the season with anticipation of great things to happen.

Transition of the nation's healthcare system toward a value-based business model requires healthcare providers to move toward value-based contracts and care delivery models. Twenty-two percent of hospital and health system leaders anticipate such contracts will constitute 50 percent or more of their payment arrangements within 24 months, up from 7 percent of those leaders six months ago, according to a recent Kaufman Hall survey.