Are innovation-oriented internal groups or subsidiaries, designed to reinvent their large healthcare provider parents, doomed to fail? Dave Chase of Avado writing in Forbes seems to think that is the truth more often than not. “The challenge is it’s hard for a big company to take seriously a new market segment when its initial revenue impact is a tiny fraction of their existing business”. The metrics of success may not be recognized or validated, lunch is eaten by stealthy competitors, and new models/behaviors stump managements used to the old ways of what constituted success and profit. His own experience was at Microsoft, where he observed the success of Xbox (fresh blood unshackled from MSLand) contrasting with MSN, the latter processed and staffed largely by Office/Windows veterans.  In this Editor’s experience, the only part that Mr. Chase has missed is the high resistance, often personally driven, of process-oriented, bureaucratic organizations to meet outside or inside change which dooms high-minded efforts at setting up ‘skunk works’. Health orgs dooming their “innovation” to failure (Please note Editor’s comment under article is ‘called-out’)