The Adoption Gap – Part 3: Crossing the Chasm in Post-Acute Care
This third of a four -part op-ed series on technology adoption in skilled nursing focuses on the work and meaning of Geoffrey Moore’s book, “Crossing the Chasm.”
This is the third of a four-part op-ed series on technology adoption in skilled nursing.
In 1991, Geoffrey Moore wrote a book that was supposed to be about Silicon Valley.
He had no idea he was writing about skilled nursing.
“Crossing the Chasm” describes the treacherous gap between the early adopters of a new technology—the visionaries willing to bet on unproven tools—and the early majority, the pragmatists who need proof before they move.¹ Moore’s central argument is stark: most promising technologies don’t die because they’re bad. They die in the chasm. They run out of runway trying to convince pragmatists using the same language that worked on visionaries.²
Look around the post-acute care landscape right now. That chasm is exactly where we are.
Where SNFs Sit on the Adoption Curve
The Technology Adoption Lifecycle runs from Innovators (2.5 percent) to Early Adopters (13.5 percent) to the Early Majority (34 percent) to the Late Majority (34 percent) to Laggards (16 percent).³ Moore’s insight — the one that changed how the entire tech industry thinks about market development — is that each segment requires a completely different value proposition.²
Early Adopters in skilled nursing are already getting the outcomes. A small cohort of forward-thinking operators has embedded remote monitoring, AI-assisted clinical decision support, and real-time care coordination into their workflow. They are winning preferred provider network spots. They are outperforming readmission rates. They are building the data infrastructure that value-based care contracts will soon require.⁴
The Early Majority is watching. Cautiously. Waiting for someone to prove it at scale before they commit.
The Late Majority and Laggards—still running on paper MAR sheets, still treating technology as a cost to be minimized, still telling their boards “We’ll wait until it’s more proven”—have already made a strategic choice. They just haven’t acknowledged it yet.
The ‘Wait and See’ Strategy Is a Strategy—With Consequences
Here’s what Moore understood that most SNF operators haven’t internalized: the chasm is not a pause. It is a divergence.
The facilities on the early adoption side of the chasm are compounding advantages right now. Every quarter, they operate with real-time monitoring data and build clinical intelligence that their competitors don’t have. Every VBC contract they win, they deepen the referral relationships that feed their census. Every readmission they prevent, they protect their CMS Quality star ratings.
Meanwhile, CMS is not waiting. The post-acute care market is moving rapidly toward mandatory accountability. The TEAM model, the ACCESS model launching in July 2026, and the broader CMS CMMI agenda signal one direction: facilities that cannot demonstrate coordinated, data-driven care will be structurally disadvantaged in preferred networks, ACO partnerships, and value-based contracts.⁵ The Advisory Board is explicit: VBC is now in its accountability era— defined by new mandatory models, measurable savings, and real downside risk.⁶
The operators who are “waiting to see” will eventually see — right around the time the gap has become impossible to close.
Why Pragmatists Get Stuck in the Chasm
Moore identifies the core problem with the Early Majority: they won’t adopt until they see proven, whole-product solutions—but the whole product doesn’t get built until there’s enough Early Majority demand to justify it.² It’s a self-reinforcing stall. In post-acute care, this plays out as:
- “Show me where it’s worked in a facility like mine.” The pragmatist operator won’t move without a comparable reference. But comparable references only accumulate after adoption scales. So, the pragmatist waits — and the chasm widens.
- “Our margins don’t support the investment right now.” This framing treats technology as discretionary spend rather than an operational lever. The SNF market is projected to grow at 8.6 percent CAGR through 2032⁷ — but the operators who capture that growth will be those who build the clinical and technological infrastructure to compete. Margin pressure is a reason to invest in efficiency, not a reason to delay it.
- “We tried something like this before, and it didn’t work.” This is the pilot trap from Part 2 manifesting as organizational scar tissue. A failed implementation becomes permanent institutional resistance — and the operator stays frozen while the industry moves around them.
What Crossing the Chasm Actually Requires
Moore’s prescription is specific: to cross the chasm, you must pick one narrow beachhead, own it completely, and use it as your proof point to expand.¹ You don’t roll out across the enterprise simultaneously. You find one unit, one use case, one DON who believes—and you build an unimpeachable win.
In SNF terms, that looks like:
- One unit. One use case. One champion. Pick the highest-acuity unit. Pick the clinical problem with the clearest ROI — readmissions, falls, medication errors. Find your early-adopter DON and resource her like the strategic asset she is.
- Measure obsessively for six months. Not anecdotes. Actual outcomes data. Readmission rate before vs. after. Staff time on task before vs. after. CMS Quality metric trajectory before vs. after. This is your chasm-crossing proof point.
- Let the data do the selling internally. The pragmatist majority in your own organization — the administrators, the skeptical charge nurses, the CFO watching the margin — will not be moved by vision. They will be moved by results from a unit down the hall.
- Then expand. Not before.
The post-acute care market is valued at $1.2 trillion today and is projected to reach $2.4 trillion by 2035.⁸ The operators who will capture that growth aren’t the ones with the best technology. They’re the ones who crossed the chasm while their competitors were still deliberating.
The chasm doesn’t close on its own. You have to jump.
The Adoption Gap is a four-part series on technology adoption in skilled nursing. Part 4 — the series finale — delivers a practical framework for building the organization that can actually change: the internal infrastructure, cultural architecture, and leadership model that makes sustained technology adoption possible.
Citations & References
About the Author
Mordy Eisenberg is co-founder and chief growth officer at TapestryHealth, a clinical support and remote monitoring company serving post-acute and long-term care facilities. With deep experience as a long-term care and skilled nursing executive, Mordy sits at the intersection of clinical operations and technology adoption — focused on helping SNF operators close the gap between purchasing technology and actually embedding it into culture and workflow. His work spans value-based care strategy, clinical program design, and the organizational change management required to make health technology deliver on its promise at the bedside. He writes and speaks regularly on the operational realities facing post-acute operators navigating an era of unprecedented clinical and financial disruption.
