If the first four phases have been done well, the model should hold. Phase Five is where everyone has to let it. Early operation brings uncertainty. The clinical team may question whether patients are moving quickly enough. The anchor may become anxious for visible results. Financial pressure, individual setbacks, or a difficult month can create a strong pull to change the model before it has had time to demonstrate what it can do.
This phase is patience, but not passivity. It is continuing to do the work well, watching closely, correcting what genuinely needs correction, and resisting the temptation to treat every early fluctuation as evidence that the model is failing.
What this actually requires: the clinical team and the organizations receiving and supporting the care must remain committed to the same arc. Patients still move through stabilization, treatment, recovery, and reprogramming. Relief is recognized without being mistaken for completion. Difficult cases are worked through rather than used as reasons to retreat. The organization continues to protect the relationship between the patient and the care team, because that remains the place where health care exists and where the model’s value will ultimately be produced.
There will be pressure to add services, alter the fee structure, narrow the clinical ambition, or produce a faster and simpler story. Some changes will be necessary. Others will be reactions to discomfort. The work of this phase is knowing the difference. The question is not whether the model looks impressive in its first quarter. It is whether the people involved are doing what the first four phases established, learning from what happens, and allowing enough time for the full arc of care to become visible.
This patience belongs to everyone. The care team must trust the clinical work. The anchor must trust the process it helped build. The cooperative must keep the conditions in place for both to succeed. When concerns arise, the participants return to the same table, examine what is happening, and solve the problem together rather than pulling the model apart from different directions.
What comes after traction: once the relationship is functioning as designed and patients are moving through the arc, the measurement framework from Phase Two can be refined around what is now happening in practice. The purpose is not to invent a better story after the fact, but to measure the real work with greater precision and prepare the model for Phase Six.
Target Endpoint: a model that has been given enough time to demonstrate its work, remains centered on the patient–care team relationship, and has earned the shared confidence of the clinical team, the anchor, and the cooperative supporting them.