Today we’re talking about the future of growth for providers, who will compete for, and capture health consumers and patients.
When greater cost-shifting from the payer to the plan member, caused deductibles, out-of-pocket expenses and patient drug share costs to soar – fallout in patient behavior and choices ensued. Suddenly prescriptions weren’t getting filled as often, therapy wasn’t being completed, elective surgeries were pushed off, and patient collections saw big problems.
By 2010, we saw the emergence of Obamacare; and when we sadly realized that health coverage isn’t the same as healthcare…the industry and politics shifted their sights on a more patient-centered, risk-adjusted, and outcome-based model with reimbursement tied-in respectively.
Truth is, whether value-based care rolls out tomorrow or in years to come, health payers and drug companies still do not and will not operate as true competitors. This means healthcare prices are not likely to come down on their own.
We also know that the current health system today (with its underlying industries) is largely unsustainable, and certainly unaffordable for many American consumers and companies. So healthcare costs, on their behalf, are likely to stay high and tight for years to come.
As a result, the market has actively employed its own free-market forces to re-organize into new innovative services, products, and arrangement for patient care and coverage. These include direct care, retail clinics, on-site primary care, direct contracting, direct primary care, super TPAs, and a stronger scrutinizing of claim management by broker-persuaded traditional insurer ASOs.
A CHIEF GROWTH OFFICER FOR HOSPITALS & HEALTH SYSTEMS
In full candor, I have enjoyed a past career in being a health provider, then a health tech entrepreneur, and finally having led consumer strategy and outbound digital marketing. It’s given me a much wider view of consumers, tapping into consumer stress & behavior, and well as effecting the right triggers for desired outcome.
As I choose an opportunity for the next phase of my career, so many provider leadership positions and expectations continue to reflect models of culture and management that led hospitals and health systems to arrive at this moment. Though I am pleased to see a greater level of technology, nursing/physician, and patient experience leadership roles.
This makes me think of one of my favorite quotes, which comes from Mike Tyson. He said, “Everyone has a plan…until they get punched in the mouth.”
The punch to providers of all sizes is that consumers and patients have a greater financial role than ever. Knowing this, hospitals and health systems must recognize that the same strategy that led them to acquire and grow a patient base locally, is the same growth mindset and strategy they must employ to grow remotely – and benefit.
Larger shifts to patient financial responsibility don’t necessarily mean that everyone is poor and cannot afford services, but rather that selective marketing for patient acquisition is greater importance than ever. Those companies that properly segment, target, position and capture patient base, by utilizing smart marketing, communications, telehealth services, efficiency, within measurable resource allocation and investment, will be in an advantageous role toward sustainability.
As technology drives efficiency and costs drop, providers must seek to find and effect greater engagement and treatment, through adding a stronger growth mindset to provider leadership. While many leaders already have expectations of growth contribution within their job role, they cannot be solely dedicated to such.
