The Uber strategy in healthcare — Can it work with ACOs?

Uber and/or accountable care organizations?

This was the question on the first side of Sg2 Associate Vice President, Consulting Brad Helfand's presentation at the Becker's Hospital Review 6th Annual Meeting where he gave a talk titled, "Health System Strategy in the Age of a Retail Consumer."

"In most cases, pursuing population health strategy can be complimentary to the consumer-oriented healthcare strategy," said Mr. Helfand. "ACO and/or UBER. They both have a channel strategy; focus on how it applies to you and imperatives going forward. The retail consumer is becoming empowered by changing healthcare plans. High-deductible healthcare plans are gaining steam. Consumers are much more activated consumers than they were in the past."

Three core concepts for consumerism today include:

1. Shopping online. People are comfortable shopping online and expect an easy experience. The online health insurance exchange market is revolutionizing how people purchase health plans and ultimately where they receive care. The public and private exchanges are in year two and are projected to grow significantly, to cover around 70 million patients combined.

2. Price comparison. The actual price of healthcare has been hidden for years between patient co-pays, deductibles, insurance payments, and hospital bills without line-items. Now, consumers and employers are price comparing providers for the best care at the lowest cost. Price transparency in healthcare is quickly becoming a reality. "A few years ago we would have talked about price transparency as a future trend," said Mr. Helfand. "Now it's a current trend and will be passé in a few years."

3. Freedom of choice. As patients take more responsibility for the financial burden of their care, they're exercising choice as consumers. People are gravitating toward channels that provide consumer access and the retailization of healthcare.

"We think that now is the time to think about your channel strategy," said Mr. Helfand. "We are starting to see channels that never existed in healthcare in the past, including mobile applications, virtual health, direct-to-employer contracting and onsite clinics for employers."

Within the new consumer-driven healthcare market, the concept of leakage is very real. Patients who were previously loyalists could go into a channel directing them to another organization. They are also looking more closely at how their healthcare dollars are spent and finding the best value, which might not be at the hospital where they were born.

"So many health systems we talk to today are just getting introduced to channel strategies and what the cost of acquiring patients really is," said Mr. Helfand. "When you think about channel strategy, consumers are complex but are very understandable. Consumers follow incentives; they go where incentives take them. But they also have preferences. Figure out what their preferences are by disease and keep their eyes on your brand."

Here are a few quick observations about consumerism in healthcare:

1. There aren't many organizations creating service area strategies for the ambulatory footprint, but that's where consumers are headed.

2. Virtual heath is another big opportunity for health systems. Patients are gravitating toward mobile and virtual health platforms, and it's time for providers to rethink their virtual boundaries.

3. Hospitals are beginning to look beyond their inpatient data sources to see where patients are going after inpatient discharge. They are figuring out where patients go for outpatient services, physical therapy, chiropractic care and other disease management services.

4. There is more time spent looking at individual patient care journeys instead of applying blanket assumptions. For example, a spine patient of working age that gets an injury on the job is different from a Medicare spine patient needing treatment for a slow degenerative disease. "You have to think about how you are going to position yourself based on this information vis a vis your competitors," said Mr. Helfand. "What is your market position today and how might that channel grow over the next five to 10 years in the acute care facility space."

5. There is more time spent on population health growth and aging. Consider the factors impacting demand growth of services and forecast algorithms taking healthcare reform into account.

6. Care teams now at any site of care are built around the patient's needs and how the patients flow through each channel. There is a different care team for rural versus urban care, home care versus primary care.

7. Half of the care team members are non-licensed professionals with a physician quarterbacking the team. They work with both licensed and non-licensed professionals to provide comprehensive care and guide patients through the channels.

"Find your inner Steve Jobs," said Mr. Helfend. "Diversify revenue base through smart use of channel management. Use clinical expertise in a way that creates new revenue and resources for the healthcare system."

When you have your project ready, set metrics on cost of the consumer acquisition to your organization and reassess whether your strategy is right or whether to take a different approach.

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