Sentara CEO Howard P. Kern: 3 core strengths for success in 2019

We read about so many disruptive forces within the healthcare industry that we often struggle to prioritize resources to ensure success. While there are many organizational attributes hospital and health system executives must cultivate, there are three core competencies we at Sentara are doubling down on to remain healthy and dynamic in 2019 and beyond.

1. Well-defined and distributed ambulatory models. Across the industry, the majority of growth is moving toward the ambulatory space. Patients can choose from an expanding network of care settings, such as health hubs with primary care, specialists, physical therapy, imaging, freestanding clinics, retail sites, workplace health centers and virtual care models. Care models and patient care management must continue to grow and evolve as new access points are created for our customers. By taking the walls off the medical home, we strive to create brand loyalty and excellent service through expanded access. The application of technology to multiply our capabilities and the ability to consistently deliver great care experience at an affordable price point are essential competitive deliverables.

These trends of evolution and expansion will accelerate as customers and payers seek accessible, effective, high-quality and low-cost care. In order to adapt to the changing environment and create the frictionless access and good experiences needed to drive brand loyalty, health systems are transforming our ambulatory platforms to serve our customers: patients, employers, providers and members.

Retail ambulatory development requires a portfolio of variable scale and location offerings depending on market and consumer potential. These can range from storefront urgent care centers to comprehensive multiuse ambulatory campuses, surgical centers and therapy centers.   

Healthcare systems must develop solution sets of services for retail locations, virtual appointments and the digital interface. Solutions should be developed for target populations with specific needs such as complex care, behavioral health, and employee health and wellness. With flexible solution sets, we can meet the unique needs of our customers through new models such as lower cost direct access primary care for employer groups.

For employers who require on-site clinics, services should include access to primary care, physical therapy, wellness programming and occupational medicine services. These clinics have proven to help reduce overall cost to the employer and employee, to help provide the right care at the right place, and to avoid unnecessary hospitalization and ED utilization. 

For providers, the platform will offer streamlined access to IT solutions, performance data and seamless care coordination. Providers must be engaged in standardizing practices and experiences through primary care, specialty and procedural teams that reach across the system. By creating targeted solutions that leverage standardized best practices, we are preparing to manage the diverse care needs of our many communities successfully.

For our payer partners, we are building new processes and care models to help provide high-quality care at a lower cost for shared customers. Ambulatory platforms enable coordinated care management across the continuum of care and help reduce unnecessary treatment, preventable admissions, length of stay and readmission of patients.

No customer — whether patient, employer, provider or payer — is the same. By developing flexible platforms, health systems will enable customers and providers to select the resources and services they need for their ideal experience. 

2. Our health insurance division. Sentara has been in the health plan business since 1984. It has not always been easy, but the hard work was worthwhile to create a quality insurance product for our customers. It took 15 years to offset the cumulative losses we sustained during our first 10 years in business.

To become a truly integrated system, healthcare organizations must align ambulatory, acute and post-acute delivery strategies with those of their health plan. Simply creating a health plan in order to fill beds is not advisable. Health plans must continue to take on more risk while also providing lower cost care models for our customers. We are focusing on growing Sentara's lives under management as part of Optima Health, our health plan, and the Sentara Quality Care Network, our clinical integration network. The design of our health plan products are continually refined to adapt to the innovations happening on the digital and ambulatory fronts. Health plans also require organization in terms of back office operations, clinical leadership, marketing/sales, actuarial/finance and technology management.

3. Digital consumer platform. Healthcare is miles behind other customer-centered industries — think retail and banking — when it comes to reaching consumers digitally. We have not delivered on the connectivity most people have come to expect in 2019. A functional digital consumer platform is no longer a helpful perk for patients, but rather a customer expectation that can determine whether they decide to further engage with a health system. This technology must be bi-directional and must not only allow us to better understand our patients, but help them better understand us. One of the biggest criticisms of our industry is that consumers often feel isolated from the details of the most personal subject possible: their health. Digital platforms can help bridge that gap and create trust.

Through Sentara's digital consumer platform, patients can schedule appointments, have a virtual visit and conveniently pay their bills. Furthermore, members enrolled in our health plans can receive automatic authorization for certain procedures and cut down on cumbersome paperwork. These platforms should not only make scheduling easier, but serve as intelligent health agents that help consumers navigate care access decisions in the system we have created. As artificial intelligence technology develops, platforms like these can help patients choose the right pathway to receive care and manage chronic conditions and other non-acute health issues in a smarter way that may actually keep them out of the medical office and simultaneously alleviate healthcare's labor shortage issue. The consumer platform is also a key delivery vehicle for all virtual care products, especially in the ambulatory environment. At Sentara, we are creating a healthcare ecosystem in which our patients and members can feel confident that they have access to an exceptional, high-quality experience at an affordable price.

Bringing it all together. Our current environmental forces will demand a system approach to our future growth. We have to shift to thinking through business decisions as system versus traditionally separate business units. Sentara is creating the healthcare system of the future by growing our services around our patients and members. Our three priority capabilities will drive customer loyalty and attract new customers. Together, we are growing lives under management and we are changing the way we think about how we manage those lives. Our digital and ambulatory strategies provide the new resources and tools we need to attract and retain lives; our health plan provides the infrastructure from which to manage lives.

As an integrated system, growth in one component of our business naturally leads to growth in another. Health systems must invest in geography, capital and talent to achieve the scale at which symbiotic growth strategy can be executed effectively. Over time, the investment will result in a loyal, strong consumer based that is satisfied with their access and delighted by their experience in the managed care, digital and ambulatory settings. When our patients under management need acute care services, we will be there too. We are going out into our communities, meeting customers where they are and establishing relationships with them. That's lasting growth.

Callie Heyne contributed to this column. 

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