Affordable Care Needs To Be Accountable Care


Another installment in the examination of healthcare through the customer experience lens from Amber Thompson and John McCabe.

Now that the Affordable Care Act (ACA) has become a reality to employers, consumers, and insurers, many are still wondering “what is the real impact to me?”  The good news is now all Americans (employed or not, sick or well) qualify for an affordable health plan as Insurers can no longer deny medical coverage based on health status.  In 2010, the U.S. Census Bureau published an article informing us that 49.8 million Americans were without health insurance. While this is an important step in achieving equality across all citizens, unilaterally providing comprehensive coverage will also help battle chronic plagues and cost drains on the system- namely using the emergency department as primary care and over-utilization of resources (diagnostics and tests, repeat admissions, frequent ER flyers).  As a result of changes forced by reform, our patient population can now be viewed more holistically. While Physicians are still focused on providing the best care possible, it is important to remember that services can now be provided to a much larger audience. With millions of consumers now eligible for insurance coverage, healthcare and ancillary service providers are faced with a new challenge- sheer volume. To avoid the old model of providing care based solely on utilization and not on quality, we need to use this opportunity to reinvent how patients are treated by the system.

One way to accomplish this goal is to provide services based on preference and convenience. If we take a page from the education industry, transformation and innovation can be driven by consumer preference, where it seems unlikely on the surface. Academic institutions have been listening to consumers.  And as a result, we now have many virtual learning options.  Many find that the virtual classroom provides easy and convenient access to higher education while providing students the same services as the traditional classroom setting.  But most importantly, the education industry created alternative options based on what consumers wanted.  And in turn, increased the amount of adult learners by 30% over the last five years.  According to a study “Going the Distance: Online Education in the United States, 2011”, more than 6.1 million students took at least one online class during the Fall of 2010.

Healthcare continues to transform delivery models.  But it’s important to remember that the patient is the most important factor in meaningful care delivery. When we provide the patient and their families’ convenient options, the ability to access Healthcare Providers in real-time to help navigate comprehensive care maps, the integrated care team model becomes much more attainable.  The Patient Centered Medical Home (PCMH) concept definitely works in bringing many providers to the patient.  But we have to make sure these options are as convenient for patients and their extended support system as they are for the Healthcare Providers.

Now that we have the ability to treat more people due to ACA, let’s make sure we take full advantage of the opportunity to drive long-term change that benefits everyone- better utilized resources (equitable consumption), reduce waste due to unnecessary tests and procedures (lower cost), and healthcare as an attractive and financially attainable career choice (create access). It’s certainly going to be a long and winding road, but it’s also an exciting time to be a part of this industry.

Brushing Up On Customer Experience

imgresSince the last post went up here exploring some of the opportunities healthcare providers have to think more about the customer experience, I’ve had my eyes wide open for some examples of healthcare practitioners that get it.  And, presto!  I found one!

I took my kids to the dentist last week.  This was the first time I had been available to take them on their semi-annual visit.  And there I found a customer experience wonderland.  This dentist, who’s practice is dedicated to kids, has created an environment where no detail has been overlooked.  And every little detail is designed towards a very targeted customer base.

It’s clear that this healthcare professional started with a deep understanding of who she intended to serve.  And, as any parent could attest, this shouldn’t have been a terribly hard process.  There are a few foundational things about kids we all know to be true.  One.  Not too many kids have life-size Fatheads of their dentists on their bedroom walls.  So, getting a young one to the dentist’s office, and then once there, having them not run out the door as soon as they sit down in the chair, requires some creativity. Two.  Nobody, young or old, likes to wait in a doctor’s waiting room.  Nor, do any of us like to sit in that chair any longer than we have to.  And, what ever can be done to distract us from what’s happening in that chair is a blessing.

This dentist understands she exists because of her patients.  She is here to serve her patients.  And her patients’ parents have choices.  I’m also guessing that she didn’t figure all this out, and design such an amazing office experience on her own.  This business clearly has the finger prints of a collaboration with other really smart folks.  But, the dentist, the HCP, had the vision and recognition that, in the end, healthcare delivery is about as personal and emotional a business as there is.

If a store that sells stuffed animals has been able to reinvent retail by taking the time and effort to design a warm emotional and personalized experience, while outperforming its rivals financially, don’t you think we should expect at least that from those with whom we trust our lives?

Why Isn’t Healthcare Concerned With Convenience?

I’m thrilled to launch a new collaboration with two outstanding colleagues Amber Thompson and John McCabe.  Healthcare as an industry is in the midst of a massive upheaval.  Amber and John have graciously agreed to bring their unique perspective on the convergence of healthcare and the customer experience here in their corner called “Two Minute Musings”.  I’m looking forward to these posts generating some great discussion from great minds on the subject.  So, to kick things off, here is Amber and John’s inaugural contribution.

When we think about how goods and services are developed, used, and sold in today’s world, it seems the healthcare industry is lagging behind in terms of delivering a happy customer experience. Think about it: we have open-source ecommerce available in every sector except healthcare- but healthcare constitutes almost 18% of our GDP annually.

Let’s look at the standard office visit today- we make the appointment based on the physician’s’ schedule, wait an average of 45 minutes in the waiting room for 15 minutes of fame, pay & check out, go to the pharmacy and wait for medications (and pay again). Remember this experience is compounded by the fact that you already feel awful and probably had to miss work for this appointment. Yet it doesn’t have to be this way because the healthcare system has the ability to treat us like consumers. Retailers understand the fundamental producer-consumer relationship: if consumers want to buy a product or service, producers will make sure we can do so with as little barriers as possible.

Now think about the average customer experience- when we want to “windowshop” on amazon, zappo’s, ebay, we can do so from anywhere at any time. Retailers don’t force us out of our way, but rather make sure we are able to spend money everywhere, all the time. Thanks to technology and forward-thinking retailers, we can attain instant gratification during lunch, on a train, or even during a chemotherapy session.

Granted- retail exchanges and complex healthcare interactions are not the same thing. However, we can look at portions of each experience in an “apples to apples” manner. Understanding how healthcare insurance and co-pays currently work is key to breaking the dependency on face to face physician-patient engagement.  Today doctors are compensated based on the patient’s type of insurance, census volumes, and based on the overall health of the aggregated patient population in a specific region. Theoretically, patients are better controlled if they have more regular access to their providers, both in person and virtually.

Now picture this scenario: *Sickpatient wakes up with a fever and feels awful. He logs onto his doctor’s virtual treatment room and signs into the secure portal. After reporting the need for treatment, he can self-select symptoms from a variety of options that run against an algorithm while waiting for the physician or nurse to engage in live chat. He can be on the couch, get diagnosed, obtain a prescription and pay for it all via one of the many e-pay systems available. Granted, *Sickpatient is sick either way, but in this scenario the healthcare system treated him like a consumer and has impacted his life in a much less intrusive manner. If the demand is there, healthcare providers will have to get on board. This is how consumer-driven markets evolve.