The disruption of Covid19 has accelerated change into previously unseen speeds for transformation in healthcare OptumInsight CEO Robert Musslewhite observes the foundational changes being made across the national healthcare landscape. According to him a several macro forces emerging, and several changes are here to stay. First is the focus on the advancement of digital health. Second is continued market pressures from new market entrants and non-traditional providers. Third traditional providers see their sort of one size fits all model, really changing as a result of these external entrants and need to continue to monitor external threats and revaluate their value propositions. Healthcare leaders can take advantage of this disruption in several ways.
- Musselwhite maintained that for the organizations seeking transformation it should first focus on the people. Understand what your consumers or patients or members need, want, and expect. And tailor your approach and your business towards that. Second, embrace digital health. and third, and perhaps most importantly, become more agile, motivate and support leadership teams to make informed decisions in more rapid cycles.
- He has explained four ways the transformation can be accelerated
- Value chain: There are several pieces of evidence of radical change in the healthcare value chain. First is the disruption in our supply chains and drop in consumer engagement. Also, cash shortages across the border will have implications for some time to come. A CEO can better understand the value chain shifts in their market by looking at specific shifts in consumer behavior to see if they are substituting services outside their ecosystem and what type of services those are. And at the same time, monitor consumer and technology companies for what offerings they are introducing into the market. CEOs can look within their own organizations for opportunities to adjust in a few ways. first, CEOs can see if COVID has revealed any gaps in service that are associated with their business proposition or mission. if they have assets that underperforming, or unrelated to the core business proposition that reveals where to consider divestiture.
- Consumerism: CEOs can ensure that their organizations are truly aligned with consumer preferences by taking several steps.it starts with segmentation. organizations need to understand who they are serving in a nuanced way, appreciating their customer’s attitudes and behaviors towards health and wellness in order to create more tailored offerings that are not one size fits all. Then, overcoming access and engagement barriers. Addressing issues related to costs, site, and modality of service, convenience language, social determinants of health, and the like. And then of course measuring and monitoring. For metrics, leaders can still look at things like utilization and retentions by segmentations, however by including NPS and consumer effort scores leaders can gather current sentiment on loyalty and learn how hard consumer s have to work to engage services.
- Holistic risk: There are really two kinds of intelligence that a CEO should prioritize when assessing holistic risk. The first is broader market analysis. the other is potential operational impacts. There are several innovative ways to address this risk. On the business risk side, the main one is considering new strategic partnerships. On the financial risk side, several options. One is moving reimbursement models towards risk arrangements or value-based care. Another is investing in new ways to close care delivery gaps and address care needs. And finally but potentially most important, consider ways in which CEOs can impact other related issues such as social determinants. And here it’s about considering how CEOs can partner with local communities and organizations to connect with patients and members and ensure better access to care and services that they may need.
- Regulatory: There are several areas where regulatory or compliance activity that’s related to COVID19 will have an impact. Certainly, Medicare and duals were hard hit by COVID 19. Underemployment now, or soon to swell the Medicaid ranks while many unqualified are falling through the cracks. The CARES Act is limiting states’ ability to reduce coverage and states will need to cut somewhere to balance budgets. There are questions, now about what federal and state govt. can even afford in the near future. CMS has extended telehealth coverage beyond the pandemic but they may not convert CARES ACTS loans or grants or reduce interest rates as providers hope. And the federal govt. has consistently shown a commitment to data security, interoperability standards, data sharing to support coordinated care, and mandated consumer access are issues health organizations will need to ready to contend with.