Change is Healthcare’s Greatest Opportunity

Ryan Lilly

This piece originally appeared on O’Dwyer’s Public Relations News:

While the healthcare industry has been talking about evolving for decades, we finally stand at the precipice of real change. With disruptors like Amazon, Berkshire Hathaway and JP Morgan pushing in, and mega-mergers like CVS and Aetna challenging traditional models of care, the pillars of this long-stagnant industry are finally being challenged. Couple this with skyrocketing out-of-pocket costs and increasingly empowered healthcare consumers, and healthcare’s status quo just doesn’t seem possible.

Exactly what the “healthcare revolution” will look like remains to be seen, but it’s difficult to imagine the industry looking the same in five or ten years. No matter where your organization falls within the healthcare continuum, now is the time to look to the future and seek opportunities to do better.

 

Fee-for-Service Model

To understand where healthcare is headed, it is important to first understand where we are falling short, so we can anticipate where change is needed most. Cost tops the list of complaints when it comes to care in this country. Many feel the fee-for-service model we’ve built, by which providers are paid regardless of patient outcomes, is a foundational flaw that drives up costs for patients. Think about it – would you pay a mechanic if they replaced a part and your car still didn’t run? Probably not. But if your mechanic was a doctor, they’d get paid for the services rendered, regardless of the outcome.

This is changing slowly, as the industry shifts toward outcome-based reimbursement and away from fee-for-service. A little disruption from non-traditional healthcare entities may be just the kick in the pants the industry needs to accelerate this change.

 

Pricing and Billing

Healthcare pricing and billing has also been increasingly scrutinized in recent years. Unlike virtually every other industry, what healthcare costs consumers is not based at all on the cost to deliver it. Instead, healthcare costs are determined primarily by what providers can negotiate with insurers. This means that pricing isn’t fixed and is generally tied to how much leverage a given provider organization or payer has. Essentially, the more members or patients fall under their umbrella of coverage or care, the better their chances of negotiating an ideal price. This is why you can pay one price for a knee replacement in one city and three times that amount in another. The increased price has nothing to do with the quality of the knee replacement or care you receive.

The pricing issue isn’t even limited to the care we receive from our doctors. It also extends to the pharmacy. This is another slice of the healthcare pie under increasing scrutiny for its pricing models — which is, again, unlike just about anything we see in any other industry. While biopharma breakthroughs are resulting in specialty drugs for rare conditions which have historically equated to a death sentence, many come with million-dollar price tags. While exciting, these innovative drugs are only impactful if we can get them into the hands of the patients who need them. And for many, the cost is simply too prohibitive.

 

Quality of Care

While the cost of healthcare is top of mind for many, quality of care also remains under threat. Currently, around half of all physicians report being burnt out. Think about that the next time you go to the doctor: Your chances of getting a physician who is still engaged in their profession are about as good as a coin flip — a truly scary prospect for patients and for the future of care in this country.

These astronomical burnout rates are attributed to several different things, but two of the most commonly cited culprits are mandated adoption of subpar technology and increased administrative workload. This is ironic, when you consider that technology has been positioned and marketed to make doctors’ lives easier and improve patient care.

The above doesn’t even begin to scratch the surface of healthcare’s many pain points, but it begins to paint a clearer picture of the areas where we are falling short and where subsequent opportunities for change exist. It is not at all surprising that such a profitable and inherently risk-averse industry is slow to change, but there is no more room in healthcare for “because we’ve always done it that way.” While I don’t pretend to think that professional communicators will figure this all out, I do know that we need to anticipate change and be prepared to address stakeholders that may not traditionally fall within our purview.

 

Communicating Differentiators to Address Pain Points

We are already seeing healthcare organizations reexamine their marketing efforts in anticipation of change. As patients find themselves with more options to access and pay for care, it is no longer enough to be a hospital or physician practice that is nearby. And as more employers build out their own care delivery networks, it will no longer be enough to be one of a few insurers in a given geography either. Already, we are seeing more examples of provider organizations charging a monthly fee. Regardless of the model, it’s clear that the normal structures are being challenged with an eye toward lower cost and increased quality.

For healthcare organizations, this means highlighting differentiators like patient engagement tools, access to telehealth or intuitive user experiences. It means looking toward a future which may see your organization delivering different messages to different stakeholders.

We are heading farther away from sterile, cold, acute settings and experiences, and increasingly toward something that is more like a spa, where aesthetic and customer service are a priority. Anyone who has been to a modern urgent care can attest to this. The movement to transform and modernize healthcare isn’t limited to payers and providers. Technology vendors are also evolving to become more Apple-esque and mirror the technologies we use in our personal lives.

Whether it is employers becoming healthcare providers, Amazon drones delivering prescriptions or visiting the doctor via an iPhone, major changes are on the horizon. This represents a huge opportunity from a communications perspective, as the industry will be looking increasingly toward thought leaders to help make sense of it all. It is up to communications professionals to help paint the picture of change, articulate a value proposition and educate the market as to how their organization is driving and/or reacting to it all.

The worst thing the industry can do is resist these changes or turn a blind eye, as the box has already been opened — and it doesn’t appear possible to shut it again. Much of the success of a revolution — like the one currently occurring in healthcare —  depends on collaborative idea sharing and a sense of the greater good. This is something that more brands should keep in mind as they turn their gaze to the future. Whether you’re Jeff Bezos, Seema Verma, Sanjay Gupta or a healthcare PR practitioner, change is coming. And we all play an important role in defining what that change looks like.

Ryan Lilly

Ryan Lilly

Vice President

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