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Solving for Similarities in Healthcare Sub-Verticals

Healthcare

I received the question the other day from a new Silverliner, as to why we focus initially on the Provider space as a sub-vertical. It’s not the first time I’ve been asked that. It’s not the first time I’ve answered it, which made me realize — maybe more people should know the answer. 

After working through our goals as a practice with a focus on driving better outcomes in healthcare, we realized an overarching pattern: The trends, challenges, and opportunities in Provider were actually the most representative of healthcare overall. 

Differences and similarities in healthcare sub-verticals

While Silverline and most organizations treat sub-verticals as distinctly different, there is a shift occurring where many goals of these various organizations are starting to come together with striking similarities. Each sub-vertical still has their own unique goals, needs, and approaches for being viable in the market. However, what I am suggesting is that there are foundational challenges that cross these sub-verticals and Silverline has knowingly, intentionally, and proactively focused on Providers first because it offers the opportunity to deliver solutions to solve these problems and then translate elsewhere.

It’s well known that industries often, and must, learn from other industries in order to establish a new norm or standard by which to do business. Hospitality comes to mind regarding customer service, retail for personalized experiences, and so on. For instance, a colleague once told me an intriguing story of how the airline industry’s approach to air traffic control was being considered to drive more efficiency in ER bed scheduling. 

Healthcare often struggles with semantics, and rightly so, it is important and can clearly have impacts on life and death scenarios. Therefore, for our purposes today I will not try to solve or explain whether we should refer to the subject of healthcare customers as consumers, patients, and/or members. Let’s assume that patient, consumer, and member are all the same for the purposes of this point of view. How do Provider, Life Sciences, and Payer worlds coalesce around these challenges?

Consumer engagement

I consider consumer engagement to be interacting with the patient before, during, and after a clinical episode in a meaningful, proactive, and effective way. Engagement can be evaluated in many ways:

  • Are you identifying who your target consumers are before a significant illness? 
  • Are you communicating with them via a channel or mechanism that aligns to their preference? 
  • Is that channel effective in helping the consumer and the organization reach the intended goal?
  • Do they actually show up for the appointment and arrive on time?
  • Do they adhere to their medicine as prescribed?
  • Are they providing timely feedback on how they feel? 
  • Can you offer self-service capabilities or automation to minimize the threshold by which to access services? 
  • Are you able to minimize volume interactions for tactical requests such as directions, prescription refill, device utilization, data capture, etc.?

Ultimately, organizations that can effectively engage with their consumers will be most successful in driving the type of interactions that keep their customers and expand relationships — not only to family and friends but across all types of healthcare services needed throughout their lives.

Value-based care

Organizations delivering care, medical devices, services, drugs, or anything intended to improve the health of consumers will now be tied to ensuring those same activities result in actual beneficial outcomes. While there may be a sliding scale and tiers, at the end of the day, the goal is to incentivize value over volume. Organizations that are able to restructure their operations to navigate a patient to the right services at the right time and for the right reason will see higher reimbursement. 

The inclusion of risk-based contracts also further holds these organizations accountable. Call it arbitrage, but the ability to predict the risk/health of that population and then effectively manage the associated services and cost is critical. As referenced in the article in Modern Healthcare: “Survey Results Show Risk Is In The Eye Of The Beholder,” a Navigant study sees 64% of healthcare finance leaders assuming a risk contract in the next 1-3 years. Further, it identifies that it is difficult to pinpoint how much revenue is actually driven through this being as low as 1% all the way up to 85% for other health systems. 

Nonetheless, the market is shifting, even if the end state — proactive and improved health for as large of the population as possible — is not yet realized.

Data utilization

Healthcare organizations have always been significant producers of data. Clinical data has been effectively leveraged in order to:

  • Bring new drugs to the market based on outcomes
  • Identify the right procedures
  • Provide consistency to diagnosis

However, data utilization has lagged when focused on the “experiential” side of the house. How can we use all of our data sources to improve the experience of the consumer? How can we ensure that we have consistent, reliable, and accessible data across our various facilities, divisions, or capabilities?

Organizations are now required to improve the overall experience of its consumers, ranging from how they push services and capabilities to consumers to how and why they keep consumers engaged via multiple channels. But how do you expose data, in a consumable format, to help consumers make more informed decisions about their health and well-being? All of this ultimately requires a robust and effective data management strategy along with the associated tools to transfer this data between systems. 

Consolidation

Organizations across the sub-verticals are merging and acquiring and the reasons span the gamut. While some are buying competitors to increase market share, others are doing it to provide more vertical services to their patients. Interestingly, while the news and media focus on the impact on the consumer here (which is rightly front and center), often in our space we see the operational impact. How do you take two legacy health systems and bring them together and deliver the same patient access experience? How do you bring on a new diagnostic test to an existing portfolio and demonstrate a holistic view of that consumer and historical relationship? What is the right way to embed a new device into your marketing and sales activities while minimizing duplication? 

For all of these scenarios, healthcare organizations are starting to embed the foundational goals of healthcare into their company strategy in order to demonstrate the importance and significance of such moves. 

Piecing it all together

This list is not exhaustive. However, if we start thinking about where, why, and what is consistent among the sub-verticals, I think we will start expediting opportunities to place the consumer at the center to drive engagement, streamline activities, increase satisfaction, and provide more proactive management of care. This happens both during in-person clinical experiences, and throughout the care lifecycle, but now across multiple new mediums: web, mobile, email, social media, and chat. 

A digital transformation is happening in healthcare, but the key is recognizing where your organization is on that journey. Get to know our healthcare solutions and download our free ebook: Silverline’s Provider Roadmap for Success on CRM.

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