Post-ANI Reflections

Guest post by Tracy Currie, CEO of Capto.

Tracy Currie
Tracy Currie

HFMA ANI 2016 was a very interesting conference for me, which yielded some unexpected insights.  Throughout the conference and in conversations on the show floor, I heard a very strong emphasis on focusing on the consumer in healthcare. Provider organizations and the vendors that support them seem to have reached a kind of tipping point on consumerism. The once conventional wisdom that outcomes trump experiences, seems to be giving way to the realities of increasingly competitive healthcare markets. For me, this conversation was a prime example of a strange idiosyncrasy of the healthcare industry where we often shy away from talking about healthcare as a business and feel compelled to put every issue in the context of improving patient care.

I heard individuals at this year’s ANI reiterating the point that there is no data to support the idea that a better patient experience correlates with better outcomes. Healthcare leaders seem to be recognizing, though, that this fact is largely irrelevant, and does not justify negligence of the healthcare consumer experience. I heard an apt comparison to auto makers – who commands a financial commitment from their customers that can be similar to the cost of healthcare. Ford, Honda and BMW do not stop at making a safe and reliable vehicle, they work very hard to outdo their competitors in creating a complete shopping, purchasing, paying and owning experience that their customers will love. Quality care – like a safe, well running car – is clearly the most important thing, but it also just the start – the foundation for the much larger strategic play: creating a total consumer experience that attracts and retains great lifelong customers and their friends and families.

Clearly, in a world where healthcare organizations must compete for customers/patients /members, we have to take experience very seriously. Especially as organizations take on risk in managing the health of larger populations, a reputation for offering a great experience is going to be essential to attracting the right mix of patients and to engaging them in more effectively managing their own health and care. Fortunately for forward-thinking HCOs, emphasizing patient experience will set them apart from the rest of the pack in today’s market, as healthcare’s status quo for customer service is similar to that of a cable company, and a far cry from paragons like the Apples or Amazons of the world. So there is tremendous opportunity to seize and hold a competitive advantage by making healthcare brands attractive and part of a consumer identity that target customers want to be part of. The financial upside for a health system that can make being part of their community a source of pride and satisfaction for customers the way Harley Davidson has will be tremendous.

Interestingly, I found that this kind of frank business talk about and concepts like market share, customer retention and profitability, is not a comfortable thing, even at a healthcare finance conference. Healthcare leaders — be they physicians, CFOs or CEOs – do not feel safe outside of the boardroom in discussing their efforts to improve the bottom line, as necessary and natural as that is. It is an odd and anachronistic instinct we have in healthcare that is very out of sync with other industries, where we feel that we can only talk about the business of care in the context of providing better outcomes, improving access to care and reducing suffering. Even something like improving patient experience and creating happier patient populations, which should be universally commendable, requires gymnastic contortions of language to always be in the context of improving care rather than enhancing business performance.

One of the strongest impressions I came away from ANI with was that we need to give our industry permission to talk about the business of healthcare as a business, without shame or the need for double-talk. We must develop an acceptable language in which payers and providers can have business centric conversations to address these issues head on, rather than circumnavigating hard commercial conversations. The outdated idea that patient experience does not matter because it does not affect outcomes is a great example of how talking about the business of healthcare only in the context of providing great care can take even smart, sensible professionals down very counter-productive roads.

One of the central ideas at the heart of the last decade of healthcare payment reforms has been to bring the power of market to bear on improving the efficiency and effectiveness of healthcare. Efforts to increase price and quality transparency, and to disintermediate the ultimate buyers and sellers of care are meant to increase the efficiency of the healthcare market. Informed consumers with real competitive options will force the market to compete for business on the basis of cost, outcomes and experience, inspiring creative innovation. The U.S. currently devotes a much higher percentage of GDP to healthcare than any other nation, and yet we consistently rank poor to average among developed nations on healthcare quality and outcomes, and with regard to patient experience, U.S. healthcare has yet to adopt a common metric (e.g. net promoter score, etc.) that would allow better national benchmarking.

If we want those invisible hands of market forces nudging our healthcare system toward world-class performance, then we need to acknowledge the economic nature of healthcare and use business terminology not just comfortably, but proudly.

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