Before the COVID-19 public health and economic crises, the healthcare industry had been slow to respond to changing expectations of the healthcare consumer, opening the door to disruptive new providers with more efficient, patient-friendly operating models. Digital innovation stimulated by the crisis will fuel healthcare’s recovery and long-term competitiveness.
Before America’s healthcare system was violently disrupted by the COVID-19 public health crisis, a healthcare revolution was already underway. In an article we published in early 2020 titled “Disruption and the “Retailization” of Healthcare”, we observed that “Healthcare in America is on the threshold of great change, driven by disruptive new technologies, regulatory pressure and increasingly assertive, value-sensitive consumers.”
That revolution has not been slowed by COVID-19 or the financial crisis that ensued for most traditional healthcare providers. Instead, the opportunity for more customer-centric companies to compete for healthcare consumers has grown. In the last several days alone, significant new investments in healthcare delivery have been made by Walmart, who announced its intention to create a new health insurance company; and Walgreens, who is investing $1 Billion to grow its primary care clinic network. Given the well documented inefficiencies plaguing the healthcare industry (high costs, poor system integration, uneven financial performance, etc.), these and other customer-centric companies are betting that their care delivery models will one day own a significant share of the primary care market.
It makes sense. The financial and social stressors that were motivating larger numbers of patients to seek healthcare in alternative settings have only intensified in recent months. Tens of millions of Americans have lost their jobs, along with the income and employer-sponsored healthcare coverage that came with them. The temporary suspension of nonessential healthcare treatments and patients’ concerns about personal safety have led to an explosion in the use of telehealth and other virtual care channels. This would all paint a pretty bleak picture for the future of traditional healthcare providers, but something else has happened since the crisis began, offering cause for optimism among health systems and hospitals.
COVID -19 and Healthcare’s Secret Weapon
It’s not hard to imagine a time in the not too distant future when we will look back on 2020 as a time of fundamental change for healthcare in America. One of the silver linings following the COVID-19 crisis will undoubtedly be the industry’s astounding ability to innovate and adapt. Here at Loyale, we believe it is this willingness to nimbly reevaluate the environment and consider new approaches that will power healthcare’s successful response to the “retailization” threat and ensure its relevance for the future.
For years, the healthcare industry was slow to embrace new operating models and technologies to make the delivery of care more efficient or more attractive to consumers. Decades of relying on insurers and government or private payers for their patients and revenue meant that there were no financial incentives for delivering a more consumer-friendly patient experience. As long as clinical care measured up to regulatory and market standards, innovation in other areas was not a priority. While every other industry was forced to react to varying degrees of digital transformation, healthcare was exempt.
Healthcare’s awakening began not long after high deductible health plans entered the market, when patients themselves became responsible for a much larger portion for the out-of-pocket costs for care. For the first time, patients - and the revenue they directed (their own and their insurer’s) - represented a third or more of total revenue. This introduced two new operational challenges to healthcare: 1) attracting and retaining patients and 2) collecting payments directly from patients.
Initially, many healthcare providers were slow to answer these challenges. Some early adopters, like HCA Healthcare (a Loyale client), invested in technology partnerships to deliver better patient experiences, improve operating efficiencies and drive better financial performance. But for the most part the industry failed to catch the signals consumers were sending. COVID-19 changed all that.
Healthcare’s Rapid Introduction to Digital Transformation
In the area of digital patient engagement, the speed of adoption has been nothing short of astonishing. According to FAIRHealth’s Monthly Telehealth Regional Tracker, Telehealth claim lines soared 8,335% to 13% of claim activity for the month of April compared to the same month in 2019. And the future for telehealth looks bright according to a report published recently by McKinsey & Company on telehealth’s post-COVID potential for growth, “with the acceleration of consumer and provider adoption of telehealth and extension of telehealth beyond virtual urgent care, up to $250 Billion of current UD healthcare spend could potentially be virtualized.”
In formulating its response to the extraordinary circumstances forced upon it by the crisis, healthcare has rushed headlong into its digital future. But the journey has just begun. By addressing the immediate need to efficiently deliver care services to a homebound patient population, providers have taken their first steps toward realizing the tremendous overall potential inherent to integrated digital systems.
With the understanding that digital systems offer scalable operating efficiencies, better patient access and improved patient experiences, providers must now look to extend their digital capabilities into every patient- and physician-facing touchpoint. Already, we’re witnessing impressive advancements in the ways providers are leveraging EHR system data to improve and standardize best care practices. What must also be considered is the financial dimension of care.
As competitors like Walgreens and Walmart look to grow their foothold in healthcare, traditional hospitals and health systems now have an opportunity to respond. By expanding their early telehealth success to realize the operational and financial benefits of platform-based operating systems, providers will uncover the ability to deliver more satisfying consumer experiences while improving their own operating performance.
The Digital Future for Patient Financial Engagement
Before the current crisis, healthcare consumers were sending several important messages to the healthcare marketplace:
- We’re not subscribing to the old primary care physician model.
- We want access to care that’s convenient and affordable.
- We want to engage with our provider in other “no-touch” settings. Not just an office or hospital, especially now.
- We’re open to considering alternative providers and care delivery settings.
- We often don’t seek care because we’re concerned about the personal out-of-pocket costs.
- We want quality care.
Platform-enabled digital engagement empowers healthcare providers with the ability to meet these market expectations head on. In the area of patient financial engagement, digital addresses the urgent demands of the present with solutions to dramatically reduce costs without impairing capacity. Longer term, it promises better patient engagement, improved affordability, superior communications and actionable business intelligence derived from data that tracks patients’ financial behavior from end-to-end.
The ingenuity and inventiveness displayed by health systems and hospitals across the U.S.A. in their response to the COVID-19 crisis, continues to amaze and inspire us. That same spirit will energize healthcare’s recovery and return to prosperity. We’re grateful to have the opportunity to play a part.