4 Moves to Grow Share and Capture and Deliver Value… Even During a Pandemic

The following is a guest article by Sonia Singh, VP, Center for Consumerism at AVIA.

Amidst the COVID-19 crisis, the U.S. healthcare system has struggled to safeguard lives and suppress the virus, while buckling under financial strains, low consumer confidence, and the burden of persistent clinician burnout. And yet, the industry is experiencing unprecedented digital transformation in 2020. Between regulatory changes and billions of dollars of investment into new disruptors, the stage is set for transformative change.

In the midst of uncertainty stemming from the pandemic, hospital and health system leaders need to make decisions about the future. While the core tenets of growth, financial stewardship, and quality remain the same, health systems must tailor their strategies to the unique realities of today’s context.

Studies show that only 14% of companies improve growth and margin in market downturns. The winners act early and take a long-term perspective. Moving with clarity and purpose gives leaders the best chance to get ahead of harnessing gains, rather than simply reacting to losses.

How can the U.S. healthcare system emerge stronger from this crisis with durable, high impact strategies? Input from leaders across hospitals and health systems indicates four big moves that center around the goals of winning the consumer to grow share while capturing and delivering differentiated value to stay essential to payers:

  1. Own the Onramp
  2. Hyper-Personal Care Orchestration
  3. Specialty Care Double Down
  4. New Work

Big Move #1: Own the Onramp

To “Own the Onramp” means to enable a flexible supply-demand matching model, oriented toward anticipating consumer demand while allowing for optimization of capacity and existing assets to meet that fluctuating demand.

The first step in this move is to shore up the transactional capabilities of a health system’s digital front door. The digital front door acts as the integrated digital access point into the system, serving up consumer-centric capabilities to digitally search for and schedule an appointment, virtually triage symptoms, navigate to the right site of care and access on-demand virtual visits. In parallel, health systems must intelligently and dynamically route demand to the right resources and care sites (like virtual care), while seeking to aggregate supply wherever possible.

A natural extension of offering patients access to the right resources through virtual care is, for example, operating a health system’s digital front door like a marketplace. This approach might include dynamic pricing for expiring inventory, merchandising to 3rd-party sites, transparency of services and pricing, and convenient payments.

Owning the onramp allows health systems to win on access by improving convenience and optionality for the consumer across their care journey, while optimizing existing assets and opening the opportunity to capture share beyond geographical boundaries.

Big Move #2: Hyper-Personal Care Orchestration

To deliver on Move #2, “Hyper-Personal Care Orchestration,” health systems must establish a strong data foundation to develop a singular view of the consumer. Health systems can then stitch together data about a single individual (not a segment or population) across clinical settings, transactions, behaviors, and health information to deeply know the consumer at an n-of-1 level. Equipped with this data, a health system is better positioned to make consumer-focused decisions that are consistent, persistent, and predictive. They can understand who to reach, what to say, when to hold back, and when to deliver unique prompts that will work for that specific individual.

With consumer data as the backbone, health systems must next focus on personalizing digital interactions (text, chat, voice) at their digital front door. By incorporating signals across the various patient interactions, the latest digital technologies in this area continuously learn, creating an ever-evolving personalized experience. They also allow health systems to build loyalty by consistently engaging patients even when they are not actively seeking care.

Finally, this singular view of the patient empowers health systems to not only provide a more convenient, personalized experience, but also to orchestrate a broader, more comprehensive care plan that drives value and improves outcomes.

Big Move #3: Specialty Care Double Down

Big Move #3, “Specialty Care Double Down,” requires investing in a digitally-enabled, frictionless specialty care experience for patients, providers, payers, and employers. It is concierge-level specialty care involving the patient, specialist, referring provider, and care team, orchestrated by digital. This orchestrated experience boosts provider loyalty, increases access, and streamlines scheduling to promote a “closed-loop” referral process. It aims to eliminate any unnecessary human intervention and waiting, and pushes multidisciplinary clinical teams to work at top of license. Executing on this move results in driving down costs and improving outcomes to promote value for patients, providers, payers, and employers alike.

Big Move #4: New Work

Big Move #4 brings the concept of “new work” into reality, converting a health system’s core operating processes, work, and assets to automated platforms that optimize cost structures and deliver value. Executing on the “new work” will yield sustainable competitive advantages, allowing health systems to win on margin by re-engineering their operating chassis and associated cost structure, ultimately making the health system essential to payers and employers.