We’ve been crying wolf about change in healthcare for a long time now, and the dramatic changes have still not quite arrived. When I started Spring Street Exchange in 2016, I used to give a presentation on innovation in healthcare that included an image I used in 2006 to talk about this very topic. During a period that included the signing of the Affordable Care Act (ACA), the mass adoption of smartphones and the mobile internet, the explosion of social media, the ubiquity of e-commerce, the emergence of the sharing economy with Uber, Lyft, AirBnB and more, there was shockingly little change in the health sector.
Evolution in healthcare has sped up in the past several years, boosted by the pandemic, increasing competition, and healthcare penetration by non-traditional competitors. Nevertheless, the general rules of the road have remained relatively steady -- so far. We still (mostly) have payers and providers in their own swim lanes, with coverage organized by lines of business corresponding to who pays - government, employers, and individuals. It’s all so entrenched that it’s hard to imagine something else.
And yet we must.
We have become so accustomed to the siloed sector of healthcare being impenetrable that it can be tempting to continue categorizing innovation and change within existing swim lanes. But this isn’t how transformation works. Kodak didn’t miss the boat just because it underestimated the transition to digital cameras. People found digital to be a more convenient way to store and share images as well. And this latter purpose became so foundational that it changed the nature of the device used to take pictures. It turns out that we often found greater meaning in the ability to instantly share a visual memory with others, and now, only 7.5% of photos are taken with cameras.
The experience, outcomes, and economics in healthcare demand something more transformational than doing a better job at yesterday’s healthcare. The changing ‘rules of the road’ will include new definitions of who is a provider, what is considered healthcare, how it is paid for, who manages the data, and more. While we may not know specifically how these trends will play out by region and market, we do know the long intransigent industry is in motion. Nothing in human history has ever been protected completely from change, and while healthcare has benefitted from regional and regulatory protection, there is no reason to believe that healthcare has some magical shield that can keep the new potential of AI and emerging business models at bay.
Despite the amazing feats of our current system, by heroic providers and administrators trying to make it right, we still are failing consumers, who face:
High Cost Exposure: People avoid care due to costs and are stressed about their ability to pay for care, even when they have coverage
High Difficulty Rate: Those with coverage report problems using it, and more than half of those with problems are unable to resolve them.
Inconsistent Quality: In relation to comparable countries, we have the highest maternal mortality rate, the highest hospital admissions rate, the lowest life expectancy, and the highest premature death rate.
People will be seeking health support that is integrated in their lives, easy to access, and available on a moment’s notice. They will seek custom and nuanced advice that is caring, convenient, and culturally relevant. While these goals have been difficult for the current system to meet, new tech and escalating focus from companies in virtually every sector of the economy are already working to deliver on these aspirations. We can begin to see tech not as a means of depersonalization, as it has historically been, but rather a means to deliver care that is more compassionate and more personal. New capabilities will redefine the core functions of providers and health plans. That wolf crying change in healthcare is now howling for a reason.
At Spring Street Exchange, we deeply believe that we don’t need to be able to predict the future in order to plan for it. And we also know that values-driven change needs value-driven leaders at the helm. Many of you are having discussions on these emerging trends with your boards, peers, employees, partners, and consumers. I’m always up for swapping stories and we can also share our approach for developing organizational muscle memory around change all while keeping today’s lights on.
We’re in this together.
Peace,
NW