Bruce Broussard, CEO of Humana, forgot the charger for his smartwatch on a business trip. Stopping into a consumer electronics store, he was struck by the options he faced of various wearable technologies. He ended up buying a new watch, which he uses for exercise tracking.
“Technology is such an important part of the direction of health care,” Broussard told the HIMSS 2015 audience in his keynote address on 14 April 2015.
But Broussard was quick to point out to the thousands of technology geeks that comprise HIMSS’s membership that improving the health/care system isn’t just about technology: “we have to change the conversation of what we are doing from a supply based system to a system around demand…a system where we put the customer first as opposed to the system <first>.” Broussard critiqued that, “Through the years, the system has been milked by adding more and more supply.”
He explained that he’s been in many boardrooms where the organization’s priority has been how to drive more volume in health care, with little expressed concern about how to improve health outcomes and patient and provider experiences.
When asked what is “health,” consumers of all stripes smile and respond that health is “happiness,” “freedom,” “life,” “everything.”
When asked what is “care,” people get visibly warm and fuzzy and say that care is “love,” “compassion,” “warm hugs,” “wrapping your arms and protecting everything you are supposed to protect,” “trust,” and “what I do everyday,” spoken by a young mom.
When asked what is “healthcare,” folks’ responses are viscerally negative. One woman first exhales, “hmmmm.” Body language folds up. Brows furrow. Voices get stressed. The words people use to describe the portmanteau were “bureaucracy,” “confusing,” “run for your life.”
One woman says these are two good words, but put them together into one? It becomes a negative.
Thus, Broussard said, “What that video is talking about is that the consumer is at the middle of the problem, and the provider is at the middle of the problem.” But these two players — patients and providers — are, he asserts, “the ones enabling system to work. They connect the system, they deal with the problems from one provider to another, and insurance companies….They are the ones that connect the system.”
Of the $3 trillion spent on health care in America, $1 trillion is wasted every year, Broussard told the audience. Waste comes from administration, overtreatment, administrative red tape — all largely focusing on supply and not on demand, he said. 60% of physicians’ time is spent on “non-valued added patient activities,” he estimated.
Our system wasn’t built for chronic care, Broussard believes: it was built for episodic care, “one and done, bill and move on to next patient.” Incentives are not aligned, consumer choice is limited, and siloes are not integrated.
Broussard then read a letter from a Humana plan member. It represented “an indication of what people are looking for. Not just insurance.”
Humana is thinking about the future in a few ways: in terms of how to integrate the system, how to convert to value-based reimbursement, and how to encourage consumer choice.about
Today, 15% of Humana’s members are enrolled with providers who are reimbused for quality. The plan has seen an improvement in wellness checkups and lower ER admissions. “When consumers have choice, competition is created and innovation comes about. We offer transportation for food when you get discharged from the hospital because we are focused on that member choosing us. Value and service is what they are choosing, assistance with their journey in health,” Broussard has seen.
There will be challenges for providers in migrating to this new world of value-based payment. Namely, that hospital and system capacity might have to shrink, the changing role of fixed assets, and the strategic role of technology in health care.
“Technology companies look at information as a shared asset, not as a proprietary asset,” he opined. Look to Apple and Charles Schwab as examples of companies that were highly reliant in an old business paradigm and moved to another.
Health Populi’s Hot Points: In our panel in the Patient Engagement Forum at HIMSS 15 this morning, #engage4health, Jack Barrette, Founder of WEGO Health, and I talked about the opportunity for people/patients/caregivers to connect with personal health information technology for patient engagement. I set the table for the discussion, presenting the cover of a “Get Well” card I recently purchased in a grocery store that had a card department, a pharmacy, an expansive gluten-free and organic food section, homeopathic meds and two aisles’ worth of vitamins, minerals and supplements.
The new high-deductible health plan, growing in use by public and private health exchanges, as well as among employer-sponsored health care companies, is the plan-du-jour for U.S. health consumers. As a result, people face first-dollar payment for health care services until they meet their deductibles, at which point the insurance company begins to pay for the member’s health care.
In this scenario, the consumer is living healthcare @ retail….in search of retail experiences, as Broussard says — moving a supply-led to a consumer-led health system.
Strategy&’s 2014 consumer survey found that at least as many people trust large retail and digital companies to help them manage their health as trust health providers and health plans.
If you look to the right side of the chart, you find the most important rationale: that people trust non-traditional companies to help them with health because they can deliver quality care at a lower price.
So value is in the eye of the health consumer, who is increasingly looking for a retail experience — service, quality, price, value, and engaging experiences.