Strategizing for Innovative Primary Care

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by Drew Corbett, Director, Innovation Consulting

Innovative primary care has an important seat at the table when it comes to reforming healthcare.

That’s because today, primary care is becoming better understood and regarded more as an intervention point for root causes of costlier episodes and conditions. Over the last decade, the healthcare industry has seen a surge of disruptive care model innovations proliferate as the health ecosystem becomes increasingly consumer-centric.

Direct primary care practices aim to rejuvenate the doctor-patient social contract while reducing burnout. Others leverage this philosophy and focus on Medicare Advantage plans and their value-based payment arrangements. For instance, Arizona’s Medicaid program will now cover Lyft rides for certain low-acuity episodes. Additionally, countless AI and machine learning companies are working to reduce the administrative burden contributing to burnout issues, while risk managers are increasingly encouraging people—particularly those in more rural settings—to web-chat, text or send pictures of their ailments to tech-enabled providers.

While these examples represent the same fundamental aim, they are very different solutions in approach. As various options for operating and economic models emerge to drive more innovative primary care, it’s still incumbent on providers to identify the right product-market fit. A 2017 NIH study captured the spirit of the relationship between opportunity and challenge well: “The potential for long‐term reduction in utilization and costs with better access to primary care is significant, but not easily nor automatically achieved.”

We’re right to be excited when dramatically new models enter healthcare and promise a way to make a solution simpler. In many ways, it’s the bold role of venture to encourage these can-do attitudes into the market.

However, organizational leaders will benefit from taking a step back from the headlines. Provider organizations should approach primary care innovation with a critical eye on how well a new solution fits their own landscape. The models fueled by this decade’s wave of venture investment are without question exciting, but sound strategy is still at the core of what will make implementing them either a success or sunk cost.

 

Keep your focus on strategy with these four reminders as you evaluate the latest innovations.

  1. Start where you are.

When you see a new operating model or technology lauded in the press or on stage at a conference, the success is often presented with a blanket implication of “This works!” What’s less often addressed is the notion that whenever you’re introducing something new, fit may be the single most important ingredient.

Even if the results are from a nationally recognized health system or leading academic medical center saw huge successes with a given solution, it’s important to remember that there’s no such thing as a one-size-fits-all solution. Although testimonials and success stories from other organizations are nice to have, it’s important to remember those organizations don’t have your contracts, physician alignment models, patient demographics, etc. Predicating your vendors, partnerships or business model decisions based on the situation you’re facing today is critical.

  1.  Know where you’re headed.

To head in the right direction with your strategy, know the specific problem you’re trying to solve within your own primary care offering from inside out. What results would you like to present on the executive committee or board presentation slide one year from now? Are non-emergent cases accessing the system via the ED with some geographic, ethnographic or seasonal trend? Is your market (patients and physicians alike) wanting a human-touch focused model amid a sea of homogenized tech solutions? Pinpoint the problem that, if solved, will tip the first domino for your system. Give yourself a realistic timeline to meet a specific goal and know your AMB (as measured by) metrics.

  1. Execute in alignment.

One of the challenges facing the innovation landscape today is a reticence to scale once success is proven in smaller settings. There are myriad reasons this could be the case, but you can mitigate one of the risks by ensuring the results of your innovation can also act as proof-points for broader organizational goals. If patient satisfaction is an organizational goal, then ensure the Net Promoter Score (NPS) of your direct primary care members is a tracked metric—or even a contractual service-level agreement if you’re working with a partner.

  1. Double down or begin again.

This is an intuitive principle, but one that’s very difficult to execute. If you’re seeing cultural and economic success with a newly implemented innovation, take on the challenge of scaling it up to the next level. This may be as simple as expanding the footprint of a technology, or it may force you to renegotiate contracts to take on more risk. In either situation, you’re truly innovating when you move beyond pilots and betas.

Alternatively, be honest with yourself about stagnant results. Failure is, more than anything, a data point to learn from. Don’t be afraid to cut losses quickly, take the learnings and try again with a more refined approach.

As a final piece of encouragement, keep an eye on how Washington is looking at this space. The Primary Cares initiative may be in its infancy, but with the future regulatory winds (hopefully) at your back, and a loaded market of innovation options to choose from, it’s a prudent time to set your strategy and make the move toward providing more innovative primary care.

 

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Digitization is disrupting the way traditional healthcare business models provide value while simultaneously enabling them to offer more creative, efficient, strategic solutions. Incumbents are being forced to redesign existing care delivery systems to meet the demands of an aging population with a dissatisfied and insufficient workforce, all the while preparing for value-based care. Please join Healthbox President Neil Patel and Healthbox Analyst Kate Berman to learn more about the factors that are contributing to shifting care delivery settings and how digital health companies are supporting this transformation. | Register for the webinar

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