Why the Healthcare Ecosystem Matters

Value-based reimbursement models have emerged to encourage new efficiencies aimed at improving population health and lowering the cost of care. With the realignment of incentives, the companies and organizations that comprise the healthcare ecosystem: primarily hospitals, medical groups and payers with connections to medical device, pharma, mHealth and others, have been working more closely than ever before. Some organizations have felt forced into changes while others have embraced the shift with an entrepreneurial spirit. Since this ecosystem largely didn’t exist until a few years ago, this change presents many challenges as well as opportunities.

There’s no better time for healthcare organizations to embrace this movement and surround themselves, both internally and externally, with those who understand the process innovations and new technologies emerging within this ecosystem to support value-based care. Simply put, this matters because the opportunity cost for those who take an overly conservative and siloed approach could be significant.

The Secret to Success
While technology is extremely important to the evolving healthcare ecosystem, the foundation for growth and increased efficiency comes from process innovation and perhaps something much simpler. When speaking about his company’s legendary success, the late Walmart CEO, Sam Walton famously stated, “We’re all working together. That’s the secret.”

Taking cues from the integrated delivery system model pioneered by Kaiser Permanente, Mayo Clinic, Geisinger and others, traditional health systems are starting to follow suit. In addition to providing leading-edge care, University of California San Francisco (UCSF) is also innovating in the boardroom. In a recent Modern Healthcare report, Mark Laret, CEO of UCSF Medical Center, discussed the importance of moving academic medical centers forward: “We want to be able to go to the market and offer employers an insurance product and a delivery network that rivals what Kaiser Permanente does in the Bay Area,” Laret said. “Kaiser has been phenomenally successful in integrating how care gets delivered and doing it in a seamless, patient-centered way. The rest of us who are fragmented really need to change our mindset. So with John Muir Health and UCSF working with 15 or 20 other physician, hospital and other providers in the region, we are looking to be able to take financial risk for the care of populations, starting as soon as 2016,” he added.

Innovation and partnerships in healthcare delivery are also showing up in plain view, right on Main Street. There are increasing numbers of walk-in clinics located inside retailers such as CVS and Walgreens. Staffed largely by nurse practitioners, the care provided in these settings is inexpensive and streamlined, according to The Economist.

In fact, Walgreens stores in Arizona recently rolled out lab testing services in conjunction with Theranos, the disruptive diagnostics company founded by 31-year-old Harvard drop out Elizabeth Holmes. Profiled in rock-star fashion by The New Yorker, Forbes and a host of other marquee publications, Holmes has been compared to another successful Silicon Valley dropout, Steve Jobs. From just a tiny drop of blood, Theranos offers customers a range of tests, saving time, money and patient discomfort. Even Sam Walton’s Walmart is getting in on the action. According to The Economist, the company plans to become a leading seller of low-cost health services in the future.

Many hospitals and health systems are taking note. According to a recent HealthLeaders report, the affiliation of retail clinics and hospitals expands access to services, speeds care, helps control spending and drives patient referrals.

Back to the Future
With the advent of the Apple Watch, many news outlets have been calling to mind the classic Dick Tracy comic strip in which the first wearable communication device appeared in the 1930s. In March of this year, Apple CEO Tim Cook announced while unveiling the new device, “I have been wanting to do this since I was 5 years old. The day is finally here.”

This is just one technology that will create new opportunities for adherence, diagnostics, provider communications, patient-wellness support and a wealth of other applications. Many health systems are seeing not only the opportunity for better patient outcomes, but also the substantial economic benefits provided by the adoption of new technologies.

By utilizing telehealth, patients save an average of 5 hours, and their family caregivers save close to 9 hours per appointment, according to UCSF in a recent San Francisco Examiner report. Furthermore, patients reported high satisfaction with their telehealth visits. “I think this is going to be the way of the future,” Dr. Cynthia Kim, a specialist in pediatric pain management and associate professor of pediatrics at UCSF said to the Examiner. “It’s truly changed my practice. There’s just no way we could keep up with our clinic unless we did this.”

Inspiration and Perspiration
Perhaps the words of legendary innovator and iconic businessman Henry Ford are the best to keep in mind as organizations navigate new opportunities and risks associated with changes in the healthcare ecosystem: “Coming together is a beginning; keeping together is progress; working together is success.”

To support the goal of the Triple Aim, it will take the persistence of many bright minds from all areas of the healthcare ecosystem. For the true innovators, this goal of improving population health and quality of care while lowering costs can be achieved simultaneously with increased market share and profitability.

David Maricich

President & COO