I’ve worked in enough start ups to know that creating
something from nothing can be hard. It is especially tough when you must create
a market and explain to people that what you’re doing isn’t nearly as heretical
as it may sound. When my friends and I started Subimo in 2000, people wondered
why they’d use our product to learn about hospital performance when (in their
words) all they really needed was to have their doctor to tell them which
hospital they should use. What people eventually realized was that there is
variation in outcomes by hospitals and even by service lines within hospitals.
That’s why the recent spate of articles about the newly
emerging direct-to-consumer companies in health care – the ones that are
condition-specific like HIMS, Ro and Keeps – fascinate me. These are companies
that have leveraged all we know about direct-to-consumer marketing and have identified
an unmet market need. In some respects, they’re not dissimilar from companies
like Simple Contacts or 1.800 Contacts or Visibly – companies that offer a
convenient way for people to get what they need (in this case, good vision). Or
companies that offer behavioral health services directly to consumers.
What do these companies have in common? Aside from a strong marketing
foundation, they have identified a market need that can be met with a new
approach that leverages technology. They are convenient, offer a high level of
customer service and may even be easier to work with than traditional players.
This week, Health and Human Services Secretary Kathleen Sebelius apologized to Americans for the issues with the launch of the Obama Administration’s website, HealthCare.gov. In her testimony, Ms. Sebelius told Congress that we “deserve better.” And with that, the social media world was set on fire with a rage of backlash aimed at the Administration – something that has been growing feverishly for months now.
Yes, we agree that the American public deserves better – but not just from the Administration. They deserve more from the private sector, too. At this point, some of the biggest naysayers of the Fed’s exchange launch have been leaders in our industry. It’s disheartening to watch.
It’s clear by now that the private sector can offer the government a wealth of knowledge and best practices. But for the Administration to truly learn from those lessons and fix the problems, we need to step up and stop undermining this effort.
As a start, there are three things the private sector should do to counteract what much of the media refers to as a complete debacle:
1. First, just calm down.Focus instead on helping clear up the confusion about deadlines, options and the law. For example, we should remind Americans that they can still get insurance, despite all of the issues HealthCare.gov is experiencing. Legally, Americans don’t need insurance until the end of March 2014. And, if they need something sooner, not only may short-term medical insurance be an option, but there are many off-exchange plans available to buy today from multiple carriers. In other words, HealthCare.gov is not the only source of coverage.
NPR ran a story recently about how some retailers are retooling efforts to appeal to consumers in light of increased competition, particularly from online vendors.
Many are striving to be more “customer friendly”; Kohl’s department store was mentioned for adopting a “no questions asked” return policy with the idea that customer loyalty could be enhanced as the retailer made itself easier to do business with.
Comparisons between health care and retail abound, and while we say it is ideal for the consumer experience to be the same in both industries, in fact they are much different. The gap between the two industries was well-illustrated in this video of a shopper in a grocery store. We see them at the counter having their items rung up. But they aren’t told the prices and when they are given the receipt at the end, they’re told the final amount due may actually differ from what they see on the receipt.
Let’s take the analogy a step further: what if the customer expected the same “no questions asked” return policy from Kohl’s? Or a money back guarantee? In health care, only recently has the federal government taken steps to impose financial penalties in instances of poor care (which is the health care system’s equivalent of a “return policy” from providers).
When our team was at Subimo we initially focused on cost and quality (outcomes) information on hospitals. It was clear that – for the same procedures – there were both low cost and high quality providers as well as high cost and poor quality providers. Our efforts with transparency were designed to help people sort through the information so they could make more informed decisions and understand what quality outcomes might mean to them. We knew there was much variation in outcomes with certain procedures (e.g. aortic aneurysm repair) and less variation with others (e.g. normal vaginal delivery). Helping people understand when a poor outcome was more likely to occur helped them with their decisions (and presumably made them better shoppers).