How five trends can reshape healthcare and offer consumers personalized, affordable and convenient care
In the past few decades, the process of providing care has dramatically changed. Many of us remember the manual blood pressure cuff where the nurse would have to pump air and then listen carefully to read our blood pressure with a stethoscope. Or the X-ray slides dentists would put in our mouth that were very uncomfortable. Thankfully we now have automated blood pressure cuffs and wrap-around x-ray machines.
However the process of finding and receiving care for consumers has barely changed. Today, most of us still find a doctor by asking friends and family, schedule an appointment by phone with our primary care provider (PCP) only when we are worried about a health issue and then just follow the recommendations of our PCP with little choice for convenience or cost.
What Consumers Want
Studies (e.g., Deloitte 2016) have shown that consumers of healthcare (i.e., “patients”) prioritize the following things:
1. We want a personalized healthcare experience where our care provider knows us and the care is specific to our needs.
2. We want economically manageable (affordable) care choices
3. We want convenience: we want care when, where and how it best suits us.
Recent Developments
There are five recent developments that are poised to finally revolutionize healthcare to give consumers what we want.
1. Amazon getting into the Pharmacy business in 2018 and into Retail Care in 2022
In June 2018, Amazon bought a company called PillPack and officially entered the pharmacy business. While the market share of Amazon Pharmacy is still small, Amazon has started to bundle Pharmacy medications with its very popular Prime subscription. Prime members can now purchase certain medicines for as little as $1 per month.
In June 2022, Amazon signed an agreement to buy One Medical. One Medical is a membership-based primary care practice on a mission to make getting quality care more affordable, accessible, and enjoyable for all through a blend of human-centered design, technology, and an exceptional team. One Medical reportedly has 790,000 members of its highly convenient primary care service.
It is still unclear whether Amazon will be able to wrestle significant market share from established care providers and pharmacies, but it will force the industry to provide more convenient, personalized care, and transparent pricing.
Amazon is known for personalized experiences and it stands to reason that they will bring this personalization to healthcare and force existing players to match this experience.
2. Walgreens and CVS getting into Retail Care
A trip to your local Walgreens or CVS can tell you that both companies are investing heavily into providing a one-stop retail care experience. CVS has Minute Clinics and Walgreens has VillageMD clinics.
Today I can drive ten minutes to my nearby CVS or Walgreens, pick up my meds, buy sunscreen (and beer), get a flu/covid vaccine and get my medical checkup, all in the same trip. For healthy people or those with mild chronic conditions, this can make more sense than making multiple appointments with their current health provider system.
3. Generational Shift in Loyalty
The older generations tend to have a strong loyalty in their primary care provider. Typically, whenever they have a health issue, they call their doctor and follow his or her recommendations.
The newer generations tends to think of healthcare as a transactional experience. I need a flu vaccine, where is the most convenient way to get that? I need a physical for my job, where can I get that easily? Millennials and other newer generations do not have the same loyalty to their primary care provider as the older generations did. According to a recent study by the Blue Cross Blue Shield Association, only 68 percent of millennials even have a primary care physician compared to 91 percent of those in Generation X. Millennials are open to getting their care from wherever is most convenient and cost-effective.
4. Providers and Payers competing with each other
In the past, health systems (e.g., Ascension, Trinity, Dignity etc) provided care and health payers (e.g., Aetna, United, Blue Cross etc) provided insurance that paid for that care. The line between them was very clear.
Today, some large health systems are offering their own health insurance plans e.g., Ascension Complete. On the other hand, health insurance companies are either starting to control the care (via measures, incentives, or Centers of Excellence) or are providing some care themselves (e.g., Optum Care from United Health).
The line between providers and payers is being blurred. Providers and payers may now see each other as competitors.
5. Government Regulations
The US government (with large bi-partisan consensus) has made it very clear that consumers should have power over their healthcare data and their healthcare choices. The 21st Century Cures Act, signed into law in December 2016, puts the patient at the center of their health information records and requires any healthcare provider to provide data to a patient in a secure and standards-based manner or be subject to Information Blocking penalties. The 21st Century Cures Act empowers the HHS Office of Inspector General (OIG) to issue civil monetary penalties of up to $1 million against software developers, networks or exchanges that interfere with the proper exchange of electronic health information.
At the end of 2020, Congress enacted the No Surprises Act which contains key protections to save consumers from the cost of unanticipated out-of-network medical bills. Surprise bills arise in emergencies – when patients typically have little or no say in where they receive care. They also arise in non-emergencies when patients at in-network hospitals or other facilities receive care from ancillary providers (such as anesthesiologists) who are not in-network and whom the patient did not choose.
The US government, regardless of which party is in power, is clearly supportive of consumers being in control of their own healthcare. Consumers will finally have choice to spend their healthcare dollars on care that is personalized, affordable and convenient.
Impact on Health Care Industry and Consumers
One of the likely impacts of the above trends is that consumers will finally get what they want:
1. A personalized health care experience
2. Economically manageable care choices
3. Convenience in receiving care when, where and how we want
While Primary Care is not always a major profit engine for health systems, it serves as the feeder system for referrals into more profitable specialist and surgical care. If health systems lose a major portion of their patient population to primary care providers outside their health system, this is likely to reduce the referrals they get which can seriously affect the bottom line.
The New Future
If you are an existing healthcare system or healthcare payer, the time is now to offer consumers personalized, affordable and convenient care. If you wait for the new competition to eat away at your revenue you will have to fight much harder to get your existing patients back from them.
If you’re a consumer, you finally have power. Exercise that power to choose health care that is convenient, affordable and personalized to you. The healthcare industry will be forced to respond once the revenue moves to more consumer friendly healthcare providers and payers.
References
- Deloitte 2016 Consumer Priorities in Health Care Survey: https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-cx-survey-pov-provider-paper.pdf
- Why Amazon bought PillPack for $753 M: https://www.cnbc.com/2019/05/10/why-amazon-bought-pillpack-for-753-million-and-what-happens-next.html
- Amazon Pharmacy is a Year Old And Making Bold Moves: https://www.pymnts.com/amazon/2021/amazon-pharmacy-is-a-year-old-and-making-bold-moves-under-new-leadership/
- Why One Medical Acquisition: https://www.healthcaredive.com/news/amazon-why-one-medical-acquisition-primary-care/627822/
- Retail Health, the new Healthcare Experience: https://www.gensler.com/blog/retail-health-retail-medicine-the-new-healthcare-experience
- Blue Cross Blue Shield Study: https://www.bcbs.com/press-releases/blue-cross-blue-shield-association-study-finds-millennials-are-less-healthy
- Addressing Generational Shift: https://www.medicaleconomics.com/view/addressing-generational-shift-patient-use-primary-care-physicians