Healthcare needs competition before the participation trophies kill us.

Opinion

By Tony Michuda

July 12 2019

I’ll never forget the look on my dad’s face 20 years ago when we moved into our new house in Frankfort, Illinois. With an open concept (before it was HGTV approved), located on a quiet street, and decked out in state of the art technology, it was a house that every 90’s kid proudly invited new friends over to. This was particularly due to the piece de resistance, a 50”x50” big screen TV that boasted the most jaw dropping Keenan and Kel, GUTS, and Legends of the Hidden Temple viewing experience technology had to offer. 

Fast forward a few years later and my dad begrudgingly walked by the new Plasma TVs at Sam’s Club that featured the clearest picture anyone had ever seen with built in surround sound and the latest smart remotes you could program. The only thing that helped him sleep at night was the $7,000 price tag. In that same house 20 years later, you will find my dad asleep in front of his 50” flat screen propped up on a do it yourself jerry rigged platform that makes his $500 voice activated 4k Sam’s Club special fit in the custom cabinet he had built for the original one ton behemoth in 1999. 

By now you’re probably thinking, “damn Tony, great story, but what the hell does this have to do with healthcare? And which one was Keenan again?” 

But in all seriousness, this is just one prime example of how an industry 20 years ago, started with a few players in the game and as competition ramped up, we had more choices, better prices, and all packed with new features year after year. This traverses every industry you can think of: TVs, cell phones, cars, subscription services, food delivery, and everything else you use in your daily life…..except healthcare. 

Here’s the good news: thanks to Barry O and the Affordable Care Act, more Americans than ever have access to healthcare. But the kicker is…healthcare hasn’t improved much as a result. It’s confusing, inconsistent, unreliable, and infuriatingly expensive. And the fix? Make no ifs, ands, or buts about it…healthcare needs more competition.

My job grants me the privilege to sit down and discuss the state of the healthcare union across the country with CEOs of major health systems and most of them will tell you it’s a competitive landscape. The buzz words are cost cutting, mergers, and acquisitions. To most bigger is better: "The bigger we are, the more I can leverage better deals with suppliers. The bigger we are, the harder it is to lose patients. The bigger we are, hopefully rate cuts won’t hit us as hard."

The harsh reality is: Healthcare notoriously benchmarks and merging with your competitor doesn’t make the fundamental problems go away, it only exacerbates them. 

All the meanwhile insurers are stonewalling reimbursement rates across the board (often times even reducing them) and the few reliable profitable sectors of ambulatory surgery and imaging are rapidly saturating. So where does this leave us? How can we move towards actually defining value and improving patient well being?

I’ll leave you with three basic thoughts to mull over while you’re waiting in line at Starbucks. Over the coming weeks, I will elaborate further these topics in the hopes of shedding some light on why I founded inHealth Management Group, with like minded innovative leaders across the healthcare landscape, and what we’re doing across the country to live out our mission of changing healthcare for the better. Are you ready? Let’s go! 

1) Breaking Barriers 

As a start up, you have to break barriers. If you don’t, you fail. Typically the fastest way to persuade a new client you’re a better alternative is through data. In order to do that, your client has to have data to compare their current performance vs your pro-forma and in today's healthcare, this is data is rarer than Tom Brady losing at Gillette on Sunday night. 

I have worked with CIOs in every form and they’re all wonderful people, but when asking for data, you never get what you ask for. Why? Because they usually don’t have it. What every hospital does have is their current rankings in some Healthcare Magazine, stats on how much money they spent improving facilities, and how much money they’ve given to cover uninsured patients. What they don’t have is standardized data on outcomes and what it costs to achieve those outcomes. As a result we need to better understand how “X” improves or doesn’t improve “Y” and how that information translates into value. This not only begins to established standards of value across specialties, but also enables health systems to better understand what new alternatives of care can add the biggest bang for their buck.

2) Breaking cultural norms 

“I can’t believe it! We pitched the CEO, he loved it, full implementation in 90 days.” Said no one in healthcare ever. If I had a dollar for every time someone complained about how slow healthcare consensuses are made, I’d be writing this LinkedIn post from my yacht in Ibiza. That’s the sad reality of the cultural norms of healthcare. Without quality data and financial incentives for providing value, healthcare leaders have no reason to reach a consensus quickly. 

We have to overcome systematic resistances to change and encourage high performance teams to act quickly and decisively. This eliminates the high carrying costs many healthcare companies face when bringing new innovations to market, resulting in lower prices, better value, and faster tracks towards product/service improvement. 

3) Breaking expectations

Your favorite restaurant probably doesn’t have one thing on the menu. Sure you might have your favorite go to, but should something new come along and the price is right, you may forgo your usual and try something different. Healthcare should be the same way and we need to start giving patients better choices and make those choices more transparent. 

All too often, the patient merry go round starts with the patient arriving at the doctor, handing over their insurance card like a credit card, paying the co-pay, doing what the doctor orders, and off you go hoping you don’t get a balance bill in the mail. This is partially why healthcare is so expensive. Imagine if you were given control over what lab test you actually had run based on a breakdown of the costs and the potential benefits of running those tests to better understand what’s going on inside your body. Or how about having the option to better understand how you metabolize medications? You might pay out of pocket for that one time test, but in the long run your medications may require smaller doses, costing you less money and sparing your liver and kidneys in the process. The list goes on and on, but more choices lead to giving you the patient more control over your health and the thing we all as human beings want - choices. 

Tony is an inspiring optimist that believes in our ability to invoke change and build the future of healthcare together. Described as “a visionary thinker committed to improving the disparities in healthcare,” Tony brings practical and innovative business perspectives to the world of complex science and diagnostic treatment. With an ambitious mission to make healthcare more accessible, more affordable, and available to all, Tony and his team are leading a movement to improve healthcare through improved continuums of care for providers and the communities they serve. To find out more head over to: www.inhealthcorp.com