20 Jan The Third Space: What Health Care Needs Now
In 2007 when the very first concepts of Crossover Health were being formed, I had a persistent sense that health care was missing a vital organization in order for a fundamental shift to happen. I was tired of hearing about health insurance companies trying to lead the way forward; and I knew that the payment mechanism had nearly every independent and system-based provider absolutely hooked on the fee for service drug. In fact, everybody was in on the game . . . suppliers, ancillary services, imaging centers, etc . . . and I was not seeing how the self assembled “system” was ever going to disrupt itself. Big, heavy insurers on one side and the entire spectrum of care providers who had grown up within the system on the other – each fulfilling their role in the opaque and complicated opera.
Meanwhile the patient was left with no where to turn for the type of care that they both wanted and more importantly needed. Ironically, there were other types of patients who didn’t know they wanted nor understood they needed this new type of care. Insurance Companies and traditional Health Providers appeared to be the only options.
In fact, the entire situation can be likened to the Third Space made famous by Starbucks. You remember that PS (Pre-Starbucks) there was typically Home and Work. Those were the two functional spaces where most of us carried our our lives, our social activities, and many of our human interactions. However, when Starbucks came along with its expensive latte’s, cool lingo, consistent service level, and cool kids club feel, consumers went nuts. Later, they added music (and sold CD’s), better ambiance, free Wi-Fi, and an expanded menu. When it was all said and done there was a Starbucks on every corner, a meeting could be had with friends, colleagues, or others, and this new “Third Space” became a fabric of our every day lives. No one was asking for this new space, but once it appeared, people absolutely loved it.
I believe the same holds true for health care – there needs to be a new entity – something different than the big, lumbering insurance companies and different than the traditional “system” providers slavishly hitched to fee for service and sclerotically bound to traditional poor service and worse outcome medicine. A new entity that is nimble, light-weight, free from the shackles of the traditional health care delivery and financial system, and therefore free to innovate a new care delivery model designed for 21st century patients.
What does this “Next Generation Care” look like? Here are a few of the key elements:
- Insurance as a form of payment is removed (but preserved as a form of true catastrophic financial protection).
- Patient experience is designed into the care delivery
- Providers are given appropriate time to build relationship and address both short and long term issues
- Service level is comparable to best in class retail, access is significantly expanded, and shared decision making is implied
- Outcomes are measured, monitored, improved, and reported back to the patient, provider, and as appropriate the payer.
- Technology is invisible but critical to the success of the practice.
- There exists a strong advisory service overlay – the new entity is a trusted source of health information and guidance for all aspects of care
- The patient feels a sense of ownership of their own health as well as their membership in the new service. Net promoter score is a surrogate marker for the value placed on membership.
I believe that people will want to join an organization that helps them stay healthy. I believe people can make the mental jump to consider their health more like a gym membership than like transactional payments only when not well. I believe they want an entirely different service experience as well as help as they need to navigate the inevitable complexities and inefficiencies of the current system. I believe they are going to want new types of services, optimization services alongside traditional disease management, and technology to help them track, trend, and monitor their progress toward their goals. I believe the time for the third space in health care to be recognized is now and the time for a new entity to be created is here.
I believe its time for next generation care. I believe its time for Crossover Health!