Walk toward the small crowd mingling at the third annual Rally Health(SM) Innovation Summit, minutes before it officially kicks off, and you’ll notice one striking thing: Everyone is wearing a name tag, but none of them list company names. It’s a small design tweak with a big impact: You can’t seek out participants from your own narrow slice of the health care spectrum, can’t pair off with people from similar backgrounds and similar perspectives. It’s forcing fresh connections and cross-industry conversations, and the 35 participants — payers, providers, employers, analysts — are loving it.
“Health care has so many big, complicated problems, and it’s clear technology will be the answer — but not just technology,” said Kathy Winn, vice president of strategic marketing and telehealth at LifePoint Health, Brentwood, TN. “We need technology — and trust.”
And trust can be hard to come by at most gatherings, which are decidedly less collaborative. At provider conferences, people tend to beat up on the payers. At payer conferences, it’s the providers who bear the brunt of the group’s frustrations. At the Innovation Summit, by contrast, everyone had a seat at the table: providers, payers, employers, physicians, and engineers.
“I did the math, and we have more than 940 years of combined health care experience in this room right now,” said Brian Dolan, Chief Strategy and Partner Integration Officer at Rally Health (™). “Seems like we should be able to come up with some solutions.” No kidding. There were a lot of great ideas flowing over the course of three days in South Carolina. Here are the five top insights that rang out loud and clear from this unique gathering.
1. Personalization Reigns Supreme
The loudest drumbeat that ran through the three-day summit was the uptick in patient expectations around digital tools.
“It’s not about whether to invest in digital; it’s about how to invest, in service of personalization,” said Shane Giuliani, manager of health care strategy and transformation at Monitor Deloitte. When the firm asked consumers to rank their priorities in health care, personalization was the clear leader, followed by economically rational coverage and care choices, convenience-driven access and use of care, and finally being digitally connected. “But that doesn’t mean that consumers don’t care about digital — it means that digital has become table stakes, in service of these other priorities,” he said.
Consumers don’t want a digital directory that serves up physicians that aren’t in their network. They want one, like the Rally app, that preloads provider networks on the back end, so their search results are personalized and highly relevant with zero extra effort. When it comes to virtual health, they want something that allows them to speak to a dedicated and personalized team every time they tap the app.
2. Data Streams Need to Flow in Multiple Directions
At one urology group in upstate New York, drug spending was incredibly high — particularly for testosterone therapy. Rather than doubling down on prior authorizations, health insurance execs gave it up completely. They set a local budget rate for that type of spending, and then told providers that if spending came in below the benchmark they’d share in the savings.
“They gave providers the responsibility, but they also gave them the data” to drive change, said Rachel Sokol of the Advisory Board, presenting the case study. “Providers had no idea there was a 16-fold difference in what they were prescribing.”
To get those costs under control, the medical group helped write prescribing guidelines for high-cost medications and got granular with its prescription-spending data, mapping high spend at a physician level. Just one year later, the medical group had saved $2.2 million.
Data in a silo doesn’t have much power, panelists and attendees agreed. “When we’re talking about plan and provider partnerships, the data has to be bidirectional,” said Adele Paulett, vice president of managed care, Christus Health, Irving, TX.
3. Employees Crave Well-being Support — and Employers Aren’t Satisfying It
Nearly two-thirds of employees say managing their health is a top priority. And on the employer side, 87 percent report that increasing engagement in health and well-being is a key priority in the near future, according to new data presented by Willis Tower Watson. Sounds like a match made in heaven, right? Not so fast.
A staggering 44 percent of employers with at least 1,000 employees have no formal health and well-being strategy in place, research shows. Instead, efforts tend to be ad hoc and scattered — a problem compounded by the fact that many employees don’t even know what wellness programs might be available to them, panelists pointed out. And wellness that feels like an afterthought stands out as inauthentic.
From the employee’s perspective, they see their employer’s promotional materials which read “we care about your health”, but it doesn’t square with what they feel, said Matt Shaffer, SVP, BlueCross BlueShield of South Carolina. “We always say we can’t do wellness to an employer. It’s about culture. And the people who feel that their employer takes care of them are in a curated culture. Those employers don’t just push communications from a third party with no integration and hope that it resonates.”
The current disconnect between employees keen for wellness support and employers who don’t realize how much their scattershot efforts are missing the mark is startling: The average net promoter score of most employer health initiatives is -51, Willis Tower Watson’s data found. (With NPS scores, 20 is generally considered “good” and 0 satisfactory.)
“For employers’ health and well-being programs, the goal here is to start using a different set of metrics,” said Michael Perlmutter, senior consultant and health imagination leader at Willis Tower Watson. “Think about how your employees are welcomed into your organization or encounter the wellness program. Do they have an experience they want to brag about on Glassdoor?” If not, it might be time for employers to reconsider the ROI they think they’re getting.
4. Health Care Isn’t Uber (and That’s OK)
Innovation isn’t restricted by industry, and market leaders can steal insights aplenty from the consumer space: Amazon’s customer retention obsession, Uber’s easy-to-use platform and financial incentives for higher use, USAA’s bone-deep customer relationships. In the health care space, by contrast, consumers often encounter speed bump after speed bump: difficulty finding an in-network physician, frustration trying to schedule an appointment, a waiting room experience that’s too long, provider bills that are confusing and duplicative. “We need something that’s simple and easy to use,” said Rachel Woods, of the Advisory Board.
Yet “health care is about as intimate and personal as it gets,” noted Deloitte’s Giuliani. Getting a Pap smear or having a hip joint replaced is wholly different from ordering paper towels over the internet or requesting a car ride to the airport.
“There’s a real distinction between consumers and patients,” agreed Nitin Goyal, MD, an orthopedic surgeon at the Anderson Orthopaedic Clinic, Arlington, VA, and founder of the Pulse Platform. “As a consumer, an action is driven by choice. As a patient, it’s driven by need.” He suggested the phrase “empathetic consumerism” to address that blending of both innovative, digital-first, highly personalized health tools and the compassion necessary to drive the “care” part of health care.
5. Anticipation Is the New Frontier
No news is good news, right? Not in health care, says Shaffer. “The absence of medical claims is not the absence of risk.”
Working with Rally, BCBS SC looked at the correlation of medical claims and Rally’s user reported health status for the past 18 months. One-third of people were deemed high-, medium-, or low-risk chronic (groups that typically account for two-thirds of medical expenses). Nearly two-thirds of the population were classified as non-chronic. However, almost half of the non-chronic population were categorized as healthy because they hadn’t filed a medical claim in that same period. Yet those non-spenders could surge to the top 5 percent of spenders overnight — say, when someone reluctantly gets that persistent stomach pain checked out and is diagnosed with stage 3 cancer or someone winds up in the ER with unmanaged diabetes.
With Rally’s and BlueCross BlueShield’s integrated approach, the benefits of engaging those “unknown” users — even with a single question asking them to rate their health — are significant, said Shaffer. Rally’s tools can show which unknown users might actually be higher risk, and be receptive to more targeted engagement before their conditions (and associated costs) spiral out of control.
“For years, CFOs would say: ‘You’re telling me you have this high amount of registered users, but you’re not telling me their level of medical cost risk. So, is it the jocks in the gym or is it the diabetic with heart disease that is using the Rally tool?’” says Shaffer. “This is a eureka moment, where we’re finally able to demonstrate that we’re actually reaching the people who are most at risk.”
And that greater reach can improve people’s health — and mean better cost savings for everyone.
For more on how Rally’s integrated approach can help you engage your at-risk populations, please contact firstname.lastname@example.org.