Will you stay true to your....hospital?

Via the Advisory Board, there is a new attempt to convince patients to stick with their chosen medical facility. JAMA recently published an article arguing that hospitals should institute loyalty programs for their patients. 

Here is their reasoning:

The benefits of loyalty programs, the authors argue, are two-fold: Customers benefit through the perks and rewards, and businesses benefit by strengthening relationships with patients.

The authors note that customers who feel positively toward their providers are more likely to keep coming back—and it's less expensive to retain a current patient than to market to new ones. Loyal customers also are more likely to overlook problems such as difficulty scheduling appointments, and they're more likely to tell friends about the business, the authors write.

Loyalty programs also can cut down on costs. Health care providers can partner with gyms, pharmacies, or other health organizations to provide loyalty rewards—incentivizing patients to focus on their health, which can lower the cost of care.

There is the obvious counter:

Some providers doubt the value of loyalty programs, believing that patients care more about clinical excellence than anything else. In this view, patients will wait in line, struggle to get an appointment, and endure subpar service if it means they can get great care.

But the authors argue that this "pervasive myth" overstates a "patient's ability to appreciate technical excellence," and that a combination of excellent care and quality customer service is a new way to attract and retain patients in a highly competitive market (Bird,FierceHealthcare, 3/1; McMahon Jr. et al., STAT News, 3/2; McJahon Jr. et al, Journal of the American Medical Association, 3/1).

What do you think? Would you be willing to institute a program if you were a hospital administrator? Do you think the existence of a program might influence your decision on which care provider to use?

In my own opinion, I think that the strategy might work if it's focused on the right group. In some cases, it may not be the patients themselves. It might actually be the family member(s) who have to shuttle their aging relatives to visits for chronic conditions. Since it's difficult to really judge the quality of the medical care, these additional perks may be enough to gain an extra percentage of patients.

Here is the link to the full article:  Is a Starbucks-style loyalty program right for hospitals? | The Advisory Board Daily Briefing 

Intermountain's Big Bet

The Advisory Board printed an article outlining Intermountain Healthcare. This Utah-based system is at the leading edge in many ways. They have made a bold proclamation:  they will pass on $2 billion in savings to their patients or lose money! Here is an excerpt from the article:

The 22-hospital system is guaranteeing that SelectHealth Share, its new health plan, will cap annual rate increases at about 4%—one-third to one-half lower than typical rate hikes for employer-sponsored plans.

Most health systems would have to skimp on care quality in order to provide such a deal, Abelson says. However, Intermountain stands apart because of its innovative efforts to track and analyze care quality. And many of its contracts are value-based: the system is reimbursed a fixed amount to care for about one-third of its patients, providing an extra incentive to keep patients healthy and costs low.

Intermountain says it will reduce SelectHealth Share's rate increases through $2 billion in savings over the next five years, including about $500 million in 2016.

The article goes on to quote Brent James talking about the program. Full disclosure, I have met Brent James at many conferences in the past and worked with him directly on a few projects.

Some of the tactics will have direct impact on Medtronic. I believe that we were one of the companies mentioned in this excerpt from the NY Times article:

Intermountain’s plan is “the first innovative thing we’ve seen in a long time,” said Dave Jackson, managing partner for FirstWest Benefit Solutions in Orem, Utah. “Share has got everybody at the table — everybody’s got accountability and got things to do.”

Intermountain has already saved money by renegotiating the cost of surgical staplers, pitting a cheaper manufacturer against another and saving $235,000 a year. It saved $639,000 a year by ensuring that heart attack patients get into the catheterization lab within 90 minutes of emergency room contact, thereby helping patients recover faster.

Here is the Advisory Board summary of the overall program (Ben Umansky):

Predictability is huge for employers right now. The idea of tying premium increases to something close to overall inflation is really attractive to a market that's seen health costs far outpacing the costs of other inputs. In fact, much of what employers are doing these days is predicated on a drive for predictability; take, for example, the move to defined contribution benefits: an employer who goes that direction knows exactly what it will pay no matter what happens downstream. Intermountain is responding to that same desire, but in a different way.

Select Health Share is the sort of provider-sponsored play so many systems are dreaming about, and this may be a lesson to other health systems about what they would have to offer in order to demand exclusivity. Select Health Share isn't trading on Intermountain's quality reputation alone, strong though it may be—this credible guarantee of predictable (and reasonable) cost growth is what many others aren't willing (or able) to offer.

This isn't something that happened overnight. If Intermountain hadn't spent years aligning governance, incentives, strategic planning priorities, and so many other factors across both the provider and insurer arms, they wouldn't be able to make this kind of play today.

I've always been impressed with how Intermountain designs its financial incentives to reflect and reinforce the system's strategic goals—from overall financial targets all the way down to individual incentives. It's a system that exemplifies "systemness"—everyone's in step—and that's so important for being able to offer this kind of value proposition to the market.

Here is a link to the Advisory Board article: https://www.advisory.com/daily-briefing/2016/02/19/intermountains-big-bet-pass-on-two-billion-in-savings?WT.mc_id=Email%7cDailyBriefing%20Headline%7cDBA%7cDB%7cFeb-19-2016%7cintermountain%7c%7c%7c%7c&elq_cid=348425&x_id=003C000001GLXTHIA5

Here is a link to the NY Times article quoted by the AB:   http://www.nytimes.com/2016/02/18/business/a-novel-plan-for-health-care-cutting-costs-not-raising-them.html?_r=3

Where do you find the time?

Original post:  Oct 1, 2014

We all know people who are incredibly busy. Ironically, it seems that many of those same people still find time to squeeze in another task. This article from the Advisory Board interviews a few superstars and asks them "How do you do it all?"

There were four recommendations these individuals made that the author picks out to highlight:

  

Austin: "I don’t drive on my commute. I walk and take the train. Walking (up to 6 miles per day) replaces what would otherwise be time spent at a gym or similar. During my commute, I catch up on news and, yes, some entertainment by podcast (at 2x speed—people speak too slowly). I read and take care of email on the train."

Tyler: "Do the most important things first in the day and don’t let anybody stop you. Estimate 'most important' using a zero discount rate. Don’t make exceptions. The hours from 7 to 12 are your time to build for the future before the world descends on you."

Austin: "I ignore most office and institutional politics, skip every possible meeting, and don’t pay close attention at all times in most of those I attend. (These habits can be potentially dangerous. I have some protective workarounds, which rely on the skills, interests, and good will of others. Gains from trade.)"

Tyler: "Don’t feel you have to finish a book or movie if you don’t want to."

One of the Advisory Board executive directors, Allison Shimooka, gives her top six productivity tips:

1. Know yourself and understand your role—what value do you bring to play? Focus your effort and attention there.

2. When you are asked to do something, before automatically saying yes, ask questions to scope the yes. Determine if the person asking really needs you to do it, and if so, do you need to do an A+ job or if giving 80% effort is sufficient.

3. Determine which of your own projects need to be A+, and which ones where a solid B will be fine.

4. Scope, scope, scope your role.

5. When working in partnership, or when people are asking you do things, establish a relationship of trust. That will allow you to push back, and rescope the project if necessary.

6. Never procrastinate. It never pays off.

What are your best tips?

Here is the link to the full article:  'How do you do it all?' Secrets from super-efficient people | The Advisory Board Daily Briefing

Listen up

Original post:  Jul 28, 2014

There is an old saying that we were given two ears but only one mouth. The implication is that we should listen more than we speak. According to the Wall Street Journal, most of us need to work on our listening skills. Honing this critical ability can really improve our overall performance.

The Advisory Board put together a synopsis that covers the highlights of the article:

Shellenbarger cites a 1987 study that found most people only remember 10% of what was said in a face-to-face conversation after a brief interruption.

Sadly, say researchers, our listening skills have probably only declined in the digital age. A 2006 study of college students showed they spent about 24% of their time listening to others in individual or group conversations, down from 53% in 1980.

It goes on to explain why listening is so important:

Being a good listener is important in the workplace: A 2007 study of 3,372 workers in the Academy of Management journal found that managers' listening plays a large role in employee engagement. Specifically, employees who believe their bosses are not listening to them are less likely to offer helpful suggestions and new ideas. They are also more likely to become exhausted and quit, says another study.

How can we improve? Be aware of when we "tune others out":

For instance, she writes, some people fail to listen properly because they are focused on what they want to say next, while others filter the conversation based on preconceived assumptions or expectations about the other person. Julian Treasure, an author and speaker on conscious listening, compares listening with such filters to "listening from a kind of concrete bunker."

Here are some quick tips:

Communications skills coach Barbara Miller recommends doing a "brain dump" on paper before a conversation in order to acknowledge the thoughts that could distract you from the conversation. 

If all else fails, says Treasure, remember the acronym RASA:

• Receive the information by paying attention to the person;
• Appreciate what he or she has to say;
• Summarize what the other person said back to him or her; and
• Ask questions after the conversation is over (Shellenbarger, Wall Street Journal, 7/22).

Here is a link to the original WSJ article:  http://online.wsj.com/articles/tuning-in-how-to-listen-better-1406070727

This link is to the Advisory Board summary:  WSJ: You're probably a bad listener. Here's how to be better.| The Advisory Board Daily Briefing