CHICAGO — Two provider CEOs sparred on Wednesday over whether the "Amazonification" of healthcare is in the industry's best interest, as they debated fixing a fractured consumer experience versus preserving its core mission.
Most healthcare spending is directed toward the sickest and most vulnerable who aren't equipped to articulate their needs or shop around for care, according to Dr. Sachin Jain, CEO of CareMore Health System, at the MedCity Invest conference in Chicago. Providers need to proactively identify a patient's needs and direct them appropriately, he said.
"Putting the responsibility on the most vulnerable isn't good," Jain said.
While proponents of new delivery models claim that they will transform healthcare, others contend customer-focused approaches may do more harm than good by leaving decisions up to consumers.
Healthcare companies have often treated the consumer experience as an afterthought. The main focus of current stakeholders is growing in size and shrinking costs by beating up competitors—they are largely not competing on consumer experience, Jain said.
Boards are constantly asking how they can get bigger when they should be asking if they can get any smaller, he said.
"They are trying to own a bigger piece of a shrinking pie," Jain said.
But Stephen Klasko, CEO of Jefferson Health, claimed that healthcare is on the verge of a consumer revolution that will have a positive ripple effect throughout the industry.
"The Star Wars technology in a Fred Flintstone system isn't going to stay," Klasko said.
The friction from consumerization stems in part from how doctors are trained, Klasko said. That is why Jefferson changed its mission statement to emphasize empathy and cultural awareness, he said.
"Doctors are selected based on their organic chemistry tests and we are amazed that they are not more empathetic and creative," Klasko said. Thomas Jefferson University's Sidney Kimmel Medical College created the Jefferson Scale of Empathy, which measures empathy in the context of educating health professionals.
Referral incentives and can also harm the patient experience. Health systems tend to refer patients to other facilities in their network even if the care isn't cheaper or more effective, research shows.
Primary care needs to move away from being a feeder system for hospitals, Jain said.
Klasko agreed, adding that systems like Jefferson should reduce their acute beds by at least 20%. He cited Jefferson's 24/7 virtual triage software that has helped guide referrals more appropriately and decreased left-without-being-seen rates from around 4% to 0.4%.
"There are 43 hospitals and five academic medical centers in Philadelphia. The chance of reaching our capacity without over-bedding is impossible," Klasko said.
A lack of data sharing has limited consumer-centric efforts. Now, insurers that get mad with providers cut off their data, Klasko said. While ownership isn't necessary, every health system should be strategically aligned with a payer, he said.
Payers and providers tend to blame each other because there is a lack of understanding, Jain said. They need to share risk and make money together, or else the conflict will persist, he said.
As these changes take place, not-for-profit systems need to be redefined, Klasko said. Bonuses and incentives should reflect improvements in life expectancy and better outcomes rather than who has the most robust service lines, he said.
"The healthcare industry is stuck in an absolute twilight zone in the volume-to-value transition," Klasko said. If an accountable care organization does too well, it can compromise certain service lines of hospitals. The incentives need to align, he said.
"We've made it too easy to say 'it can't happen in healthcare,'" Klasko said.