I have written about healthcare reform
implications before but wanted to add some additional thoughts to ponder.
More on Local Medical Tourism
Ever since traveling overseas to consult on medical tourism, I have had
this notion that medical tourism does happen and could happen on a larger
scale in the U.S.
So when Lowe’s home improvement announced that all of their cardiac
surgery for employees would go to the Cleveland Clinic, it made me pause.
Living just miles from Lowe’s HQ and surrounded by very good major medical
centers; it had to send a shock wave locally to these hospitals. Lowe’s
realizes that while the initial cost may be higher (or not), they are
paying for the quality that the Clinic has and betting that overall costs
(fueled typically by possible readmissions, etc.) will be lower because
their employees will be taken care of right the first time.
This certainly changes the complexion of marketing. And it calls more for
figuring out how to leverage word of mouth and patient stories in the
offline and online world. And no doubt in the future these decisions to
use distant providers will not only be fueled by quality metrics but also
on metrics surrounding the healthcare experience and much more than just
HCAHPS.
As an aside, critical access hospitals that have pretty much catered to
the indigent and uninsured will now face new challenges. As those people
become insured and have choice, will they make decisions to travel
somewhere else? It makes one think that marketing for critical access
hospitals will ramp up and patient experience will play an even bigger
role.
Owning The Continuum
As healthcare reform is interpreted and rolled out one of the things that
the industry is grappling with is this notion of accountable care
organizations. It has been better defined in the hospital sector and would
include multiple providers and physicians being responsible for the health
of a population and being paid as one, a bundled payment. My first
reaction to that was how would you actually coordinate this and cooperate
to get it done. I further surmised that one way to do that would be
through more mergers and acquisitions so that fewer providers would own
more of the services and in essence create their own accountable care
organization. That decreases competition and eases the whole discussion of
how to divide payments.
I further have blogged
that long term care needs to think about their own interpretation of the
accountable care organization. It could include home health, adult medical
day, DME, continuing care, assisted living and nursing homes, and hospice.
The whole continuum of aging could therefore be one accountable care
organization that is paid for the care of a given population outside of
the hospital/physician relationship.
So then what happens? Gentiva Health Services pays $1 billion to buy
Odyssey Healthcare essentially now owning the home health and hospice
piece of the continuum.
By controlling more of
the continuum of care, organizations will be prepared for the implications
of healthcare reform and they will be assuring the filling of their
pipeline as people progress from one level of care to another. That in
part is why Gentiva made this move. At the same time, the consistency of
the brand experience over time will help develop loyalists and ambassadors
for organizations that will continue to fill the pipeline for years to
come.
So while I firmly believe
in competition, smart organizations are going to start owning more of the
continuum. That will have implications on marketing. How do you merge
cultures? What about your own career? How will it evolve and change?
Questions to ponder.
Tax Exemption
Finally, the whole arena
of community benefit and tax exemption has to come into play. If much of
your exemption is based on providing care to the uninsured and that goes
away then what? The nature of Foundations might also change too in this
environment.
So put on
your thinking caps folks and start looking at the long-term implications
not just for your organizations but also for YOU!
