View From the Summit: Breaking Through the Chaos of the Consumer Hassle Map

Senior healthcare leaders convened in Chicago Thursday at the fourth annual Oliver Wyman Health Innovation Summit to explore “The Consumer Imperative: Transforming Healthcare from the Outside In.” Here’s a recap of Thursday’s Main Stage Sessions:

Terry Stone, the Global Managing Partner of Oliver Wyman’s Health & Life Sciences Practice, opened the Summit by looking back on what’s transpired since the inaugural Summit four years ago, and she admitted the progress to Market 2.0 has been more incremental than many would like. “Back in 2012, things were very different: We had just started ACOs, big bets were being made on value, and whole-genome sequencing cost $10,000. Then the ACA launched, and we realized our first foray into creating a consumer market didn’t start out very well.”

Now, Terry contends, we’re at a point where we’re going to see a business-model shake-up. “A lot of the plans that were in the ACA are pulling out because it’s not sustainable The big guns are coming into the game, and the legacy players are figuring out what business model will work. In 2016, there are going to be a handful of big winners and also some also-rans,” she said.

So why “The Consumer Imperative” as theme for the conference? “Because we haven’t yet broken through the chaos of the consumer hassle map,” she explained. Gaining a better understanding of and serving the needs of consumers (and then doing it faster and smarter than competitors) has to be the focus of any organization looking to succeed in today’s landscape. “It’s achievable,” promised Terry. “We just have to take a different lens.”

Sam Glick, a Partner at Oliver Wyman and Co-Director of the OWHIC Leaders Alliance, delivered a powerful talk on what the consumer imperative actually means. “The consumer imperative is not just the theme of the conference, it’s the whole ballgame. This is it,” he said.

He acknowledged that people have a right to feel skeptical, as “we’ve been talking about consumer revolutions here in healthcare for a very long time.” So what’s different now? This year, Sam explained, the legal definition of a high-deductible plan and an average plan deductible crossed lines. “For the first time in history, a typically commercially insured person paid all of his or her own healthcare costs. We’ve changed the basis of competition.”

Consumers are no longer choosing where to spend someone else’s healthcare dollars; they’re choosing whether to get healthcare or buy new tires or re-up their cell phone plan. “The old way of winning was to be the tallest guy in healthcare; now, you have to compete with everything people are spending their money on. The whole marketplace has changed.”

Sam went on to show how the consumer imperative is also a demand imperative (“We have to get out of the mentality that thinks ‘I’m going to do best job I can at what I do’ and instead get into mentality of ‘my job is to make a seamless experience for every consumer I touch”); an innovation imperative (we need to get more personal; “we could save $500+ billion a year simply by engaging people in healthcare the way the average retailer would”); a supply imperative (“Six out of 10 healthcare employees are burned out”); and a moral imperative (“50% of Americans can’t find the money to pay for an unexpected $2K in medical expenses in 30 days”).

Kyra Bobinet, MD, MPH, is the founder and CEO of engagedIN. She discussed brain science and how it influences individuals’ behavior in her talk “Getting the Horse to Drink: The Science of Changing Consumer Behavior.” She described the difference between fast brain and slow brain design, and explained self-awareness as the act of watching an initial design fail, and then doing something about it.

Understanding brain science and how it relates to consumer behavior is the key to consumer engagement; and empowering individuals with the knowledge and tools they need to manage their experience is only way to achieve lasting impact, she said. “If we can turn everybody into a designer of the process, instead of a person living the process, then we have persistence, resilience, evergreen behavior change.”

The session “From Insight to Impact: Making Engagement Make Business Sense” featured panelists Kent Bradley, MD, Strategic Advisor, Frame Health; Gary Foster, PhD, Chief Scientific Officer, Weight Watchers International; Tom Spann, Co-Founder, Vice Chairman, and COO, Accolade; and Alexandra Drane, Co-Founder and Chairman of Board, Eliza Corporation, as moderator. The discussion explored the current state of affairs and how these innovative companies are leading the way in understanding and engaging with consumers.

Kent Bradley offered a sobering statistic: Two-thirds of providers said they couldn’t provide individualized care because they felt they didn’t understand the individual. “We’ve lost the ability to effectively communicate with our patients because the structure—how we have designed the patient experience--doesn’t allow for it.”

Tom Spann talked about the importance of listening to what consumers want: “They want to be treated like people; they want us to make it about them and make healthcare easy to access.” Doing that delivers real value, and savings.

Throughout the discussion, panellists emphasized that health companies need to get to know consumers and apply solutions that are contextually relevant to each individual.  Only when interventions are relevant in and to a person’s life—not just their medical needs or their once-a-year touch points with the health system—will engagement efforts succeed.

In the afternoon, Roy Rosin, Chief Innovation Officer at Penn Medicine, took to the Main Stage to discuss “The Innovation Agenda: Design, Validate, Iterate.” He drew from his experience outside of healthcare, including his tenure as VP of Innovation for Intuit, to discuss how organizations must embrace a culture of innovation.

In the Main Stage session, “A Road Test for Collaboration: Let the Consumers Drive,” Niyum Gandhi, EVP and Chief Population Health Officer for Mount Sinai Health System, and Mario Schlosser, Co-Founder and CEO of Oscar, shared what it takes to design a collaborative partnership focused on making a better patient experience.

“Everything from step 1 was co-designed, including price point,” Gandhi said. “Often [these are approached as] ‘the provider’s job is this, the payer’s job is this.’ But when you start there, you miss the engagement of everything in the middle.”

Conversely, for a collaborative partnership like Mount Sinai and Oscar: “If you get into the same room, there’s a lot of excitement to be able to cut through what we wouldn’t be able to cut through if we were by ourselves,” Mario said.

In this partnership, both sides knew that the traditional payer-provider model wouldn’t work. “Traditionally you split the pie, but the realization that should be clear to all providers moving at all toward risk is these curated network products don’t work in FFS. We tried that 20 years ago, we failed. That is why ‘HMO’ is a dirty word in a lot of markets. We had to architect a financial model that worked for both organizations.”

In the panel discussion “The Board as a Consumer Advocate: Partnering with the CEO to Drive Change,” Mark Ganz, President and CEO of Cambia Health Solutions, Mack Hogans, Chair of Cambia’s Board of Directors,  and Paula Jones, Cambia Board Member, discussed how a CEO and Board can work collaboratively to push an organization toward transformation. That is not to say, however, that such a process is walk in the park: Mark did describe the Cambia Board meetings as a “full-contact sport, carving on ideas together.”

He also gave the Cambia Board credit for being receptive to Cambia leadership bringing “half-baked ideas” to the floor. “We need their thoughts and expertise to help inform decisions.”

Mack and Mark both stressed the importance of having open dialogue between the CEO and Chair. “You have to work at it. You start with no surprises and openness. Talk early, inform and learn. There’s a value in having that accountability and relationship,” Mark said.

Mack and Paula both stated that their commitment to the Board has, over time, become personal, as they are deeply committed to the Cambia mission. “The reason I was initially attracted to cambia is not the reason why I’m on it today,” Maci said. When I first had the opportunity to come on this board, a lot of that was about professional development for me. But over time, in seeing where the company was going and being a part of that, it’s very personal and I have an emotional connection to the cause of this company.”

For the last session of the afternoon, Justin Kao, Co-Founder and SVP Corporate Development of Helix, discussed personal genomics and how whole genome sequencing can be used to empower consumers.

“Millions of people will be sequenced in the next few years – I don’t think there’s any turning back. So the question is how can we drive forward the best way for people to use it, rather than sitting in some medical record or some researcher’s lab, and that person never being able to tap into the power of their own genome?”

With all the press coverage of genomics recently, Kao believes the concept has entered the consumer consciousness; but it has not yet broken into the mainstream and continues to be a niche application. Why? Genomics has not traditionally been integrated into products and services consumers actually use,” he explained. “We have tremendous responsibility and we have to think a lot about what the consumer wants.”

At Helix, he said, they spend an inordinate amount of time on customer design. And what they’ve learned is that despite concerns people won’t want their personal genomic information stored in the cloud, people are actually OK with that; they just want transparency and control. “They want to know they’re in control of how their data is being used. Ninety percent of people said they should be in control of who has access to my data. They simply want to be in control and communicated to in a respectful way.”

In the Dinner Keynote address, Farzad Mostashari, MD, ScM, Founder and CEO of Aledade, entertained and informed in a talk that covered everything from the worst night in his life to his current role helping independent primary care physicians join ACOs.

He shared how, when his mother was in the hospital suffering complications from what should have been a routine surgery, he felt abandoned by the system. A physician by training, he felt the disempowerment that comes with being on the other side of the medical chart, as a consumer in today’s system. “When you’re the patient’s son, how does it feel to go ask to see the chart?” he asked.

He relayed how the system’s incentives thwart efforts at reform. “Did the hospital lose money because she had complications, or did they make more money because she had complications?” he asked of his mother’s hospital stay.  “That’s indecent. It perpetuates the failures of the system, because the CEO and chair of the board are not going to say we need to fix this until the economics of the system are changed.”

He also talked about his time serving as head of the Office of the National Coordinator for Health Information Technology, and his regret over the Meaningful Use program that could have been. As originally designed, the program tied data collection very closely to outcomes. Industry opposition resulted in backing off of outcomes. As a result: “Instead of making music on the piano, it was practicing your scales. We’ll monitor America’s doctors to make sure they practice their scales,” he said.

“And so we get compliance. That can’t be what drives change. Compliance can never be what drives change. We have to be going to something.”