Never before in the history of U.S. health care has there been so much competition for market share. In the past, traditional delivery was widely focused on particular geographic areas. This limited patient’s options to the providers nearest to them.
Now, however, patients have access to online telehealth and other wellness resources. Online retailers, who are new to the health care industry, are capitalizing on this consumer trend. We’re all aware that disruption and innovation has the potential to improve service delivery and patient care. However, the reality is that these new kids on the block are threatening the market share of established health systems.
That leaves the industry to ponder. What will it take for health care providers like IDNs, primary care clinics, and hospitals to survive the storm of disruptors?
Challenge 1: Disruption from all angles
What makes this challenging for long-standing medical systems and hospitals is that these interferences come from so many different sources. As a result, traditional models of care are trying to put out multiple fires just to stay in the black.
Consumers of health care are used to immediate service in everything from one hour grocery delivery to on-demand streaming services. This expectation of instant gratification especially among millennials means that convenience in health care matters more than almost anything else. In fact, around 80 percent of patients admit that they choose providers based primarily on convenience.
In addition, patients with barriers related to the social determinants of health often require better care coordination and accessibility of services. These economic, geographic and social factors can prevent patients from receiving care. As such, they are predisposed to look for the most readily available forms of medical services.
Large employers and online retailers
The shift in patient mindset has opened up opportunities for businesses outside of the industry to jump into the market. This trend will only continue to grow as more and more health care consumers demand convenience and immediate access to services.
However, many of these competitors don’t have long term experience in health care. But they do have an edge when it comes to consumer-centric products and services. Consumers themselves believe this. As many as 47 percent of patients would be willing to receive medical services from tech giants like Microsoft and Google.
In addition, large employers like Amazon are partnering with experienced health care and financial professionals. This is in an effort to improve employee health care and decrease cost. It’s no secret that Amazon is driven by consumer obsession, making them a formidable disruptor in patient centric care.
Traditional high cost business models in health systems
CMS, the largest payer in the U.S., is pushing value-based care. However, health systems as a whole are traditionally designed to operate on a fee-for-service model.
Relying primarily on hospital admissions, health systems are grappling with losses in revenue. Patients are encouraged to seek less costly methods of care. And even though ERs are still a significant source of revenue, certain populations strain medical resources.
To complicate matters, health systems now have to compete with both traditional and new models of care. These competitors include pharmacies inside CVS or Walgreens who offer on-demand access to clinicians.
As these disruptors jockey for market position, health systems need a multi-faceted approach to acquiring and retaining patients. By increasing staff efficiency, and welcoming innovation, medical companies can improve patient-centered care. In addition, health systems need to be prioritizing patient privacy and data security to leverage long term growth.
Challenge 2: Low patient engagement decreasing the bottom line of health systems
In the midst of all the disruption happening in health care, IDNs and hospitals are facing other financial strains. CFOs are tasked with retaining revenue while also committing to more value-based care contracts. As we’ve seen, the traditional fee-for-service model is now discouraged by many payers and health plans.
Payers such as Medicaid don’t want to simply see the services rendered. They also want proof that patient outcomes are tied to those programs. However, the fragmentation present in health care has resulted in passive patients and therefore poorer outcomes. This may be why nearly 60 percent of CFOs rank consumer engagement as the top priority. Engagement ranks higher over other risks like cybersecurity and value-based care.
Yet many health organizations aren’t fully prepared to engage patients. Hospitals rely on referral systems from specialists for pre- or post-op. The result is a system that’s flooded with patient needs. But the system lacks resources to engage patients for long term patient reported outcomes.
Health care needs a solution that engages customers. And that helps medical establishments take advantage of their strengths in order to offset the competitive disruptors.
What health systems need to scale patient engagement
What’s needed are low cost, scalable solutions. Health care disruptors leverage convenient access. One of the best ways to retain market share and acquire new patients is through a “digital front door.” Hospital systems can then monetize on the back end with profitable services and hospital referrals.
Launching value-based care and effective patient engagement
This need is why Melon developed a digital engagement platform. We believe patient engagement helps traditional medical systems innovate and improve value based services while helping clinicians be more effective. Over the last six years we’ve served over thousands of patients and seen significant results.
Partners such as Midlands Pinnacle health network are seeing excellent results from integrating Melon into their long term conditions program. A recent study of prediabetic patients showed nearly 80 percent no longer pre-diabetic after participation in Melon’s 16 week program.
As chronic diseases continue to erode revenue streams of hospital systems, Melon’s platform is uniquely situated to help prevent financial losses. We help patients manage and improve the most costly diseases facing the U.S. population. These include obesity, diabetes, cardiovascular disease and mental illness.
There are an estimated 84 million people in the U.S. who have pre-diabetes many of whom will develop type 2 diabetes in the next five years. Around 40 percent of these people, however, want to change but simply don’t know how. Melon is positioned to help health systems reach these populations. We know how to engage and activate patients within a scalable model.
Offsetting the disruptors
We help keep patients inside the existing medical community. We achieve this by augmenting their care with our three-pronged model—peer support, education and health coaching and ultimately whole person care.
Melon Health provides a low cost, scalable solution to health plans looking to deploy patient engagement through provider network channels. And to health systems looking to respond to disruptors of referral flow. Our system is proven to defray expenses and improve patient retention.
Learn how by downloading our guide to Scalable Supported Self Management below.