Hoangmai Pham, MD, MPH is vice president for Provider Alignment Solutions for Anthem, Inc.
It's time for curated, customer-centric thinking to come to healthcare, writes healthcare industry executives.
This article was co-authored by Jeff Micklos, executive director, Health Care Transformation Task Force.
Insurers and employers have long acted on the belief that all consumers really want is choice, along with large amounts of information to help them make informed choices.
That same type of thinking led retailers to expand their big box stores, and left shoppers to determine and seek out their favorite products. It led cable TV providers to add channel upon channel of programming until many Americans had hundreds of channels to choose from with an absurd number of game shows, soap operas, sports and news programs at any hour.
We are now in a marketplace being disrupted and even led by customized solutions. Some of the country’s largest and fastest growing companies offer on-demand content or goods ranging from clothing to meals—all based on location, age, gender, past purchases, and preferences. And they deliver those items at lightning speed straight to our doorsteps.
It’s time for that kind of curated, customer-centric thinking to come to healthcare.
The first step is to identify and tailor networks of doctors and hospitals that evidence tells us are the cream of the crop. Just as others use what consumers share about themselves to customize what they offer us, insurers like Anthem Blue Cross and Blue Shield have the advantage of extensive and sophisticated data that tell us precisely who the high-performing doctors and hospitals are, which of them is improving over time, and how they compare across metrics or within specialties.
Anthem then works with those providers to create a custom experience that meets its customer’s needs, with digital solutions, navigation and transparency tools, and cost savings without sacrificing quality.
Rather than throw all of that information at consumers and collect premiums that reflect the cost of unlimited choice, Anthem is going to offer a better way: networks in major cities around the country that are made up of high performing, efficient doctors and hospitals with tools that help guide customers to a provider that is a personalized match for them based on their needs and preferences.
Choosing a health plan that is built around a high-performance network saves employers and consumers both time and money, while also ensuring that customers are truly seeing the best doctor for them, or receiving care at the best hospital their community has to offer.
This won’t be a short-lived experiment, but a pivot for the industry as a whole — one that builds on what’s been happening over the last decade. We believe that networks built around high-performing providers can reignite informed consumerism in health care and fuel the transition to a healthcare system focused on delivering value.
Anthem will begin offering high performance networks to its customers across the country next year. Many large employers have asked for this type of product directly, and Anthem will deliver. Many others should follow suit.
Anthem’s efforts are in line with the approach encouraged by the Health Care Transformation Task Force (HCTTF), an industry consortium of purchasers, payers, providers and consumers dedicated to accelerating the pace of transformation to value-based payment models. HCTTF members believe that high-performing networks are essential to delivering effective value care that reduces cost, improves outcomes, and drives better population health. As a member of HCTTF, Anthem’s initiative is an example of dedicated organizations that are taking on the challenging work of improving the delivery of healthcare.
Anthem remains committed to supporting and empowering all hospitals and doctors to improve their own quality and cost performance and to adopt value-based care models that will land them in the same sphere as their high-performing counterparts. In this way, Anthem will be a transformative leader in changing our nation’s healthcare system to one that truly puts people first.