The health care industry is poised for disruption. Consumers are savvier and more demanding than ever. And services and spending extend across a more diverse set of web-based applications, channels and digital tools.
Now, with economics related to COVID-19, the market is even less forgiving of any misalignment with local market demand. Buyers and investors are rewarding those who can offer ease, convenience and quality at a lower price point.
This level of disruption is upending delivery models and local value chains on a vast scale. Organizations are working hard to stay well-positioned and secure their relevance in the face of rising competition in several ways.
The first comes from alliances, joint ventures or M&A activity among traditional health companies. M&A activity is high across all health sectors, with 483 deals announced in the first half of 2020.1
These collaborators are betting that their combined assets and capabilities can better meet shifting consumer demands and offer more specialized clinical and care management programs.
At the same time, nontraditional players are making significant inroads into the health market. These include start-ups backed by private equity investments and well-funded consumer organizations.
This group is typically more adept at consumer segmentation, digital enablement and marketing. They are well aware of the market opportunity created by the inefficiencies or limitations of traditional health organizations. Many already have the geographic footprint, digital capabilities and consumer data to successfully peel away some share of the health care dollar.
As health care moves further away from the inpatient environment, health systems see their ability to control the consumer relationship diminish.
In the past, consumers were loyal to one primary care physician who was their conduit to the rest of the system. But now, health care happens wherever the consumer wants it: in their home, at a retail location, via telehealth or through remote monitoring.
Today, to own the customer experience — and the rich data that accompanies it — means having a digital front door. It means connecting consumers to lower-cost, high-value services they desire.
The digital front door
The digital front door is an integrated, mobile platform that serves as the gateway to services. It is built around customer profiles and accounts. Here, consumers can view their clinical and claim information and access the tools and information that guide their health decisions. These tools can include:
- Navigation and concierge services — Consumers want help finding the best services for the lowest cost. A digital front door can guide them to the most appropriate care channel. It can also help them navigate the multiple services associated with a more complex procedure or health event. This support for navigation ensures consumers effectively engage the entire ecosystem.
- Online scheduling — Automated phone systems are often frustrating for consumers. Online scheduling eliminates the need to call for an appointment and puts consumers in control of their schedule. To be even more competitive, offer schedules that go beyond traditional office hours.
- Prior authorization and upfront cost estimation — A digital front door can:
- Facilitate prior authorization
- Confirm a consumer’s financial obligation
- Put consumers in control of their financial health
With roughly 137 million adults experiencing financial hardship due to medical expense, enabling early understanding of financial exposure and easy access to lower-cost digital services is a distinguishing advantage.2
- Telehealth — Consumers are embracing telehealth. The number of virtual visits has skyrocketed during the pandemic and is predicted to hit 1 billion by the end of 2020.3 So far, many of these visits have been for minor and routine appointments. What remains to be seen is how to integrate these more broadly into the health experience. Providers can explore pairing virtual visits with in-person visits to increase engagement and lower costs.
- Remote health and monitoring tools — 94% of consumers who tried telehealth during COVID-19 expressed interest in other forms of virtual care.4 They prefer to stay well on their own, heal at home and age in place. Wearable devices that track health metrics like blood pressure, heart rate, weight, glucose levels, etc., continue to grow in popularity. These tools can regularly collect data for health organizations and allow consumers to stay well or manage conditions remotely.
- Outreach and disease management — Preventive measures intercept disease when it’s most treatable and when those treatments are most affordable. A digital front door can leverage predictive analytics and population health strategies to reach out to consumers before their health deteriorates.
Each of these digital offerings on its own offers value to consumers. But what's truly transformative is how the whole is greater than the sum of its parts.
Taken together, the components reimagine an individual’s experience of their personal health journey. They create a new kind of relationship with the providers that guide and support them seamlessly, whether in-person or virtually.
A successful digital front door gives consumers confidence that their unique wants and preferences — as well as their health needs — are anticipated, understood and addressed.
It empowers them with meaningful information to take ownership of their health decisions. And it establishes the provider as a trusted, expert partner dedicated to improving their health while protecting and preserving their data and privacy.
To deliver differentiated, lasting value, traditional health organizations need to disrupt their own outdated modes of engagement. A commitment and ongoing growth and innovation mindset is also key. This means re-envisioning their relationships with consumers and conducting:
- A rigorous self-assessment
- An inventory of their current digital capabilities
- An evaluation of their partnerships
A large-scale shift to digital requires significant investment, and traditional organizations must consider whether to build, buy or rely on partners to achieve it. The current innovation cycle has accelerated the demand for a digital front door. Those wishing to remain competitive must determine their path and move forward or be left behind.
1. PricewaterhouseCoopers. Health services deals insights: Midyear 2020. Accessed December 2, 2020.
2. CNBC. American Cancer Society says high health costs cause financial strain for more than 130 million US adults. Accessed November 20, 2020.
3. Marr B. The 5 biggest healthcare trends in 2021 everyone should be ready for today. Forbes. Published November 23, 2020. Accessed December 2, 2020.
4. Henooz AM. Telehealth is working for patients. But what about doctors? Harvard Business Review. Published November 13, 2020. Accessed November 20, 2020.