A CEO’s Guide To Group Health 2.0

While many new healthcare technologies show great promise, few have been made widely available. CEOs have a population right in their backyard, the collective health of which they want to continually improve. What can you do to improve your employees’ well-being right now?

It’s my argument that group care — let’s define that as cohorts of 5 to 5,000+ individuals — is presently the de facto locus of innovation: forward-thinking businesses who invest in culture and retention that together represent enough buying power to accelerate our current system’s evolution.

Large-scale hospital networks aren’t where change will originate, nor is the individual a viable path to systematic upgrades. It is, instead, you and your organization who are most likely to move things forward near-term.

Here’s a quick layman’s overview of which companies are changing the way your company accesses care. These are the ones to watch, and try.

Offline Data

The first and foremost problem in group healthcare today is the online/offline divide, which we’ve yet to consistently bridge.

Data standards, data commons and data sharing are staggeringly behind the times. The digital divide is nowhere more obvious than in healthcare. Simply ingesting, normalizing, decorating and storing basic data in a modern way is a challenge.

CrossChx, a Columbus, Ohio-based startup, is helping to solve our medical identity crisis using biometric fingerprint scanners that not only verify (and in so doing help de-dupe) patient identities, but also retrieve medical records and benefit information on-the-fly, which enables a host of exciting applications to be built on top.

Imagine the modern social web without OAuth. Hospitals are leading the charge here, but I believe you’ll see biometrics cross over into the enterprise soon.

A company out of Spokane, Washington called NextIT is using advanced AI technology to streamline medical billing and insurance claims processing, another one of our most recalcitrant problems.

It takes courage to be an early adopter in healthcare.

Expect to see more and more smart, proactive experiences replacing everything from antiquated policy lookups to even care itself, given the extreme doctor and nurse shortage we’re currently experiencing.

Wellness Data

Especially if you’re in the midst of a talent war, have you ever stopped to think of health and wellness as a differentiator, not just a box to check?

Employees demonstrably value benefits that are not only affordable and comprehensive but also accessible, and they value knowing their employers are looking out for their health.

In fact, rethinking the way you access benefits on a system-wide level is an incredible opportunity to improve the health of yourself, your employees and their families over the long term. Each of these individuals costs employers a lot of money in salary alone.

Why are we not more aggressively investing in their ongoing productivity? New companies like Oscar (next-gen group health insurance), Zenefits (a tremendous “broker in the cloud” for all manner of benefits) and Stride (benefits for freelancers) are proving that everything measured improves, reducing population risk and changing underwriting forever.

Lip service about innovation too often goes unimplemented in practice.

Health and dental insurance has seen little innovation since the dramatic expansion of employer-sponsored coverage following World War II, yet things are beginning to change there too, thanks to these new plans and platforms. The goal, as always, is to get better care more affordably, largely by taking a preventative stance. Keeping people well instead of waiting around for them to get ill is best for everyone.

American Well is an example of a company making it possible — finally — to speak with a doctor 24/7. American Well isn’t a payer, but it works with a variety of companies to change the cost structure of healthcare forever.

Wasted Data

Another systematic data problem in healthcare is that we just don’t value the data we do have, at both the individual and the organizational level. Today, we can manage our individual and collective health the way we manage our wealth, yet apathy reigns supreme.

Would you ever give or even throw away your CRM (Salesforce) data? Your systems log data (Splunk)?

In today’s competitive business environment, that would be sinful. So why do we cease to care when it comes to the health and wellness of the people who, ultimately, are your product?

A more engaged and proactive relationship with our health is, of course, necessary for any real change. Every day we vote with our time and our money about how we want the healthcare system to be. The ACA and its exchange have certainly forced us to be more considerate. Still, lip service about innovation too often goes unimplemented in practice.

High-fliers Evolent (population health) and Castlight (cost transparency) help companies design and implement programs that are as unique as they are.

Absent Data

The last problem is that we’re not collecting nearly enough data in the first place. Many of the answers we need are all around us.

Imagine, for example, using the data that wearables and other connected devices provide to design company-wide wellness plans that guide individual employees to action.

Imagine forming new habits tailored to your particular needs, while maintaining a broader familial or organizational context that further motivates and incentivizes participation.

Companies like Jiff (enterprise health benefits), Human API (connected devices), BaseHealth (genomics) and Theranos (lab testing) are making health and wellness data gathering cheaper and more computable for companies of all sizes, and they’re just the tip of a much bigger iceberg.

Even Fitbit (activity monitoring) dove headfirst into this area. Their awesome corporate wellness program can be found here.

It’s All About Better Data

The theme running through everything I highlighted above is that the ways in which we leverage data to deliver care remain antiquated.

The fundamental systems of record for healthcare require a considerable upgrade. The adoption of more pragmatic “right now” solutions to healthcare’s systemic issues are an essential first step.

The above technologies ultimately target antiquated pillars of our healthcare system. They address, in many cases, our weakest links. No amount of forging ahead matters without the gritty work of elevating our least common denominators.

Most healthcare problems these days are actually data problems.

In fact, behind almost every big healthcare success of late is an unsexy-as-hell plumbing job, centered around data. Most healthcare problems these days are actually data problems, and the successful companies addressing them all leverage data in a novel way. Smarter data is the clear through-line of all these efforts.

Inside each company and each household are day-to-day inefficiencies that chip away at our ability to perform at our best. We put on the blinders, cross our fingers, press snooze. We like to believe that we’re both literally and figuratively covered, if and until we’re not.

Conclusions

Corporations are a key proving ground for real innovation in healthcare because, for better or worse, our system in the U.S. begins and ends with billing, and I’d sooner bet on payers than EMR companies.

In conclusion, I’ll leave you with a broader call-to-action. If you control a P&L or steward a population, get off the sidelines and get into the game.

This article is peppered with links to companies who represent fundamentally new lines of thought that merit your strategic consideration. Each of them is ready to engage right now.

It takes courage to be an early adopter in healthcare; I get it. But right now we need customers, not concepts. We need organizations that live and breathe online, properly value their data and are interested in learning, measuring and improving continually.