If you want a glimpse into the future of health care, turn on your TV.
In 1992, when cable mogul John Malone predicted a 500-channel universe, that vision of an entertainment utopia seemed like a cruel joke. Would fans even want hundreds more iterations of Cheers or Murphy Brown? And yet, today, TV may be the one part of modern life that has been significantly upgraded in terms of quality, satisfaction and ease while still delivering the basic services so many rely upon.
So, what does this have to do with health care?
Let’s start with business model design. Network TV is financed by advertising. The more people watch a particular show, the more ad revenue a network can earn. The familiar mediocrity of shows that lack sharp edges and complex storylines is a deliberate strategy to appeal to the most viewers possible.
Traditional health care is also about maximizing audience. In the “fee-for-service” model, providers are paid for the number of patients they see and the number of procedures they administer. Perversely, this incents much of what we dislike about health care, from rushed visits with doctors to generic treatments designed to address the broadest population of patients.
Now let’s look at cable TV. Cable channels like ESPN revolutionized TV by attracting viewers willing to pay a subscription to watch particular shows while earning a little extra on the side through advertisements. This has led to the 500+ channel proliferation that Malone predicted.
Health care is going through a similar business model transformation right now as it shifts from paying for volume (fee-for-service) to paying for value (quality of outcomes). Accordingly, many health care organizations are re-thinking their “programming” and their audience, focusing on targeted segments of patients with more targeted value propositions, such as the Cleveland Clinic, which has developed a focused factory for cardiac care. This kind of specialization happens in every competitive industry – it’s just new to health care.
Cable TV channels discovered that value pays. Passive TV viewers may be willing to sit through any show (and its commercials) so long as it’s free. But if a viewer is expected to actively seek out and pay for a channel, that programming had better be substantially better than whatever is available elsewhere.
Health care organizations traditionally defined value as safe, quality care for patients who are sick, injured or dying. But now many patients (and employers) are trying to address higher level needs. They might be wellness or chronic care management or convenience or concierge-level services – the answers will be as varied as the range of shows that are available to cable audiences today. Delivering value as defined by the consumer—and for narrower segments of consumers—will be key to success in the future.
Radical change in how care is delivered and paid for is inevitable. Our care will be medically advanced, convenient, timely and actively tracked. We’ll go to the hospital less, email our doctor more and monitor our wellness like we monitor our finances.
Like the TV industry two decades ago, health care is on the cusp of a major transformation. Who will become health care’s version of ESPN?