Corporate Behemoths in Healthcare: Will the Patient Win?

The past several weeks have been abuzz with the mergers and acquisitions in the healthcare arena. CVS has purchased Aetna for a cool 69 billion dollars and went through the regulatory process with flying colors. Amazon (on their quest for world domination) has teamed up with Warren Buffett, CEO of Berkshire Hathaway and financial powerhouse J.P. Morgan to use their resources, influence and power to, according to Buffett, “tackle healthcare costs in our nation.” Buffet also said that because the U.S., at 18% of our gross domestic product, the U.S. is at a competitive disadvantage, at 3.3 trillion dollars annually. He believes the private sector can handle healthcare better than the government.

Albertson’s, a grocery company, is ready to acquire retail pharmacy giant Rite Aid. And now, Cigna, the insurance behemoth, is buying Express Scripts in a deal for upwards of 50 billion. Software giant Apple is dipping their toe into employee health, while things are starting to rumble at Wal-Mart, the retail monster.

After all of that information, you need a breather. But will a disruption by these companies be the thing that makes healthcare better in the U.S.?

Yet, as a patient advocate and caregiver supporter, my main concern is this: Will all of this be a win for patients, caregivers and families? You know – the healthcare customers?

While the shake-up in healthcare is oh-so-long overdue, is the combination of behemoths the right way?

First, this healthcare shake-up won’t be the last of the behemoths to combine. I would be willing to bet on that. We have yet to hear from the likes of Microsoft, Walgreens, Google or any of the Generals (Electric, Motors, Mills). What about other insurers? Where is Humana or United Healthcare in this game?

Many companies will follow suit. It’s just a matter of time. I liken it to the most popular girl in high school getting into a relationship with the most popular boy and becoming a force to be reckoned with. Everyone will see the trend, its benefits and potential, and jump into it. Sorry for the high school analogy.

The point is everyone sees that it is time for change in healthcare.

So what’s in it for patients/customers?

Something we must question is this: Are these corporations in it for the billions of dollars that healthcare is worth or do they really want better conditions, cost and efficiency for patients? Will the combination of all these behemoths reach past their employees and meet the needs of all patients in our nation? What are their motives?

My mission is to empower patients and caregivers to navigate healthcare confidently and correctly, to save them and all parties involved time, money and frustration. I show them that they have rights and responsibilities in their Healthcare journey and must take a strong and active role in their care. Patients are the lifeblood of the healthcare system.

None of these behemoth combinations will be successful without patient/customer buy-in. They’d better put all of their goals into a nice and helpful package for patients so they feel supported and empowered. If these corporations can show how the patient will be helped and how their alliances can save money for all parties involved, they should have no trouble in the regulatory processes they face.

But I implore all of you behemoths… DO SOMETHING.

Do something for the 64% of Americans who avoid getting care because they are afraid of the costs.

Do something for the working poor who make too much for Medicaid and not enough to afford skyrocketing healthcare premiums.

Do something that shows how healthcare can actually be affordable and where service prices do not have to be excessive.

Do something to empower patients and establish real healthcare cost transparency.

Do something about actual care and system processes to show that it doesn’t have to be as difficult or time-consuming as it is currently.

You behemoths have the power to change healthcare for the better for the foreseeable future and possibly, forever. Please don’t look down from your Ivory Towers upon us mere mortals and pity us or hope for the best. Do something.

Make it a win for patients, and we all will win.

Healthcare Cost Savings – Health Facts and Figures Part 1

Healthy lifestyles can go a long way toward solving today’s healthcare crisis. These facts and figures give some clues as to where we can make some changes to prevent disease and cut healthcare costs.

One Dollar Saves Three

The federal government doesn’t keep track of statistics on how wellness programs can impact healthcare costs but some businesses have found that promoting wellness reaps handsome rewards. According to the Wellness Councils of America, a non-profit group that promotes healthy lifestyles, companies can save three dollars on healthcare expenses for every dollar they spend on wellness programs that teach employees to lead healthier lives.
Source: Wellness Councils of America

Lifestyle Could Reduce Diabetes by 87 Percent

The combination of losing weight, moving more, cutting out trans-fats, saturated fats and excessive alcohol, and eating more fiber could reduce the incidence of type 2 diabetes by a staggering 87 percent. A modest 5-percent weight loss can lower risk significantly. The incidence of type 2 diabetes increased by 60 percent in the United States between 1990 and 2001. Treatment for diabetes and its complications consumes 10 percent of America’s healthcare dollars.
Sources: British Journal of Nutrition and American Diabetes Association

The Aerobic Cure

Aerobic exercise alone cured metabolic syndrome (sometimes called syndrome X) in 30 percent of people in the HERITAGE Family Study in Canada. The syndrome is a combination of elevated blood pressure, blood glucose, triglycerides, cholesterol and high waist circumference that significantly raises the risks of diabetes and heart disease. People in the study rode a stationary bike three times per week for twenty weeks.
Source: Medicine and Science in Sports and Exercise

The Obesity-Cancer Link

Researchers have found 37 percent more cancer among obese women and 25 percent more among obese men, compared to people of healthy weight. Death rates for all cancers are 62 percent higher among obese women and 52 percent higher among obese men. Among obese women, risks for specific cancers increase as follows: breast 150 percent; uterine 200 to 400 percent; kidney 200 to 400 percent; pancreatic 200 percent; and colon 46 percent.
Source: Mayo Clinic Women’s HealthSource

Weight Gain Explained

Americans’ per capita daily calorie consumption increased by roughly 300 calories per person between 1985 and 2000. Grains (mainly refined grains) accounted for 46 percent of the increase, added fats for 24 percent, added sugars for 23 percent, and fruits and vegetables for 8 percent, while meat and dairy consumption declined by 1 percent.
Source: American Heart Association

Multivitamins Could Cut Medicare Costs

Medicare could save at least 1.6 billion dollars in the next five years by providing multivitamins to people over the age of 65. Cost savings would result primarily from fewer admissions to hospitals and nursing homes as a result of heart disease and infections such as pneumonia.
Source: Multivitamins and Public Health: Exploring the Evidence Conference

Calcium and Folic Acid Could Save 15 Billion Dollars

A study commissioned by the Dietary Supplement Education Alliance shows that the use of daily calcium supplements could prevent 734,000 hip fractures annually, saving 13.9 billion dollars in healthcare costs. Daily use of folic acid supplements could prevent 600 cases of neural tube birth defects, saving an additional 1.3 billion dollars. Foods fortified with calcium or folic acid offer an alternative to supplement pills.
Source: Dietary Supplement Education Alliance

Preventive Healthcare: Why It Is Becoming Increasingly Necessary For Corporates?

The annual business game plan lays out a straight forward framework that focusses on priorities, tracks progress and manages every facet of the business. Such proactive culture is the key to success. Our health too demands a similar game plan. Various researches have showed that it is possible to prevent the onset of diseases with preventive healthcare measures. Rather than treating a disease, prior diagnosis through preventive tests can save employees in an organization from a lot of distress.

Studies have evaluated that investment made in health and wellness programmes by employers ultimately result in behavioural change and attitude of the employees towards the organization. Thus, preventive healthcare in corporates pays rich dividends in the long run.

Now, the question is HOW?

Happy employees make happy customers!

June 21st, corporate India turned their lawns and cafeterias into a makeshift YOGA workshop in celebration of International Yoga Day! With a host of healthy activities that includes free sessions with popular YOGA instructors and arranging healthy diet for employees, the day was wrapped well. With maximum participation, credit goes to the talent engagement teams for adding life to the health and wellness dimensions of the employees’ lives. People are health conscious and such initiative repays. But with the rise in employee demands, it’s a tough for the employers to measure up as well.

Employees feel they are supported and taken care of!

Instead of comforting the cribbing and complaining workforce with unnecessary investments, it’s high time to choose an option that makes a real difference. Group medical insurance, accidental policies, parental insurance, such competitive benefit packages do attract talent but there are other employer-sponsored benefits that are non-cash compensation but and extremely beneficial. The American company, Aflac’s annual employee findings survey have showed that 60% of the employees would take up a job with lower pay as long as they received better benefits.

The waves of innovation and technology have kissed the healthcare industry with spurring benefits and introduced the era of e-medicine. Online Healthcare services are ubiquitous and offer various benefits for corporates, which aim to crack the business model with effective strategies. With the launch of digital healthcare space in organization, employers can play a proactive role in taking healthcare aspects to the next level. The e-medical service will help employees to get their check up done on time and avoid severe health complications later. The preventive healthcare measures extended with online medical facilities in-house, will never go unnoticed. After all prevention is better than cure.

Seeking medical advice before falling sick!

A very inexcusable scenario of the modern era is premature death due to preventable and curable diseases. Routine check-up is, hence, a mandate for all. Regular online medical consultation is a practice of gauging health status even when we feel fit and fine. Employers will go an extra mile if they instil such practices within the workforce by launching a healthcare benefits that enables employees to feel relaxed all the time. A regular headache after a certain period of time at work every day might make an employee tense about his/her health. With the available, accessible and affordable online health consultation, employees can speak or chat with a general physician from the workstation itself and reduce anxiety. It is time to idolize, “We care for you”, the universal motto printed on every employee handbook.

How preventive healthcare addresses the present occupational health situation from deteriorating

“Lifestyle disease” is a very powerful term associated with deteriorated health conditions of employees in private sectors. We cannot escape the norms of competitive market but we can certainly help ease the stress factors with some impactful actions. The preventive healthcare segment with technological advancement has made the journey a lot easier for corporates that have built alliances with online medicine industries. With online medical care through app or desktop, organization encourages its employees to create personal health records with reputed doctors. It helps them to gain access to quality healthcare services at anytime and from anywhere.

Preventive Healthcare allows employees to have their mind at work

Attending an important meeting while leaving a sick child at home is the messiest phase in the life of a parent. Apart from applying for a half day leave, online health care service enables us to contact an online doctor and talk about the symptoms of the child in details. The medical advice from a reputed doctor will certainly be beneficial. We may also fetch prescriptions online and hold a video consultation once back home. Being a parent, it is extremely important to keep a close check on children’s healthcare. Our office work should not delay the necessary and preventive healthcare measures dedicated towards our children. With online healthcare benefits, harassment and delays of doctor’s appointment are eliminated, thus, allowing patients to get treated at the earliest.

Helps to be a Considerate Employer

Employers owe a duty of care towards a traveling employee. The change effects in various ways on the employee should be thoughtfully compensated by the employer. Along with the monetary benefits, it’s the care factors that play a vital role. Employees’ health is of paramount importance and employer should empower the individual with online doctor service installed in Mobile Apps. This will help the employees to have access to doctors from anywhere and at anytime. Digital healthcare is an effective and prompt medical consultation system that would provide assistance anywhere and anytime. Organization will be praised further if it extends its assistance to the employees’ families by providing them access to online doctor facilities at any point of time. The care-o-metre will certainly keep the employee happy and relaxed.

Work place morale plays a great role! If the employees are healthy, they are happier, and a happy employee is the most productive one. When employees understand that their company takes care of their wellbeing and health, it generates loyalty and trust. Hence, the benefit is mutual. While the company invests in Health apps and virtual GP services for employees, they receive substantial improvement in work performance through those affiliated employees.

On-demand access to healthcare 12 hours a day will make employees feel relaxed at work and, thus, improve the attentiveness.

Aids in Reputation management

An organization, whether product based or service based, is more concerned about its global reputation, not just as a provider but also as an employer. Companies are often evaluated on their workplace and people management culture. Wellness programs are, therefore, a definite practice that uplifts the banner intact. Health camps set-up on a quarterly basis receive havoc responses from employees as they feel it’s easier to consult a doctor amidst work instead of a pre-fixed appointment. Keeping these scenarios in mind, online healthcare industries have extended their reach among corporates to build alliances and act as a preventive healthcare regime within the organization.

Reduces Absenteeism

The Associated Chambers of Commerce and Industry of India (ASSOCHAM) report on Preventive Healthcare and its impact on Corporate Sector states that “One rupee spent on prevention saves Rs. 133 in absenteeism costs and Rs. 6.62 in healthcare costs”. Increase in productivity through maximum attendance is one of the major boon of Online Doctor services.

Preventive Healthcare as Customized Package Offerings

Exclusive female doctor consultation is another top feature provided by the Digital healthcare service. Expectant females can at anytime cross consult their health issues with certified physicians available online through chat or call. Today, corporate tie ups with online healthcare industries that call for health check-ups of employees and such practices foster a stronger employee-employer bond that will bear fruit.
Strict confidentiality about employee health records or consultation is highly assured.
Preventive Healthcare is an opportunity for corporates to contribute to the well-being of its employees and also their families. It is also an awareness and education program that is much needed in today’s fast-paced life, thus, restoring the much needed healthy balance for a happy and productive work-life.

Evolving Healthcare Trends

The model trends in the healthcare system have been changing over the period of time. The old trend gave importance to the individual patients and the emphasis was on treating illness. The goal of the hospitals was to do inpatient admissions, fill up the beds and more emphasis was given to acute inpatient care. The role of managers in the old paradigm was to run the organization and coordinate services. In the old system, all providers were essentially the same. The hospitals, physicians and health plans were separate and not integrated.

The newer trends that evolved gave importance to the population as a whole. It not only treated illness, but emphasized on promoting the wellness of the people. The goals of the healthcare system after being transformed over the years is to provide care at all levels which is continued. The role of managers in the new paradigm is more broad. They see the market and help in quality and continued improvement. They not only run the organization, but also go beyond the organizational boundaries. In the evolving system, the providers are differentiated according to their ability. The hospitals, physicians and health plans have formed an integrated delivery system.

One of the current trend in the healthcare delivery model is that continued care is emphasized. The key professionals are not only treating patients for their illness, but they are promoting and managing quality of health. For example, a patient with high cholesterol visits a doctor. He is not only given one-on-one medical treatment, but he is also offered to attend a group session where information is provided on how lifestyle and behavioral change can help. The patients learn from the clinicians and also from each other. Another current trend is to take care of the health of the defined population and not only individual patients. All the health needs of the population as a whole are identified and served. It is emphasized that the community uses the health and social services provided. Healthcare has become more population-based. Another trend that has evolved is that the hospitals, physicians and health plans have got connected and have formed an integrated delivery system. More investments are being made with a goal of providing services to the customers and retaining them.

There is a beneficial impact in the transformation of healthcare towards emphasizing continued health. The way healthcare has been viewed in the past has been changing. The shifting of care from treating acute illnesses to providing continued care is resulting in enhancement of the health of the people. The only appropriate and feasible model is to provide a continuum of care with the emphasis firmly on the family and community. The health of the population and community is considered as a whole. This is advantageous as it creates value in the healthcare delivery system. The healthcare providers work with the community as a whole and consider to improve the health of the general population. Even though this requires new kinds of ways of organizing and managing healthcare services, it helps in understanding the health needs of the target population. By studying their needs, the right health and social services could be provided to them. Examples of promoting wellness of the whole community are organizing health campaigns and providing preventive education to the people in general. Another example is providing awareness about flu vaccines and encouraging people to get the vaccination.

Integrating the healthcare delivery system has led to certain advantages to the patients. For example, they can be offered alternative sites of care depending on their convenience. It helps in meeting the needs of the customers and their preferences which is taken into account. The number of providers are expanded and the patients get to have a choice. The relationship between providers and health plans are organized in the current trend and this ensures that the right care is provided in a convenient way to the customers.

There are defined budgets and expenditure targets for the populations which implies that there is a need to be efficient and productive. The formation of strategic alliances, networks, systems and physician groups can also add value. There are capitated payments and budgets allotted to the healthcare organizations. These are used to provide care to the defined population. The organization might like to improve on the payments and budgets as the expenditures of the companies increase. This results in the management to make decisions like forming strategic alliances with other organizations and increase the total resources. The growth of such networks will help in providing better care to the customers. Financial resources greatly influence the efficiency and productivity of the organization.

The aging population is influencing the healthcare delivery. There is increased demand for primary care of people over 65 years and for chronic care of people over 75. The ethnic and cultural diversity is also influencing the healthcare delivery. This provides a challenge in meeting patient expectations on one hand and diverse workforce on the other. Biological and clinical sciences have met with technological advances and have led to new treatment modalities. This has led to open new treatment sites and manage across the organization. External forces change the supply of certain areas of health professionals like physical therapy and some areas of nursing. The management needs to compensate for such shortages and they need to develop different teams of caregivers at different work sites. Changes in education of health professionals implies that the management be more creative in offering healthcare services. With an increase in diseases like AIDS and morbidity from drugs and violence, there is more and more need to work with community agencies, form social support systems and there is a need for more chronic care management. Advances in information technology is another area where there is a need to train the healthcare employees in new advances. They also need to manage issues of confidentiality and rapid information transfer. Increasing expansion of world economy has led to more competitive management of strategic alliances, care of patients across the nations and of different cultures.

Current environmental trends impact the healthcare delivery model. Organization’s success depends on its external and internal environment. The complex environments made up of uncertainties and heterogeneity of components leads to different organizational designs. The current environmental trends influence managerial and organizational decision making. The unique challenges facing the healthcare delivery organizations should be analyzed in order to develop and implement new and effective operational processes and strategies. As an impact of current environmental trends, the healthcare delivery system needs to improve individual, team, and organizational accountability and performance. The impact of advances in medical knowledge and information technology on the process of healthcare delivery should also be examined, and it should be leveraged to improve quality of care, process and cost controls, and revenue. New strategies would need to be identified and implemented for learning and performance improvement to create a culture that supports accountability, safety, and high-quality care. Innovative models in healthcare delivery would also be required in order to develop and implement strategies that promote organizational success and competitiveness.

Due to the current environmental trends, more emphasis is given to the customers and there is more of a patient-focused care. The healthcare delivery model has been shifting to the community based care. There has been an increased modification in care processes. The traditional ways are being challenged and more experiments are being performed to fulfill the demands to improve the quality of care. Due to the shift in the environmental trends in the healthcare delivery model, more emphasis is given to quality improvement. This will help improve the performance levels of key processes in the organization. The performance levels are being measured, the defects are eliminated and new features are being added to meet the customer’s need efficiently.

There is a new emerging contemporary trend in the U.S. healthcare system. Presently, the management research and assessment have been offered increased recognition. The emerging trend seen is that this is slowly forming an integral part of managerial and organizational effectiveness. With the emerging efforts in information management, it is leading towards clinical and financial networking. The trend seen among the physicians and nurses is that they are being increasingly involved in managerial activities. The managerial trends are also changing with respect to role performance and changing values. The managers role is getting more and more recognized in managing finance and human resources. Management training, lifelong and distance learning is being offered in preparing future managers.

The healthcare executives and managers will be faced with the major responsibility and challenge in the years ahead. They will be working with other healthcare providers and will be creating a competitive future for their organizations. They will not only be managing organizations but also a network of markets, services and joint ventures. Formation of more and more strategic alliances and partnerships will lead the management to manage across boundaries. The management will change from managing a department to managing the continuum of care. The management will be following a community-based approach. Trend in management is also shifting from just coordinating services to providing improvements in quality.

As the demands in healthcare are increasing, the management is responsible for forming performance standards. The management is also challenged to maximize the productivity and quality to serve the health needs of the community. The management is looking after the demands of the external environment as well as attending to the performance of the internal environment. The management is responsible for the performance of the organization.

Healthcare organization leadership will be responding to new trends and competitive forces. It will respond to continuum of care, overall health status of the population and more complex organizational structures. These emerging trends in the healthcare system will effect the organization’s leadership. The future managers would need leadership skills and vision to integrate the organizations and help in providing the best care. The managers will have to be committed to leadership and work on giving their organizations the best place and help their organizations adapt to the changing circumstances. More value will be given to leaders who will be able to lead the change process. As changes are inevitable for the betterment of the organization, the leaders should be able to identify how the change is to be received and how it is to be communicated at all levels of the organization without damaging the implementation process. The leaders might have to deal with increased pressures due to organizational complexity.

The leader in the organization provides strategic direction to the organization, manages diverse stakeholders, becomes mentors for management, is willing to take risks, helps the organization interact with the external environment and attends to the internal needs as well. Where required the leader will involve physicians in governance process and align physician and organizational interests. There will be a need for formation of learning organizations. Transformational leadership will create the required vision for the organization. Leaders will have a greater role complexity and they themselves will have to adjust rapidly to new situations. The healthcare organization leadership will have to live up to the values of the organization and will help in fulfilling the mission of the organization.

Individuals and groups within the healthcare organizations require more and more competencies. An enhanced lifelong learning is required due to the fast, changing environment. The individuals and groups within the healthcare organizations will be benefitted as there will be rapidly developing medical technologies which will result in increased services. More sophisticated health services will be provided to the consumers. The range and quality of services provided will be regulated for the benefit of people requiring home care, long term care and ambulatory care. The anticipated future development will also result in the increased competition among the health services organization. The individuals and groups will be involved more and more with the community for issues like drug abuse, teenage pregnancy and violence.

Individuals and groups will be faced with increased strategic planning and management in the healthcare organizations as there will be ever increasing involvement by the trustees and physicians. As the future environment in the organizations will be more complex, the individuals and groups in the healthcare organizations might feel more pressurized. They will need to serve the changing demands of the community as the population of elderly patients will increase. These individuals will require more professional training, increased levels of education and should be taking part in continuing education programs.

Due to the anticipated future development in the healthcare organizations, those individuals and groups will be valued, who are adaptable, committed, are able to add value and embrace change. These individuals will be required to experiment more and help in redefining the mission and goals of the healthcare organizations.

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