STRATEGIC PLANNING

COVID-19, Consumerism Driving New Business Models for Northwell Health

Northwell Health has devoted extensive time and resources gathering consumer insights, or, as Executive Vice President for Strategy and Analytics Jeffrey Kraut puts it, “slicing and dicing data about our customers so we can reveal their DNA.”

“Then came February and all of that work came crashing to a hard stop as we, and all other health providers, had to shift our focus,” he said. Because of the COVID-19 crisis, Northwell has been forced to completely recalibrate its understanding of patient expectations amid the pandemic. As of July, some 51 percent of the nation had lost income to some extent, according to the Census Bureau. And 25 percent had no plans to resume routine medical care, the Kaiser Family Foundation reported.

Wanting to better understand the factors fueling this state of mind, Kraut and his team have turned to their constituents for answers.

“There’s still so much debate, misinformation, fear and emotion out there that we believe it’s vital to engage our customers and seek their input on how best to redesign care and processes to meet their changing needs,” he said. “The focus is not only on reopening, but reassuring consumers that it is safe to seek care, that it is convenient, and that it is critical to their health to do so.”

Northwell Health’s consumer research — gathered by Monigle — indicated that when asked what would increase their confidence, about 51 percent cited, “Make it safe to get care when I need it,” as the top answer. Another 45 percent wanted providers to help them understand and manage all aspects of their health. And 40 percent said they desire doctors who work together to devise the best care plan, according to the survey of 600 consumers, conducted in five waves between April and September.

As many COVID pundits have said, the “genie is out of the bottle” on telehealth and there’s no turning back. Consumers want to continue receiving care virtually, as a safer and more appealing alternative to doctor’s office visits, emergency departments and other types of hospital care.

“This is not a passing trend and it is hopefully going to be embraced by policymakers as health care organizations, cities, states and the federal government deal with significant reductions in revenue,” Kraut said. “We’re expecting a major drop in spending from the state side of funding, and I don’t think being a health care hero is going to save us from that,” he added.

The shift to virtual care will be about quality, along with patient safety, convenience and cost, says Kraut. He expects this trend to intensify in the coming months, and strategists must remain mindful of all of these factors. Unemployment rates have hit record highs in 2020 and it’s resulting in a payer mix shift. As many lose their higher-reimbursement, employer-sponsored plans, they’re moving to Medicaid and insurance exchange coverage, with narrower networks and higher deductibles.

In response, patients and providers are embracing health and wellness, and models that deliver post-acute care in the home, Kraut said. Some states are even deploying paramedics to help maintain a care connection with consumers. “Obviously when you combine all of these opportunities, the major enabler is going to be creating models that are more sensitive and personalized to patient expectations and make use of that digital front door.”

New Models

A key piece of this puzzle will be segmenting patient populations by both their disease type and preferred engagement method, according to Kraut. Add to this their health status, capabilities and any cultural challenges. Convenient care will need to be married with digital monitoring tools to stay connected with the patient. Kraut gave the example of a pulmonary rehabilitation patient at home using a Peloton-like system while communicating with their therapist.

“We have to really think differently about care models because people’s mindsets have changed. The need for digital engagement is growing and certainly COVID-19 has served as an accelerant,” he said.

Before the pandemic, strategists might have used a one- to three-year timeline to develop new digital strategies. But in 2020, they’re finding cycles that move as quickly as nine months or even half of that to build out new capabilities and adapt new technologies. As a prime example, Kraut said, look how quickly hospital systems had to figure out their patient symptom-monitoring strategy, track coronavirus outbreak data in their community and support vastly expanded telehealth in short order.

But it’s not just about the digital front door. COVID is also beginning to reshape Northwell Health’s bricks and mortar strategy, Kraut said. Health system leaders are now working on building two new facilities and grappling with questions related to HVAC, negative air pressure and single-bed rooms. Beyond that, they’re debating how many patients need to come into a facility at all, how registration will look in this new normal and ways to eliminate as much paperwork as possible. Northwell is even exploring the possibility of creating testing facilities where patients can come for blood draws and other lab work solely in conjunction with virtual visits.

“I think there is going to be a lot of changes to our bricks and mortar thinking,” Kraut noted. “It’s really up to us to redefine the ‘H’ and what it means to individuals. We’re all still learning the issues in this rapid cycle we’re in, but I think everyone will need to recheck basic assumptions that have been driving strategy.”

To learn more, you can access a recording/slides of the program, “How Consumerism Is Driving New Business Models in Health Care,” from the recent SHSMD and AHA virtual conference Navigating a New Reality. You can view this recording, plus over 20 other sessions, by purchasing on demand access to this virtual event for $49. 

This article features an interview with:

Jeffrey Kraut
Executive Vice President, Strategy and Analytics
Northwell Health
New Hyde Park, New York

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