Healthcare Leadership Roundtable: Doing More with Less

Jumpstart Foundry approaches early-stage investing from an “industry-first” point-of-view. We start by defining problem areas and attempt to understand what the industry is looking to adopt through qualitative research. 

We held one of our invite-only roundtable discussions on ‘Doing More with Less’ focused on how healthcare leaders are responding to shrinking reimbursements, growing political pressures, and challenges around clinician burnout. This provided unfiltered insight into the world of physicians, ASCs, and healthcare systems. 

 Below are some highlights of our conversation:

1. Provider organizations are forced to split their attention amongst “customer” groups: patients, payers, clinicians, and increasingly employers. 
2. In order to reduce costs and improve efficiencies, health systems are pressured to offer more preventive ‘upstream’ services and standardize administrative systems. However, incentives and reimbursements are rarely aligned. “In physician reimbursement, you have to do more to get paid the same. Yet because there is more paperwork and more regulation, you do less per minute and see fewer patients a day.”
3. There is an important (and incomplete) debate surrounding behavior change. Obesity and diabetes, for example, can be prevented at a low cost with simple behavior changes; however, our society often relies on surgical procedures and other expensive care interventions. Who is ultimately responsible for preventing and treating chronic conditions? Policy makers? Providers? Payers? Individuals?Consider: Regardless of whom, how do you manage change for successful, long-term implementation?
4. Clinician burnout is linked to frustration around EHR systems, the documentation processes, regulatory stress, reimbursement difficulties, and less autonomy and time with patients. Burnout is not exclusive to physicians. RNs, NPNs, medtechs etc., all experience it. 

“It’s everywhere. I think everyone, the staff, everyone, is being asked to do more with less and there’s pressure all the way around.”

 “The highlights of my day are when I just get to take care of patients. Like when I’m in the operating room…It’s the noise that’s going to cause you to walk away and…most people get into this because they are passionate about taking care of [patients] one by one or at scale…getting back to that could, well, be the solution.”

Consider: What are the best avenues to address burnout? Technology, education, innovation, system structure?

 Possible areas to alleviate pain points: 

• Decreasing the administrative burden on physicians via automation, for example process documentation and work flow management solutions.  
• Utilizing lower-level providers as patient advocates and preventative care influencers to manage higher volumes where appropriate and ensure patients get to the right doctor, at the right facility. 

Highlighted trends:

• ASCs partnering with young physicians—Due to burden of education debt, physicians are seeking ancillary income via investing in ASCs. ASCs would rather own something than nothing and thus are partnering with eager physicians at 51/49 or 60/40 split to allow them to buy-in at a lower price. Industry implications: Consolidation and centralization; shifting negotiation power and leverage with payers and vendors; fueling continued adoption of enterprise technology. 
• Patients are getting more ‘savvy.’ They know to ask, “What’s my out-of-pocket? Can I go to an ASC?” Industry implications: Rise of consumer branding; transparency websites; technology-enabled approaches to engaging patients.
• Self-insured employers who are ultimately paying the bill are becoming more sensitive to cost and quality. Industry implications: Changing models such as direct-to-employer model that eliminates insurance middlemen; increased contracting of telehealth; referring workers to Centers of Excellence.
• A shift to lower-level provider care at home via telehealth with CMS reimbursement. Belle, JSF ’17, is at-home diabetic foot care service provided by nail techs. The nailtechs have immense influence on the patients due to regular visits which can provide insight to the payer or influence an in-person visit.  Industry implications: Quantifying savings upstream is currently not feasible and thus not reimbursable; however, payers see value in the service, and so there may be future potential. 

Over the next 3-5 years, the healthcare system will have to do more with less; while this can be challenging, it offers innumerable opportunities for improvement. The Jumpstart strategic advantage is a deep understanding of market demand for innovation: knowing where the industry could benefit from solutions now, and which areas of improvement need to be delayed into the future. Jumpstart Foundry brings together Insight Partners with creative entrepreneurs in order to facilitate innovative solutions that deliver better outcomes and save money. Please continue to connect with us as we are making something better in health every day.