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Chief Executive Officer

In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates.

COVID-19 Discussion with Jon Cohen, MD

Blog - 0043

Head of Healthcare

Healthcare has long been dependent upon call centers, and hold music is only sometimes enjoyable. It’s not a secret that human-staffed call centers are ineffective and old-fashioned, as our automated answering machines. A recent survey of consumers found that <a href="https://www.patientpop.com/blog/patient-experience-stats/" target="_blank">over half of consumers</a> said that automated phone systems are the most frustrating part of customer service.  Call centers rely on <a href="https://assets.ctfassets.net/xj0skx6m69u2/tp7lvOofmLEEU7iPb32Op/7213f9400946c26628be836c565a37ca/future-of-the-contact-center-a-forecast.pdf" target="_blank">complex phone systems</a> operated by a network of agents to solve issues. The quality of service can change from person to person, largely depends on individual personalities, and how well each customer service representative understands your business. Computer technology has led to some improvements, but not enough to drastically improve the customer experience.  Not only does this risk losing potential patients, but call center inefficiencies actually impact your business at every operational step…  Three Major Costs Of Using Contact Centers For Patient Management  1.High Financial Costs If you want to establish a call center as a touchpoint, you can either create one in-house or outsource it. You&#39;ll need to pay salaries, overhead, and initial setup costs in both cases. Call centers are not plug-and-play, so you&#39;ll need to recruit, train, and onboard customer support agents, which can take weeks. Plus there are software, hardware, and headset costs, amounting to thousands before you take a single call.  According to <a href="https://www.glassdoor.com/Salaries/us-customer-service-representative-salary-SRCH_IL.0,2_IN1_KO3,34.htm" target="_blank">Glassdoor</a>, the average customer service representative in the United States earns $49,116 per year while customer <a href="https://www.glassdoor.com/Salaries/us-customer-service-manager-salary-SRCH_IL.0,2_IN1_KO3,27.htm" target="_blank">service managers </a>make $68,703 each year plus benefits. For a team of five (four agents and one manager), you’ll spend about $265,167 each year on salaries alone. Outsourcing call centers can reduce some of those costs, but they are still far from cheap, running from <a href="https://www.cloudtask.com/blog/how-much-does-it-cost-to-outsource-a-call-center#:~:text=If%20you%20look%20around%20the,week%20or%20%24349%2C440%20per%20year." target="_blank">$25/hour-$65/hour</a> per call center representative. The roadblocks don&#39;t end when your team is set up. Agent turnover is a persistent issue at call centers and maintaining regular staffing numbers can be a challenge. To build a dedicated staff, you&#39;ll have to ensure that employees feel fulfilled in their roles and spend money on the kinds of benefits that compel them to stay.  2.Human Error Call centers require a significant amount of oversight to ensure quality day-in, day-out.  There are a few factors that lead to poor quality service and human error when it comes to call center customer service:<ul><li>If the call center agent is having a bad day or hasn&#39;t taken the time to read their training manuals, callers will receive subpar service.</li><li>Outsourced call center agents are often assigned calls for multiple practices. Therefore, their time and attention may be divided throughout the workday. </li><li>Security: The standards for background checks differ between countries and states and may even change from company to company. Depending on who you choose to work with, confidential or sensitive information may be left unsecured. </li></ul> 3.Outdated Technology &amp; Lack of Communication  Many call centers run on outdated technology. That can mean longer wait times in the absence of automated menu options or voice commands. A lack of automated triaging can result in people being shuffled around a phone tree. Patients are not leaving their consumer expectations behind when they interact with their doctor. They expect the same level of service, ease, and accessibility that they receive everywhere else. <a href="https://www.patientpop.com/blog/patient-experience-stats/" target="_blank">68% of patients </a>would prefer a provider that enables them to book, change, or cancel appointments online while 69% of patients are more likely to choose providers that communicate with patients via email. <a href="https://www.patientpop.com/blog/patient-experience-stats/" target="_blank">70% of patient</a>s would choose a provider that sends emails or texts when it’s time for follow-up or preventative care and 57% expect automated text, voice, or email reminders for appointments. Conversational, Generative AI as an Alternative Conversational AI overcomes the limitations of conventional call centers.  Advanced artificial intelligence can…<ul><li>Text, chat, email, and most importantly, talk like a human can over the phone, answering all questions and handling a wide range of inquiries and requests. </li><li>Collects information like insurance information and other patient data in a secure and accurate way. </li><li>Scale to meet any call volume, ensuring that patients always receive answers promptly and efficiently. </li><li>AI doesn’t have bad days or bad moods. It never sleeps, never clocks out, and never changes jobs. </li></ul> Not all customer inquiries require the same amount of attention. AI makes sense of simple questions and answers them quickly, forwarding the complex calls to your team directly, no phone tree required. Generative AI ensures that everyone&#39;s needs are met, and you reserve your team&#39;s energy for where it is applied best. Learn more at <a href="https://health.eliseai.com/" target="_blank">HealthAI</a>.

Generative AI Is The Cure For Call Center Inefficiency

Blog - 0214

Sr. Vice President & Chief Health Equity Officer

Health equity is described as every person having an opportunity to achieve their optimal health — without unfair differences in their ability to access or receive care. In a healthy and just society, health disparities would not exist. Yet these considerable care disparities — connected to race, gender, socioeconomic status and sexual orientation — do exist from community to community. Coming together to address variation in health care outcomes for everyone and building a more modern, better-performing health care system overall will empower quality outcomes for everyone. And, doing so will confront health care inequities head on. So how can we as an industry resolve health inequities? Identifying and acknowledging that disparities exist is a crucial first step. Further, meaningful change will include recognizing the impact of implicit bias on our thoughts and decisions to address health disparities.  We must also acknowledge that this change will take time. Results may not occur until well past our tenure. But there are ways to achieve opportunities, build momentum and create a foundation for lasting impact. Four pathways to equityAcross the UnitedHealth Group companies, our key metric for health equity is improving clinical outcomes. To organize our activity against this goal, we prioritized four pillars of action. These categories offer opportunities for results that lead to bold, long-term systemic change. Each pillar lends itself to measurable goals, so that leaders can <a href="https://www.optum.com/business/resources/c-suite/insights/health-equity-cfo.html" target="_blank">build a business case</a> to support the investment of resources needed to address each one.  1. Leveraging data and emerging analytics to monitor and address disparities in careThrough community partnerships, it is possible to gather richer consumer data, ZIP code information and social isolation data. This will help to build a more comprehensive picture of all the factors that can impact people’s health. Healthcare organizations have already identified the populations with poor utilization or outcomes. Overlaying social determinants of health information can reveal the root causes. This will further concentrate efforts to overcome disparities and inequities, guide your partnerships and inform the financial rationale for your actions. 2. Delivering on personalized care based on individual needsRoot causes threaten an individual’s core safety and well-being and prevent them from achieving optimal health. These causes can include social determinants like economic factors as well as non-economic factors such as mistrust or disaffection for a healthcare system that does not match their individual needs. Personalizing for needs means offering care programs that people trust, can easily access and want to engage in. Any effort to learn more about the root causes that impact your populations will naturally lead out into the community; and community involvement will create a deeper understanding of what truly shapes the lives of people who live there.   3. Improving the health of underserved communitiesCOVID-19 made the health inequity in our communities clear. Widespread and costly disparities were on display as the entire nation watched the tragic results. This cannot continue. A powerful first step toward equitable care is to make health equity part of the organizational mission. This supports the mandate of looking at everything through an equity lens. Unconscious or implicit bias can be hard to spot, but poor clinical outcomes are obvious. The level of bias in health care is the same as in the general population and it will need to be addressed in everything from scheduling to surgery. It will be easier to integrate into your culture when it is an openly stated part of the mission. Next, narrow in on the population whose clinical outcomes are falling below benchmark. Ask your leaders to look for the underlying causes and identify where demographic data may be incomplete or systems unable to collect it. Gather feedback from this population and see if their feelings about their health experience match staff perceptions. Doing this will reveal gaps that can be addressed. Finally, choose one area where you believe you can make the most clinical impact and focus resources there. 4. Promoting equity and diversity in the health workforceA natural way to narrow in on health equity is to start with your own organizational culture and levels of diversity. Do you match the populations you serve? Can you ensure that employees are culturally competent to serve the community? Do they understand and respect the cultural norms, language and beliefs shared by your consumers? Building gender and racial diversity into the recruitment process and leadership succession plans are concrete ways to advance here. Another consideration is inclusion. Even if you have diversity in your ranks, those in the minority may not feel like they have a voice at the table. Only leaders can create a respectful, welcoming environment that brings forward all voices. Research tells us that diverse companies are 35% more likely to outperform their peers. So, along with advancing health equity, those who enable a diverse, inclusive workforce are also building a more resilient, competitive organization. The pandemic taught us many lessons in health care, and we can take heart in the courageous strides we made there. But our job is not yet finished. Health leaders have a critical role to play in advancing health equity. It is up to us to take the lead in addressing systemic issues and improving health outcomes for everyone. Health equity can’t be addressed as a short-term fix. It will require the same passion and drive with which we pursue other growth strategies. It will require the same sense of urgency, sacrifice and cooperation required of us during the pandemic. And it will take formal, out-loud, organizational commitment. To read more on health equity, <a href="https://www.optum.com/about-us/health-equity.html?V=optum.com/healthequity" target="_blank">click here</a>.

Health Equity: Four Pillars of Action

Blog - 0090

CEO/ Founder

Almost a century after Albert Einstein said this, it remains as true as his theory of relativity. The healthcare crisis in the U.S., as in much of the world, is structural and not incidental. It is the inevitable result of an outdated, reactive, episodic, clinic/hospital-centric, “fee for service” system that is unscalable, and therefore increasingly inaccessible and unaffordable to many. It reminds me of the time around a quarter of a century ago when my car would break down with little warning, costing me a not-so-small fortune to fix at a “repair shop.” Today, most cars are equipped with sensors that continuously collect data, computers that dynamically analyze performance and alert the driver when “pre-emptive service” is necessary to avoid a breakdown. Many physical assets nowadays have these capabilities built in, but not the most important one: our body.  Predictable and preventable illnesses are responsible for almost 70% of healthcare expenditure. The current system we call healthcare is misnamed; it was designed for “sick care” and should be renamed as such. For a true healthcare service, we need to create different economic incentives and operating models that are not just designed to deal with crises and emergencies but to avoid them wherever possible. Much of what is required for this new economic and operating model for healthcare is already here, it is just not well distributed or fully developed. “It’s the economy, stupid.&quot;  James Carville’s famous phrase applies to the healthcare sector as much as any other. Most institutions optimize for their financial incentives. Many say our healthcare system is broken. That is simply not true when you look at it from an economic incentive lens. How can a section of the economy that has been showing the fastest and most consistent year-on-year “growth,” to now have captured just shy of 20% of the GDP, be called broken? In a “fee for service” system, where providers are paid for “activities,” any rational capitalist institution would optimize to maximize those activities. And that is what they have successfully done. So, the starting point of any transformation from sick care to healthcare should be to fix the economic incentives. Instead of paying for activity, we should align the incentives of payers, providers and beneficiaries. We should be paying providers for managing their population’s health and they should benefit from avoiding crises and emergencies. This preventative approach is what is happening across all other areas of “asset” insurance and maintenance with great results and should now be applied to healthcare. The good news is this is no longer a niche idea but is now accepted and advocated by many.   “If you can dream it, you can do it.” Walt Disney’s advice is even more true in today’s world of accelerating innovations. Instead of the current reactive and crisis ridden sick care service, it is possible with today&#39;s technology to create a new data-centric, proactive and integrated care service for population health management at scale. This no longer needs to be a dream and can be built.  Babylon’s approach delivers a digital-first health service in a manner that is scalable and affordable through an omni-channel mix of AI, digital, virtual and physical services as necessary. Central to this approach are continuous monitoring and collection of relevant data; algorithms for real time and intelligent analysis; protocols for appropriate rewarding and alerting; and a scalable and proactive, digital-first “health service” that can intervene early before small concerns become unwanted and unnecessary emergencies. Digitizing, automating and virtualizing as much of the physical care needs as possible is also necessary to improve the accessibility and affordability of healthcare. Much of the thinking and capabilities needed for the transformation of the sick care industry to a healthcare service are already here, and we cannot afford to revert back to the old-ways that caused this mess. It is now possible to reshape a new model for healthcare. Those who do so and deliver it at scale will make quality healthcare accessible and affordable for every person on Earth.

We Cannot Solve Our Problems with the Same Thinking We Used When We Created Them

Blog - 0146