While the COVID-19 pandemic is not over,
and the transition to a post-pandemic world will be blurred rather than
discrete, it is time to recognize that while we as healthcare leaders have had
our heads down keeping patients alive and trains running, a new cultural
zeitgeist is emerging that will dramatically shape and change health care in
the years to come.
We have gone through not only the
pandemic crisis, but great political and social disruption as well. There is a great wave of retirements of our
pre-pandemic leaders, and new leaders are looking to shape the future. Furthermore, we observe a generational shift
among those entering the workforce and also see this new generation (Gen Z) creating
a distinct perspective as consumers. For example, while early studies indicate
that members of Gen Z are more pragmatic and trusting of institutions than
millennials, they also expect more innovation and integration of the tangible
and digital (they want the option to engage digitally or in person at their
convenience).
As with previous social shifts, part of
these post-pandemic trends will be reactionary, but trends will also be driven
by a genuine interest in the new, different and better. In particular, we see this new cultural
dynamic as being epitomized through the values of simplicity, care, and experimentation.
Simplicity
In reaction to the constant disruption and loss of control many have recently experienced, there will be a move to embrace the simple, transparent and predictable. Clear statements of truth will be appreciated over value-signaling or activism, and cultural trends are likely to shift to the tangible over the abstract (i.e., more things and fewer experiences). We see growth in focused (rather than diversified) business models, and a move toward distinct new products over extensions of new systems or platforms.
In recent years, healthcare has embraced complexity through multi-prong alternative payment models, complex risk-sharing and mitigation arrangements, multi-layered care models with specialization and handoffs, and an explosion of increasingly nuanced programs for increasingly targeted populations. We see these complex payment and delivery structures giving way to simple, predictable models (e.g., payments that are FFS, salary or capitation). There will be movement toward tools that enhance existing care relationships rather than layering on new ones. Leaders will thrive by embracing and communicating the straightforward over the complex.
Care
While politically our country remains divided, in the background, the routine with which the average person is engaging with those divisions has declined.[1] Many are experiencing overload from the forces in our culture that seek to make us angry, enraged, engaged or activated. In response, we anticipate a move toward seeking individual personal connections, less willingness to be defined as a member of a group, and individuals placing an increasing value on being listened to rather than talked at.
In healthcare there will be a renewed emphasis on the provider-patient relationship—both will seek more personal fulfillment from their care relationship. Interventions that add complexity through care coordinators, burdensome processes, and complex algorithms will wane, while those that enable direct, interactive care with a provider or care team will expand. Leaders should evaluate where processes create barriers or unnecessary layers between patients and caregivers.
Experimentation
Times after crises have historically marked departures from tradition and where the future and its potential are embraced. We have become accustomed to having traditions disrupted during the pandemic, and this will increasingly happen not out of necessity, but of choice—in contrast to recent years it will not be because these traditions are labeled as antediluvian, but they will be baggage that inhibits trying new things or doing them a different way. Broadly, we foresee the rise of novel types of music, art and style in a way that creates a meaningful departure from trends of recent decades. This experimentation will also permeate into business as old models are replaced and new constructs emerge.
While healthcare has embraced innovation broadly (and nominally) in the recent decade, we now anticipate bifurcated experimentation in the industry. Specifically, because much new experimentation will fundamentally question the premises of the healthcare system, we believe current players may be unable or unwilling to accommodate these models—they will be rejected as impossible or foolish. Indeed, some will be impossible or foolish, but we also foresee the greatest opportunity in decades to fundamentally disrupt healthcare.
For current stakeholders, we see experimentation as enabling new approaches to make their existing core business better. As with many new disruptions, the new will not simply extinguish the old, they will for a time compete and then merge—the strongest of the old will survive, and, in the process, incorporate the ideas of the new. Leaders should look for ways to enable small scale experimentation, while consciously being more receptive to new ideas from non-entrenched stakeholders.
What does this mean for leadership?
Given the changes we see on the horizon, we believe there are several actions healthcare leaders can take now to better position themselves for these changes.
Humanity over Value-Signaling
In recent years it has been fashionable and expected that healthcare organizations signal their values to the broader public via media campaigns, community engagement, and strategic leadership statements. While there are well-noted business successes in using this approach to create a dedicated workforce and loyal customers, it is becoming co-opted to such an extent that it is increasingly ineffective or bromidic. Post-pandemic, there will be as much risk in value-signaling as in not, and there will be heightened scrutiny in how a particular value or social cause is really in the domain of an organization’s business.
Instead, leaders should think about inserting more humanity into their culture.[2] Customers, employees, and stakeholders will want to be seen as individuals (with political, social and demographic labels less tied to their identity). Practically, this means being able to customize at scale and provide increasing opportunities to engage individual expression. This could be done through allowing user customization of products, a “no wrong door” approach to services, or revamping programs targeted or implied to be for certain groups and make them more inclusive.
Spinning the Flywheel over Seeing what Sticks
Cheap capital has allowed organizations to launch a wave of vertical integration by acquiring businesses or launching products in adjacent businesses. In healthcare, some systems have launched their own venture capital funds, others have acquired adjacent service lines, and still others have looked to integrate the supply chain. Many of these activities have been done with less-than-optimal execution, and while the market was forgiving, it is clear some spaghetti didn’t stick to the wall. Looking back, it was easy in this environment to support growing revenue (even at negative margins) and talent to staff these ventures was relatively easy to identify and scale.
With more expensive capital and tighter labor markets likely to persist in the near-term, leaders will need to re-evaluate their portfolio. Ventures that drain talent or have countervailing goals to the core business may need to be jettisoned. Employees and customers will also be increasingly valuing the straight-forward over the complex: grandiose visions of solving social ills will need to be scaled back to simply stating what the core business does and explaining why that is good in itself.
Time for Spring Cleaning
Generally, healthcare organizations have grown and innovated by building on top of what already existed. New systems were layered on top of old ones, new processes tried to optimize for the existing constraints, and attempts to change culture manifested in programs that created new competing priorities rather than evolution. Part of this has been fueled by the ongoing trend of healthcare needing to be more than just healthcare. As healthcare organizations became IT companies, public health agencies, drug and device suppliers, and care model innovators, the compliance, management, and financial complexities increased (sometimes exponentially).
Now is the time for healthcare leaders to undertake organizational spring cleaning. With new employees, heightened optimism, and more acceptance of individual risk-taking, the opportunity to do away with outmoded traditions and reduce organizational clutter will be high. Leaders will need to ask themselves what activities are really tied to organizational objectives. They will need to question and reevaluate assumptions about how and what they measure. Finally, if objectives are simple, clear and transparent, employees can be empowered to solve problems in ways that allows for meaning in work and enables the person-to-person engagement that we see as fundamental to future success.
About the Author: Adam Zavadil JD MPH
Founder and Principal at ZAHealth, for over fifteen years Adam Zavadil has been helping clients at the intersection of healthcare delivery, regulation, and financing. Adam has developed deep expertise and substantial technical knowledge across many areas of delivery and finance including Medicare Advantage, health plan strategy, clinical program development, and alternative payment model design. Since its inception in 2019, ZAHealth has partnered to serve over a dozen organizations involved healthcare finance, delivery, and technology—from Fortune 50 companies to innovative start-ups.
Adam received a Bachelor of Science from the University of Notre Dame in biochemistry and a MPH in Health Management and Policy from the University of Michigan School of Public Health. Adam also received his Juris Doctorate with honors from The George Washington University Law School.
[1] https://www.axios.com/media-ratings-traffic-2021-a6be4d72-ba5f-4f8a-ae3e-0872ecd87677.html
[2] This is often done well as the individual caregiver-patient level, but fails to permeate into a broader organizational culture.