Traditionally, the US healthcare system has been siloed. Various stakeholders – patients, payors, and providers – have their own perspectives on health care, making it difficult to work across lines with each other.
Providers historically have focused exclusively on cost containment while patients and payors (including state and federal agencies) have started to demand better quality and outcomes – as well as lower costs. Because of this divide, physicians are accustomed to operating almost autonomously.
Over the years, however, it’s become impossible for these disparate groups to work as separate entities. To meet the growing demand for higher quality, physicians have been forced to learn to align their goals with patients and payors.
Naturally, the role of spearheading this integration rests with a CMO. But to keep pace with the rapid evolution of health care, CMOs must be ready and willing to pivot on a dime.
Higher expectations and expanded opportunities
Efforts to align stakeholder goals are underway, and there have been some promising results. For example, Blue Cross and Blue Shield of Kansas City recently partnered with Vera Whole Health to add three more clinics to its Spira Care initiative – which guarantees members coverage for all routine and preventive appointments. Because even routine checkups can have significant out-of-pocket costs for patients, this partnership could be a game-changer for patients who struggle to afford health care but desire a high level of service.
Not only do consumers demand more affordable care, but they also have higher expectations for the entire healthcare experience. They are used to one-click checkouts and on-demand Uber rides. This expectation of better and more convenient experiences has seeped into other areas of their lives, influencing how consumers shop for and use health care.
CMOs are at the nexus of this shift. They are in charge of how physicians deliver care to patients and what care plans will be administered to patients who are members of a particular health system. As a result, they’re used to collaborating with the three major stakeholders in health care: payors, patients, and providers. The bulk of this collaboration historically happens offline, but the right technology can make this possible in far less time.
4 areas of expertise
To lead the charge into the next generation of health care – and set their organizations up for success – CMOs need the following expertise:
1. The ability to balance stakeholder goals
CMOs are in the business of providing the best possible care for patients while preserving the financial stability of the organizations they represent, whether it’s a health system, a health insurance plan or a healthcare services organization. They must have a foot in both worlds to be effective gatekeepers, successfully balancing the goals of patients, providers and payors.
The role of the CMO always has been focused on this balance, but that was far more difficult when everything was siloed in faxes and paper charts. In the digital world, CMOs now have access to real-time charting and imaging from doctors – as well as direct feedback from patients on how they’re feeling and how they rate the care they received.
2. Background experience in healthcare and technology
To take advantage of the digital disruption in health care, CMOs must be well-versed in current technology and look ahead at what’s coming. CMOs need to fundamentally understand how consumers use technology when interacting with companies in other industries, and they must then apply that knowledge to health care.
Members expect to use their smartphones to interact with providers, ask questions, schedule appointments, and pay bills. A CMO who doesn’t understand that may not have the necessary know-how to help care teams fulfill it, which can lead to poor user experiences – and unhappy patients. When 90% of healthcare systems plan to make significant investments in smartphones and other technology over the next 12 to 18 months, according to a survey from Spyglass Consulting Group, CMOs would be wise to stay on top of consumer desires when it comes to technology.
3. A knack for forming cross-functional partnerships
Being a gatekeeper between providers and payors (and between patients and their care) doesn’t always make CMOs popular. However, it does give them the unique ability to build partnerships and relationships with third parties – even beyond the healthcare world. This collaboration is important because CMOs will need to work with people who aren’t in health care if they want to capitalize on the latest technologies.
According to a PricewaterhouseCoopers report, about 84% of all Fortune 50 companies are venturing into the healthcare sphere. As more companies look to join the healthcare mix, it’ll become more critical for CMOs to hone their networking skills and form partnerships that benefit their companies.
4. Empathy to see things from a member perspective
Technological and medical knowledge is essential, but the shift in health care has focused more on patients’ unique needs. CMOs must understand, in general, what comfort, care and security mean for patients. They can’t truly lead the charge for better patient experiences, if they don’t understand what would make those experiences better.
When you think about it, CMOs don’t focus on routine checkups and doctor visits. They mostly handle major healthcare needs and problems, which gives them incredible power over the quality of care that patients receive. This aspect of the position provides CMOs tremendous insight into the needs of patients and the empathy to understand how their decisions affect patient needs.
Right now, there’s a wave of CMOs retiring and heading into their golden years. The incoming CMOs who take their places will need a strong background in health care, a decent knowledge of technologies, and experience forming partnerships across industries. It’s a big job, but the next generation of CMOs will be well-equipped to tackle it with a blend of the right technology and the right experience.
Originally published in:
Healthcare Business & Technology
Never miss insights
Stay in the know with our thought leadership