With the Patient Protection and Affordable Care Act (PPACA), impetus was created to drive providers to create Accountable Care Organizations (ACOs). Interesting in that the ACO model was left open. That is, patients can move outside of their ACO home for service and care. Unlike Health Maintenance Organizations (HMOs) where care was restricted to in-network providers, planners were afraid of the backlash that would occur if they created a closed-model HMO style, ACO model for Medicare beneficiaries. Studies suggest that up to 1/4 of beneficiaries enrolled in ACOs would not stay within the ACO network and would need incentives to do so.
That is a big out-of-network churn rate and too expensive to the ACO.
So what is a healthcare provider to do?
1. Make sure that you have a Customer Experience Management Program place. You need to be close to your members by understanding their current needs and how their needs change over time. This is consumer-directed healthcare not provider-directed healthcare. If you don't meet the experience needs of your consumers, then they will go out-of-network or leave all together. This means listening too, instead of talking at, your customers. It means constantly monitoring that state of the experience.
2. Invest heavily in customer service training. "The Patient", aka customer, is not here to serve you, you are there to serve them. You can never have enough customer service training. A well developed, and implemented customer service program will contribute in significant ways to keeping patients in your ACO. Exacting customer service standards for employee behavior with measurable and reviewed individual performance goals and objectives, are the only way to ensure that exceptionally high levels of customer service are deliver across the entire organization. What gets measured gets done.
3. Brand is everything. A highly developed brand, brand promise and brand promise execution in the organization is essential. Promotional materials, patient education materials etc., need to be of high value, provide useful and usable information, as well as reflect the experience that you want patients, caregivers and customers to have when interacting with your ACO. Your key message must be consistent across all materials. Your employees need to be trained to be brand ambassadors.
4. Define and market the customer experience around quality and outcomes. People will be buying based on price and quality. Since more of a financial outlay will be coming from individuals, they will care about the price they are paying in the way of insurance, co-pays or deductibles. If the patient does not believe that they are receiving exceptional quality and service for the price paid, that will become a large motivator for going out-of-network or changing ACOs all together. You need to be the transparent organization in price, value and quality.
5. Create incentives to use you and not go out-of-network. That may mean lower copayments and premiums. It may mean loyalty programs with no wait services. Online registrations for care etc.
6. Communicate in a variety of ways the value and benefit to the consumer for using you. Educate them to understand why you are better than the next ACO down the street. Don't assume anything. Differentiate!
7. Make access seamless and easy to use. One ACO to the customer/patient, one customer/patient to the ACO.
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Michael Krivich is a senior healthcare marketing executive and internationally followed healthcare marketing blogger read daily in over 20 countries around the world. A Fellow, American College of Healthcare Executives as well as a Professional Certified Marketer, American Marketing Association, he can be reached at firstname.lastname@example.org or 815-293-1471 for hiring as your senior marketing executive , for interim assignments in all aspects of healthcare marketing whether it be strategic or tactical market planning, customer experience management, rebuilding and revitalizing your existing marketing operation, integration of sales and marketing teams, media relations or service line revitalizations. Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni, both highly respected and successful international sales training organizations, I can lead your organization though the challenge of integrating sales and marketing.