Gartner’s Jim Sinur wrote up his recent personal experience in healthcare, Bad Processes are a Stumbling Block to a Good Reputation, and brought up an excellent point about customer service: Who is the ‘customer’ of healthcare delivery? This questions could be the key to bringing healthcare into the 21st Century.
Few industries are as far behind in customer service as the delivery of healthcare. How many hours are spent in the waiting room of over-scheduled offices? How many times has care been administered without options or explanations? How often is cost or copay a major factor in choices?
Healthcare has an enormous gap to cross before they can say they’ve joined the customer service world. The biggest challenge that we hear at conferences and from customers is the simple question, “Who is the customer?” In a traditional sense, the customer is the one who choses the service. But in reality, the customer is the one who pays the bill. In the vast majority of cases this is the patient’s employer.
The first time this is said, it sounds strange. My employer is the customer of my healthcare? Absolutely. Can I be the customer if I don’t actually pay or withhold payment?. No. It can’t be the insurance company, either. By offering healthcare plans to employers, insurers act as the aggregator of services. The insurance company also allows employers to hedge risk and limit cost (through group negotiation with doctors and health networks) but isn’t the customer. So the only party left to be the customer is my employer.
Because my employer is the customer and never interacts with the service provider, there is a fundamental disconnect with customer service. It ends up being no surprise that basic process of delivering service and collecting feedback is broken.
There have been moves to change this, including with Intermountain Healthcare in Salt Lake City, where the network is large enough and the coverage area extensive enough that the employer can engage the service provider in a direct relationship.
When the healthcare team and the true payer are connected, they can begin to do some remarkable things to improve outcomes (keep employees healthier), cut cost (keep employees healthier) and improve day-to-day service (keep employees happy and on the job).
Given where the current system ‘lives’, this is a model to be replicated as part of healthcare reform and creating truly accountable care. But with companies operating in far-flung places and across state and national borders, we’re not quite in a place for this to happen in the near term.