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New Players Take the Field: How Private Employer Healthcare Could Mean More Focus on People



Contributed Commentary by Darryl James 

February 25, 2020 |  Depending on which side of the gurney you find yourself, the U.S. healthcare system can be simultaneously viewed as either a modern-day gold rush or an impossible financial burden. In large part, this is because humans have been displaced by business objectives as the focal point of healthcare. 

If you’re seeking some sign of restored equilibrium between massive healthcare corporations (59 of the S&P 500 companies are healthcare-related) and the individuals they are meant to serve, there’s an inkling of real change, growing out of an unlikely corner… other massive corporations. 

I’ll explain, but first let’s marvel at the scarcely-conceivable size of the healthcare economy. Already the most expensive system in the world, the Centers for Medicare & Medicaid Services (CMS) estimates that U.S. healthcare spend will rise by an average of 5.5% per year over the next decade, growing faster than the economy, from $3.5 trillion in 2017 to $6 trillion by 2027. The U.S. spends orders of magnitude more per capita on healthcare than any other developed nation and yet shows arguably poorer results. 

It’s understandable that more players would want a piece of this giant pie but how does that translate into a benefit for individuals? 

Well, it’s because some of the entities finding themselves on the patients’ side of things are 800-pound business gorillas who are motivated to optimize their employees’ health. The Kaiser Family Foundation, reveals that employer-sponsored insurance plans cover 49% of the population, and according to data from the Integrated Benefits Institute, employers collectively paid nearly $880 billion in healthcare benefits for employees and dependents in 2018. On average, employers lose another $580 billion per year due to lost productivity from illness. 

It’s no surprise that some large employers are increasingly offering health services of their own in an effort to reverse this trend of skyrocketing spend. A recent survey by the National Business Group on Health revealed that almost half of all large employers with more than 5,000 workers had onsite or near-site clinics in 2019, with two-thirds expected to provide them in 2020. 

Now, there has been a lot of human-centered progress in the traditional arenas of healthcare. But in order to achieve real balance, there needs to be a deeper shift in orientation, the kind of disruption that often comes from outside, rather than inside, a system. 

The emergence of these new players, from outside the health industry, has the potential to refocus the healthcare system on the people at the heart of it. This is evidenced by Walmart, Amazon, Tesla and Starbucks standing up their own services for employees. 

In Fall 2019, Amazon launched Amazon Care, a virtual primary care offering for its Seattle-based employees and their dependents. Inclusive of telemedicine, on-demand house calls and prescription fulfillment, Amazon is partnering with Oasis Medical to provide the best of both virtual and in-person care. 

Walmart is also piloting a suite of new services as part of its 2020 healthcare plan, with offerings that will be made available to associates in select markets, including expanded telehealth, a quality provider resource, personal healthcare assistants and access to a nationwide fitness club. 

Starbucks, for their part, announced in January that it will add Headspace to its suite of benefits and resources. Inspired by Mental Health First Aid, the company is also providing dedicated training for all North American store managers, with a program designed by the National Council for Behavioral Health that aims to foster skills necessary to support someone in a crisis, whether it is related to a mental health issue or substance use and beyond. 

All of which recalls something Elisabeth Rosenthal writes in her book An American Sickness: “The central mantra of ‘innovation’ in the past decade has been ‘patient-centered, evidence-based care.’ But isn’t that the very essence of medicine? What other kind of medical care could there be?” 

Indeed. 

The above initiatives are all incursions into the service infrastructure surrounding healthcare. With deep-pocketed new players, there is an opportunity for fundamental change. These new payors and providers come from industries that already rely on great customer experiences for survival and have already enshrined them as core values and directives. They are starting by providing services to their own employees, whose health they obviously take a vested interest in. Taken together, and with a bit of momentum, this conceivably adds up to a new gravitational pull in healthcare, one based on results for patients, that augments the straight profit motive with a deeper ethos of reinstating people as the proper center of the healthcare system. 

Darryl James, Senior Design Strategist, EPAM Continuum, draws much of his thinking from a broad background of analysis and storytelling. After 10 years as a photojournalist for national newspapers, magazines and wire services, he brought his education in psychology and anthropology to bear on design problems. Since then, he's worked on everything from healthcare to wearable cameras, cheese packaging to telematics, and mobile operating systems to connected speakers. His favorite projects have revolved around emerging technologies—molding new capacities to the scaffold of a user's context, worldview and latent needs—that are applied to problems of public good. In pursuit of this space, Darryl has headed up a number of health and well-being efforts that range in scale from specifically improving the patient experience of a hospital’s emergency room to broadly designing an entire healthcare ecosystem in Latin America intended to expand access to care and information for millions of citizens. He can be reached at: darryl_james@epam.com. 

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