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By Monica E. Oss

I’ve had some interesting feedback from my recent piece last week—What Does It Take To Outlast The Disruptors?. One of the themes in that feedback is that “disruption” in the health and human service space is unlike other market spaces. It is highly regulated, it is life-and-death, it is an imperfect market (from an economic perspective), and more. I agree with all those comments—but still believe that many specialty provider organizations delivering services in “traditional” models under “traditional” financing will face market share erosion from “disruptors” in the field.

But those comments made me ask who are the disruptors and what would need to change for them to have bigger impact on service delivery?

First, what exactly is a disruptor? They, and innovators, are often thought about in the same way—both are builders. But not all innovators are disruptors—disruptors change how we behave and do business, displacing an existing piece of the economic value chain with something new and more valuable (see Disruption Vs. Innovation: What’s The Difference?).

In health and human services, these organizations come in a few flavors—incremental innovations that have big impact; technology and analytics that dramatically reduce costs and/or improve performance; and radical disruptions that fundamentally change service financing and delivery (see Alexa, What’s Going On With Healthcare?). These disruptions include employer direct provider contracting, innovative clinic locations, online direct-to-consumer sales of services, medications, and medical equipment, virtual health, tech-enabled consumer-directed care, and more. And there is certainly a lot of private investment money going into these innovations.

With all that capital, why is disruption in health and human services taking so long? I did some research about what the executive leadership of these disruptive organizations are saying (see Healthcare Disrupters Need More Freedom To Change A ‘Dysfunctional’ System, Private Sector Says, 5 Things Preventing Technology Adoption In Health Care, The Biggest U.S. Health Care Challenges Are Management Challenges, Barriers To Health Care Innovation, and Positive Disruption In Health Care: What Will It Take?). These were the most common items on their “wish list”:

  1. Permit consumers to use their health savings accounts to purchase a direct primary care membership.
  2. Develop uniform national regulation of (and universal reimbursement for) virtual health
  3. Eliminate the fee-for-service payment model.
  4. Modernize the academic education of clinical professionals.
  5. Eliminate “employer health benefits” and “Medicaid/Medicare health benefits”—and allow consumer to spend the dollars on the health plans and services that they want.
  6. Develop national universal definitions for health care processes and procedures—and universal standards for data sharing.

I don’t think we’ll see any of these changes in the health care landscape happen any time soon in one “big bang.” Rather, we are moving (glacially) in this direction. In the meantime, don’t discount the disruptors in specific geographies, payer sectors, or consumer markets. In nature, glaciers do move at different speeds.

For more on navigating a glacially disruptive market, see:

  1. Innovation Isn’t Enough
  2. Who Should Be The Consolidators?
  3. Can You Teach A Fish To Climb A Tree?
  4. David Versus Goliath?
  5. Don’t Let The Big Disruptors Out Of Your Sight
  6. The Top Priorities For Innovation Are.
  7. The Rational Response To Change – Innovation
  8. ‘Agile Innovation’ Needed For The Challenges Ahead
  9. Innovation Success Formula = Strategy + Marketing + Scale
  10. Three Models For Structuring Your Organization For Innovation
  11. What To Do About The Innovation “Hiccup”

For more, join Leigh Davison, Staff Vice President, LTSS Specialty Organization, Anthem, Inc. on February 15 at The 2019 OPEN MINDS Performance Management Institute for her session, “Innovative Collaborations & Partnerships For Long-Term Services: The Anthem Perspective.”

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