While most people dread flying during the holidays, it’s hard to ignore
how efficiently the airlines are able to move millions of people across the
country. While we tend to dramatize
issues with flying, today I want to appreciate the tremendous job the industry
has done to create an effective (and dare I say friendly?) member experience
that healthcare could learn from.
Flight Purchasing
How The Airlines Do It: How do you like to buy plane
tickets? Some people use a travel agent,
some people call the airline, others buy online (either directly from the
airline or from flight comparison websites).
Airlines give customers several channels to buy tickets by creating
their own infrastructure, but also opening up their data for other companies to
use. Freeing up their data also creates price
transparency, leading to greater competition and lower prices. While everybody hates the new fees airlines
tack on, decoupling extras (e.g., checked luggage) can also lower costs or keep
them steady since only the people who use these services are paying for them. Finally, customers can also get lower prices through
group buying, using companies like Egencia that exchange volume for price.
What Healthcare Can Learn: Right now, you have very few choices
about how you can pay for healthcare – given the high cost, insurance is the
only route for most people, and that’s often tied to your employer. This may change with the individual
exchanges, as employers may drop coverage and folks will get to choose which
plan is best. As a result, insurance
companies will need to create more customer-friendly plans and interfaces to
help customers understand their choices in a much more competitive market.
While healthcare is mostly fee-for-service (i.e., you’re only charged
for what you use), there remains a lack of price transparency – do you know how
much your x-ray costs? While new
startups have emerged to address this (e.g., Change Health, Healthcare BlueBook), we need to continue to create easier tools and better incentives for people
make the right treatment decisions. Finally,
group buying has existed in groups such as Pharmacy Benefit Managers, but newer
incentive-based models (e.g., ACOs) have the opportunity to be scaled up.
Pre-Flight Experience
How The Airlines Do It: Airlines have embraced technology to
make the pre-flight experience better.
First, airlines use code sharing agreements to fill less crowded flights
on other airlines or transfer frequent flyer points across multiple carriers, completely
blind to the customer. Second, airlines
have embraced newer consumer technologies – for example, United and American
are two of the first businesses to work closely with Apple to integrate their
apps with their mobile payment service, Passbook. Finally, security, one of the most important
parts of the operation, is handled by a centralized agency, the Transportation
Security Administration, meaning airlines can focus on what they’re good at
rather than the complexities of security.
What Healthcare Can Learn: The code sharing agreements are akin
to hospitals and doctors seamlessly transmitting patient information across
systems. While hospital systems do this
today, it needs to be more portable and touch more patients, possibly through larger
alliances that cover more health systems using the same technology. I also like how airlines are working closely
with mobile companies on cutting edge consumer technology – major health
systems may benefit from tighter alliances with those major tech companies. Finally, ceding certain activities to a single
group takes healthcare companies out of what their bad at (e.g., data
management). EHRs may be a good example –
does it make sense for the industry to name a single standard, and then allow
health systems to outsource the work to dedicated vendors?
In-Flight Experience
How The Airlines Do It: Sure, the seats are cramped and the
food is mediocre (when there’s food at all), but airlines have done some things
right. First, any in-flight purchases are
cash-free, limiting the payment options, but simplifying the process to make things
more efficient. Next, airlines have
created partnerships with movie and television studios to present current entertainment
options or started handing out tablets to personalize the experience. Finally, frequent flyers are often rewarded
in-flight through a variety of special perks (e.g., free checked bags,
automatic upgrades).
What Healthcare Can Learn: Efficiencies gained through limited
payment systems would be a clear benefit to healthcare (i.e., eliminating the
complexities of the fragmented insurance system means less admin headaches for providers). The entertainment partnerships are vaguely
similar to ACO’s, where there’s an incentive to produce and deliver high
quality products – in this case, the airline benefits from having an engaged,
happy flyers, and the studios have a captive audience to pitch their best
shows. Finally, I’ve written about “frequent flyer” healthcare programs in the past – integrating something like this into a
hospital system could be an effective way to gain loyalty with select consumer
segments.
These are certainly pipedreams with a multitude of complexities and
challenges, but after flying this past week, I’ve come to appreciate what the
airlines have done in the face of tremendous challenges and I’m hopeful
healthcare can do the same.
