Not too long ago, the Robert Wood Johnson Foundation invited me to speak to their entire organization about Sherpaa, re-imagining healthcare, and designing a better way of doing things. The Robert Wood Johson Foundation is the United States largest philanthropy devoted solely to the nation’s public health and they do absolutely wonderful work.
After I spoke, they asked me to write a piece for them. Here’s what I wrote:
Everything great comes from an elegantly designed process. Just think of all of the experiences we love and use on a daily basis. Consider the iPhone. Apple re-imagined what a phone, or rather, a tiny computer in your pocket, could be and created a revolutionary device. Steve Jobs designed not only the interface that changed computing forever, but Tim Cook designed the manufacturing and material sourcing processes that enabled them to produce a remarkably complicated device at a relatively inexpensive price. They understood that, in order to deliver an exceptional user experience, they had to design the entire process, from the interface to the factory.
Health care was never designed. It just happened, revolving mostly around doctors’ needs and wants, in a culture that strongly believed “doctor knows best.” But our culture changed with the democratization of health information and other industries quickly evolved, raising consumers’ expectations of what health care could and should be.
Comparing the Apple Genius Bar with today’s average health care experience is laughable.
So how can health care catch up? Design an elegant health care process that enables intelligent health care delivery. Don’t only design that process, but implement it. Essentially, combine the elegance and creativity of Steve Jobs with the process-driven business savvy of Tim Cook. That’s what we do every day here in my company, Sherpaa. Here’s how it works:
- Our salaried, full-time doctors have one mission: communicate via phone or web and creatively solve our patients’ health problems, all day, every day.
- When patients have health problems, they log in and tell us their story.
- Our doctors then, online, ask the right questions and get a careful history, prompting them to either order lab or imaging tests, treat with a medication, watch and wait, or refer for an in-person evaluation to a doctor in the patient’s neighborhood.
- 70% of the time, our doctors treat or solve the issue without having to refer to an in-person doctor. When we do refer, it’s always to the exact specialist the patient needs.
Does that really mean that 70% of primary care, specialist, and ER visits don’t need to happen? Does that really mean that 70% of those insurance claims should never happen? Yes, exactly. If you give patients accessible doctors at the right time to skillfully decide how best to use health care, health care is used intelligently with very little waste. In this system, everything that’s done actually needs to happen.
All of this is the result of an elegantly designed health care delivery process. But elegant processes aren’t free. So, in conjunction with this process, you must have an equally innovative business model to pay for this new process. There’s a hard fact floating around companies saddled with health care costs—health insurance premiums double every seven and a half years. Employers have a vested interest in taming those costs. And with roughly 70% of health care costs in America fronted by employers, they are the perfect innovation partner. Employers pay us to innovate their way out of rising costs through intelligent health care delivery.
This is all very interesting for the early adopters—the innovative and creative companies looking to make health care awesome for their employees. But what about the rest? What about the unions, those folks on Medicaid, and companies with minimum wage workers? Well, it’s called trickle-down technology. When the iPhone came out, few people could afford it. Over time, we now have cheaper versions of iPhones and, most importantly, Google’s Android smartphones. There’s even a $25 Android smartphone soon to be released. Now, almost everyone can afford this fancy “new” technology. This will also happen with health care. Start with the innovators who can’t stand frustrating experiences and who are dying to pay for something better. Work with those folks to refine your process and make it even more elegant, build an even bigger business, and watch competitors arise. And in the not too distant future, we’ll all wake up one day to see health care transformed by a little combination of dreamers, designers, and businesspeople who couldn’t stand seeing something broken without doing something about it.
30 years ago today, The Breakfast Club met for detention.
Perhaps the most iconic detention of all time.
The first time I heard this song, I cried. It was simultaneously a confirmation that I wasn’t alone in my thoughts and feelings, and a condemnation of them. But that’s youth, right? In our modern society? I read in a book that we are programmed to fall in love with one person in our village of 300 people. And now that hard wired biological programming is totally going haywire in this modern world where we meet our one in 300 every couple of weeks. But we’ve evolved and adapted as a society, I suppose. I used to think it was a curse and now I think it’s good old fashioned common courtesy, like the British and holding the door. After you, my dear Alphonse. It took me another 20 years to learn that.
1993. Later that summer, Matt Johnson brought The The to Boston, and since Dusk was such a big “hit” in that town he played Great Woods. The show started with this song, the audience did their part. It was glorious and wonderful. Every time I hear it, it still sends chills down my spine.
Matt Johnson was such an incredibly lyricist. I’d give anything for one more The The album. There was a book launch party for the new History of 4AD, and Matt’s in the photos from the party, looking like Matt.
Great Album-never get’s old.
11 Never-Before-Seen Photos Of Malls In The Early ’90s; or, BuzzFeed explores the Malls Across America project, an old school Kickstarter project that’s about to be published.
Here’s the real reason why Sherpaa is important. It actually bends the healthcare cost curve. There’s something called the Rule of 72. It’s a rule for estimating an investment’s doubling time. To simplify, if an investment has a 10% interest rate, it will take 7.2 years to double the initial investment. If it has a 5% interest rate, it’ll take 14.4 years to double. And so on.
Healthcare premiums in NYC are, on average, about $15,000 per employee and increasing about 14% every year. They have been for the past 20 years. There is no real suggestion that these premium increases will slow, even with Obamacare.
That being said, every company we cover with Sherpaa has had premium increases less than 6.2%. So, over 10 years, because premiums with Sherpaa increase about half as much as premiums in companies without Sherpaa, we save companies $110,000 per employee. And, the total cost to companies over the course of that ten year period is about $7,000 per employee for our services.
Why does Sherpaa make health insurance less expensive for companies? Well, here’s an analogy. If you’re purchasing car insurance, and you have an impeccable driving record, your premiums are much lower than reckless drivers. Because healthcare is so confusing and people have difficulty understanding how best to use the right, most effective, and most cost-effective healthcare, we’re all like those reckless drivers. But with Sherpaa, our doctors solve 70% of health problems over the internet without you having to see a doctor nor pay a co-pay. And for the 30% of the time you do have to see a doctor in person, you’re always seeing the exact doctor you need to see. So, office visits, ER visits, and, therefore, claims decrease by 70%. Your company starts looking like really safe drivers. Everyone saves time and money and has a doctor at their fingertips.
It’s a win/win/win and a short and long-term strategy to control costs and deliver employees a lovely healthcare experience. I’m very, very proud of that.
Neil deGrasse Tyson chats with Dan Aykroyd on topics as varied as the science of humor, Earth’s molten core and the birth of the Blues, with a little help from Chuck Nice and astrophysicist Charles Liu.
Scientists may have invented the lightsaber
A team of Harvard and MIT physicists liken their discovery to the iconic weapon wielded by Jedi and Sith alike in the George Lucas films.
From this WSJ article:
- A guy buys a catastrophic health plan that pays up to a fixed amount for doctor and hospital bills based upon the diagnosis
- He needs a hernia repair
- He tries to use his insurance and they try to make him pay $20,000 up front for the procedure
- He cancels the procedure and goes back to his doctor to regroup
And here’s the solution he and his doctor discovered:
Most people are unaware that if they don’t use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the “list” price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.
So we canceled the surgery and started the scheduling process all over again, this time classifying my patient as a “self-pay” (or uninsured) patient. I quoted him a reasonable upfront cash price, as did the anesthesiologist. We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services. He underwent his operation the very next day, with a total bill of just a little over $3,000, including doctor and hospital fees. He ended up saving $17,000 by not using insurance.
This is exactly the kind of thing we do here at Sherpaa. Healthcare is so damn confusing and so stupid expensive. There are so many tricks and loopholes that the average person can’t understand nor be expected to know. Come to us first, and we, through our insider experience and knowledge of these tricks, will craft a plan that can save you the cost of my awesome 2010 Mini Cooper.
This also works wonders for not only individuals like this gentleman, but also for self-insured companies.