The Great Consolidation series has focused on the coming market shakeout in the employer health services space. The ever-growing flood of companies and consortia promising or positioning to be “Full Stack” Primary Health solutions will increase in the short term (6-12 months), but inevitably consolidate over the mid term (18-36 months). Part 1 described the thesis behind the “Great Consolidation”, Part 2 described the four necessary capabilities to enable the Full Stack, and Part 3 described the three organizing categories of solutions from which employers will choose to build their ecosystems. In Part 4, we are going to dive into the one ingredient that will tip the scales in favor of the eventual winner in this consolidation, capabilities, and category contest.
So, lets get down to the nut cutting.
The single most important success ingredient for businesses who offer services is trust. People learn to identify with and come to rely on specific brands, companies, and labels because they have a consistently positive experience when using the service to solve a problem. The brand becomes trusted—it’s something that can be relied upon to deliver a specific experience, service or result. New services offered under the trusted banner are also readily adopted because of the trust capital which has been built up over repeated use. This goodwill “capital” (perhaps more appropriately termed “currency”) can then be leveraged by both service provider and end user to continue to promote engagement over time, across services, and into new offerings. Trust is the medium of exchange that makes the experience economy work.
Trust used to derive from the hierarchy of tested knowledge. However, that hierarchy shifted long ago from the “priests” (people with access to specialized knowledge—i.e., yesterday’s physicians) to the power of the “people” (with the democratization of information—i.e., today’s digital health startups). And healthcare has certainly experienced its own decentralization with the rise of the internet and digital health. Today, anybody can become an “expert” with trust often flowing from brands or organizations that speak from—and to—people “like me” (i.e., the rise of the influencer economy). Services that can solve a particular problem in a certain way can earn the trust of their members in this way. This partially explains the rush of 1,000 new entrants into healthcare attempting to solve a specific niche issue. However, trust is not only fickle, it has to be earned over time, which includes trusting that this service will have the necessary staying power to be there when you need it. One of the drivers for the Great Consolidation will be putting the most trusted point solutions onto a “platform” that will become the chassis that can on the road long enough to drive sustained change.
So if the new health economy will be based on the currency of trust—who will be the most trusted entity? Will it be a technology company, a navigation company, or will it be the medical group?
As a national, tech- and data-enabled medical group, Crossover has always relied on the currency of trust to effectively deliver our services. We believe the medical group is the most trusted entity in the ecosystem, and as such is best positioned to influence, direct, and guide members to their best health outcomes. The medical group can both promote and prescribe services (best catalyst for engagement), diagnose and deliver care (without any gaps or handoffs required), and be organized to be accountable for achieving outcomes (can your app do that?). A next generation medical group—defined as having meaningful engagement, care, technology, and outcomes capabilities—is the most proximate to the patient and will become most meaningful to the member. A next generation medical group is not only the best positioned but is now the most capable to earn, build, and maintain trust.
More than code. More than coordination. More of what a member really needs and wants—a trusted relationship with a care team that solves real problems, 24x7x365, rain or shine, in sickness or health, now and next year. Trust over time.
Just in time to lead through the Great Consolidation.
Scott Shreeve, MD 