Specializing in consulting services to help providers with payer management to increase revenue, reduce waste, and streamline their operations.
There are many articles that discuss the value of connections. It’s true! In business, we need each other to grow. In the simplest terms, relationships matter. The trouble is building and understanding the strength of the relationship. Everything is great, until a problem arises. Connections as a result are rendered useless or seize to exist, this makes building meaningful relationships difficult.
Companies are often left searching for a better way forward. In healthcare, it is a symbiotic relationship. A symbiotic relationship is when two independent organizations must learn to co-exist in close proximity to thrive. There are a few different types. The ideal relationship is when both organizations benefit from each other’s interactions. In developing meaningful connections this is the goal. We want to achieve growth and market saturation uniformly together. A great example of this relationship is when technology companies integrate with providers directly. The provider has the patient volume, which the technology platform requires. The provider does not have the innovation to continue growing without electronic medical records, telehealth communications, electronic billing, patient portals, etc. There are infinite possibilities of technology that would enhance a practice’s operation. Both companies benefit from the skillset of the other, without disruption. We will discuss the importance of mutually beneficial symbiotic relationships.
Another slight variation is when one organization gains an advantage by aligning with another independent company. In this instance, the hospital system acquires, partially or in whole, the community provider. The community provider quickly receives increases in payments, enhanced resources, and additional volume. The hospital may experience a gain in revenue, otherwise, there is little to no impact on the organization. There is no negative impact either. This is not a bad situation, as sometimes in there is a long-term gain, even if the short-term advantage is to another organization. This situation is very common. What we want to avoid are harmful relationships.
This usually develops when one organization needs something from another, without the ability to give anything beneficially. This is when relationships come at a cost. The best example from the healthcare perspective is when a provider would like to join a health insurance’s network. The provider would like to be able to see the insurance’s patient as in-network. When providers become participating, the patients pay lower costs for services, as opposed to self-pay rates. The issue that arises is whether the health plan really needs the provider. Once the health plan has met their adequacy, meaning the market is saturated with provider options for their patients, there is no need. If the provider would like to join, the initial offer is going to be low. The provider is often left feeling undesired. This could also result in a negative impact on the bottom line. There is little benefit. This is one of the reasons providers need to find their uniqueness. Luckily, we know a few good consultants who can assist. It is imperative your connections are beneficial. If not, in direct terms, you have the wrong arrangement.
We cannot grow without some type of partnership. This may lead to arrangements between providers and health plans or different providers joining forces for a common initiative. Either way, there is little value in being independent. It does not mean there needs to be common ownership. The best arrangements that drive real, meaningful results have a partnership based on core beliefs with a shared vision. Yes, this is absolutely essential. Connections created out of convenience generally fail. Convenience is when you ask for a one-time favor from someone that you have established no relationship that will not be inclined to help again. These do not survive the long haul in business since there is no foundation. For a partnership to grow from a connection there must be alignment. This alignment will develop into motivation, motivation will organically create symmetry. This does not mean all values and visions must be shared. However, the core value that drives the project must be shared. It is this commonality that cements the connection. Everyone talks about having shared interests when dating, the same is true in business.
In healthcare, it is essential to be connected. The good news is finding similarities and shared values are not difficult. We all want and need to focus on the patient. This is also the reason consolidation is extremely common within the healthcare industry. Healthcare is tough to navigate. Therefore, we lean on those, like our firm, with the knowledge to assist.
We all understand the value of relationships. It is evident in dynamic partnerships. There are a couple of examples where competitors became allies from a single shared vision. In North Carolina, Duke, and LifePoint joined forces to strategically develop and cultivate efficiencies for community hospitals. One organization is academically based, while the other focuses on operations. Together, this created a partnership that is mutually beneficial where each had their own unique skill set to offer.
Even more unique in Georgia, the two competing hospital system giants joined forces. Piedmont and WellStar partnered together to create their own health insurance plan. Their shared goal was to provide more cost-effective insurance to their employees, while utilizing the network adequacy of their own hospitals. This was dynamic, as the hospitals are avid competitors in the market. In the end, their core values developed into an opportunity that both would have been remised to avoid.
More recently, CareFirst BCBS co-founded a new non-profit pharmaceutical company. Civica Rx was created in 2020 to develop generic medications at a reduced cost. The shared vision of investors was to overall lower the cost of prescriptions in key areas driving up cost. CareFirst is an integral part of this partnership. If successful, CareFirst will benefit greatly, as the medical expenditure for insurance companies for pharmacy services is substantial. It is one of the highest costs for medical insurance. Civica RX will likely develop into a top pharmacy quickly. This partnership is outside the box, but it may very well create a solution unavailable elsewhere in the market.
These opportunities were created by shared interests, common values, and open-mindedness. These are the network connections that drive innovation. Every connection should be seen as positive, even competitors. As leaders, we know businesses rely on the strength of our networks. It is imperative to partner with like individuals. As consultants’ connections are integral to our ability to elicit success for our clients. It is this understanding that creates the foundation for great partnerships. We couple this with the ability to think globally and drive innovation.
You may be wondering how these partnerships began. It starts with your approach. Most providers begin an adversarial relationship with health plans. Within the healthcare industry, there is an avid sense of rivalry. Unfortunately, this is not necessary. Providers only lean on their contacts when there is an issue or a favor is needed. While this may appear healthy, it is extremely one-sided. Health plans have some exceptional talent. When I was working on the health plan side, I often partnered with actuaries to analyze potential business opportunities. These are highly intelligent individuals, who are driven by numbers. In order to communicate, I had to learn their language, translate it into a business model, then simplify into a meaningful process to implement operationally. This is only easy if you have developed the appropriate relationships. This is really when I personally started to learn about a strong network. A strong network is a group of key contacts when combined together synthesize into a greater team to accomplish shared goals. This all goes back to the main goal – mutually beneficial symbiotic relationships.
It may be surprising as health plans have many goals in common with providers. This belief is not widely accepted by the provider community. It is true. It is also one of the reasons, we have been able to negotiate and create innovation and solve problems. No company is perfect. Therefore, it is better to approach connections as friendship. Healthy friendships can withstand being on opposite sides of the negotiation. This comes from mutual respect for each other’s roles and abilities. Our network’s strength determines how we move forward, it provides direction. When there is no connection, we start spinning our wheels. There is a famous quote from Aristotle, “It is the mark of an educated mind to be able to entertain a thought without accepting it.” We can respect each other’s viewpoints while offering a counterpoint, nonetheless. Often to be successful, we must understand each other first.
The connections that I made from my first job out of college laid the foundation for my career. At the time, I had no idea. Many years after leaving this company, I received a call to again partner on a new venture. That was a great project, which I would have otherwise missed had I neglected relationships. In fact, most of my career has been driven by connections. Once the foundation is established the sky is the limit. A strong network will also insulate you from uncertainty. The healthcare community employs over 20M people, in over 6K hospitals and 900 health insurance companies retaining the majority of professionals today. While it may seem like a lot, we are all neighbors. It is simple to build the foundation.
In business, there is competition. We have to compete to succeed. The same is true within the healthcare industry. Unfortunately, without revenue, we cannot care for patients. Revenue is still the core of our businesses. This does not need to be negative. As peers, it is easy to share in the success of each other. We still have respect for each other’s roles. This is the reason most of the top experts in the field present on discussion panels, post on similar topics, and head similar conferences. While competitors are separate organizationally, when a problem impacts the market, priorities quickly shift. If the connection is only adversarial, it could be difficult to cultivate a true partnership. There is also a lot of consolidation in the market. Therefore, someone could become a colleague quickly. We’ve all learned there are only a few degrees of separation. That’s also the reason every connection is an opportunity. It’s easy to reach out or follow someone socially these days.
Healthcare is an ever-changing, adapting, industry that undergoes constant change. This is evident enough from the past three years. In order to innovate, we must look at the problem from multiple angles. This could include unlikely partnerships. It goes back to a vision of shared goals. Often times it is a decision on resources. What is necessary to accomplish our goals? Do we need help? This is one of the reasons businesses partner with consultants; knowledge, speed, and flexibility. Our future innovations all start with the same thing, an idea. It is difficult to realize without help.
Lunch is still valuable. Most communications are electronic. It is quick and efficient. Salespeople who utilize social media are 78% more likely to close deals. The counterpoint to this statistic is it takes on average 8 communications to start the conversation. We are not taking the time to understand and cultivate engagements. This is only accomplished through meaningful discussions. By today’s standards, this is an old-school strategy. The average client is more likely to remember a story. This situation can be applied to connections. When relationships start to develop, we share details of our lives. These details provide insight into our shared experiences. This leads to opportunities that we may not have realized existed otherwise.
Building the foundation of relationships is time well spent. While it might seem silly, it is still necessary. A good portion of the startups, which I have been involved, are from my network. Also, one of the relevant examples of a lack of partnership is from the technology industry. There are hundreds of start-up tech firms that go under within 3 years. This is directly related to creating a product that is useless. It may be a fantastic idea. However, if no one buys into the idea it is irrelevant. Ideas can be solidified, developed, marketed, and sold seamlessly with the right network. The tech firms that understand partnerships thrive.
It is valuable to have a network of connections. With the creation of LinkedIn and other social networks, the ability to connect is easier. Even with these applications, we must be conscientious of our approach. It is not enough to simply “add” someone to your network. Unless your goal is simply numbers. To create functional relationships that drive the beneficial symbiotic relationship, we must communicate. This could be through email with a marketing campaign. This works well for selling items. Someone can easily and quickly receive information and decide to buy. It’s not as good for developing partnerships. There is always a chance of being pen pals. For those unfamiliar with the term pen pals, this is where people, who did not know each other or have a connection otherwise, wrote letters back and forth. For business, we need to be more than pen pals, social media likes, and followers. Partners need to know each other or have a shared vision.
To approach a new contact, it is simple to reach out socially. It is best to send an introductory email/communication that provides insight into who you are and why you are reaching out. Most people are very receptive to new connections. This is a goal for us all to grow our networks. Your network can always be a little bit larger. It’s not all about numbers though. Let’s start with a bad example. A guy that grew up playing tennis with my now husband reached out one afternoon to him wanting my contact information. My husband had not spoken to him in years. When my husband inquired about the reasoning, he wanted me to recommend him for a job at my company. Actually, I think at the time, the job was on my team. I never even had a single conversation with this person, who thought my husband would be his pawn to secure an opportunity. This is the wrong way to go about introductions.
A better method is to actually take the time to get to know the person. Reach out directly. In the introductory call take the time to introduce yourself. It is not good to focus on your intentions, what you need, etc. Instead ask the person about their life, passions, hobbies, and career. This creates the foundation for a healthy symbiotic relationship. It is important to take the time to cultivate depth in the relationship. The first part of my meetings is spent catching up. Yes, add in the time. It is important to know your relationships. That includes their lives outside of work. If you run out of time, you have an easy reason for a follow-up meeting. You’ve seamlessly led to another conversation, keeping your contact warm. This applies to relationships in general, whether or not it is business related. It’s important to be genuine.
Follow-up with a meeting. This is good for multiple reasons. It is always good to associate a person with their face and voice, virtually or in person. The conversation will organically develop. There may be alignment. If so, this will come up quickly. It is highly unlikely nothing comes of the conversation especially if the goal is to find your shared vision. My introductions usually involve the issues surrounding healthcare, whether personal or business-related. Honestly, it’s my (our) passion. This should not be surprising. Plus, we are problem-solvers. I have plenty of introductory calls with healthcare professionals. There may not be an initial opportunity, but there sure is a shared vision. Regardless, we are laying the foundation that will continue to grow. Social Media does help with this aspect. Plus, you can partner with a consulting firm, like us, that have the network to make the introduction. We certainly have the contacts to help.
Within the healthcare industry, there are so many niches. This makes it difficult, sometimes impossible to find the right subject matter expert. Our expertise is in connections with providers and insurance. The value of these contacts is substantial. While the healthcare industry may seem large, it really is not. In another article, I mention there are 900+ insurance companies. That’s an average of 18 per state, that’s not considering the majority are within California, Texas, and New York. Each of these states have at least 50 different plans. If you trying to grow your market, relationships are at the core of your growth strategy. The right contact can really help align your business. Sometimes it is a team of contacts. There will be times when a competitor is an ally, markets and legislation change. This is the reason good connections are invaluable. It is important it is mutually beneficial. If you struggle, find a good consultant to help bridge the gap. Our entire model rests on our ability to cultivate relationships.
Specializing in consulting services to help providers with payer management to increase revenue, reduce waste, and streamline their operations.
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