Healthcare organizations can take a portfolio approach to deliver more coordinated care: Learnings from the consumer healthcare sector

This article was first published in Healthcare Business Today

In the consumer healthcare sector, there are many single-problem-single-solution products: cold and flu medicine, topical acne treatments, supplements to improve digestive health. This diversity of products is not dissimilar from the diversity of healthcare specialties in integrated health networks.

I often recommend to clients that manufacture and merchandise products in these categories that they should think of their product offering in its wider context as one of a portfolio of products that can be leveraged as and when the consumer needs them. This mindset encourages brands and manufacturers to center their product merchandising and marketing on the consumer as a holistic person across the life course, rather than on a series of discrete problems that consumer tries to solve at a single point in time.

The portfolio mindset also means that brands think of consumer lifetime value in a different way: shifting from “how many times will this consumer need a pain relief product” to, “what are our consumers’ overall health challenges, since we know they have periodic muscle and joint pain,” to use the example of over-the-counter pain relief.

The approach resonates for many brands, and some have taken more of a portfolio approach to cross-promote their products and leverage cross-functional capabilities to stay top-of-mind for consumers. For example, Dove markets skincare products for diverse consumer needs under a single brand. Kenvue focuses in their thought leadership on the common scientific underpinnings of fragranced products across their portfolio.

Like the typical approach of single-problem-single-solution products in the consumer healthcare space, most healthcare providers in the United States practice a single specialty, managing patient well- and sick-care in discrete, short appointments, mostly on an as-needed, periodic basis.

A fascinating exception to this approach is pre-natal care, in which patients receive intensive, well-coordinated care across many healthcare domains for a period of nine months leading up to the delivery of a baby. Pre-natal care can include obstetrics, genecology, fertility medicine, fetal medicine, mental and behavioral health, weight management, primary care, physical therapy, coordination with pediatrics, and other specialties depending on the specifics of a patient’s health requirements.

While most specialties deliver care in a single vertical, pre-natal care takes a portfolio approach, assembling the right set of products and services to meet a patient’s complex needs as their health evolves. This highly coordinated approach leads to better health outcomes for pregnant patients and their babies, reduced complexity, and reduced healthcare costs in pregnancy, delivery, and the early post-partum period.

So, why stop great care coordination at the delivery of a healthy baby?

How can the leaders of integrated healthcare networks leverage the pre-natal period as an “acquisition channel” to engage motivated patients (new parents) to access more preventive care, not just in pregnancy and the early post-partum period or with their new baby, but in the long term? With relatively little effort, integrated health networks can take an integrated, portfolio approach to keep their patients engaged in the healthcare system. I’ve included several specific tactics that the leaders of healthcare systems can take to earn long-term patient loyalty, resulting in better health outcomes, reduced costs, and more delivery of preventive care.

Default to opting out of coordinated care

In the single-problem-single-solution approach, taking the next step in accessing care is incumbent on the patient. During pregnancy or after delivery, a patient might be asked if she has a primary care provider. If she answers that she does not, the prenatal provider might suggest, “you are in your 30s now, so you should probably get one.” The patient nods, adds it to the long mental to-do list, and leaves the appointment.

In a portfolio approach, the prenatal care provider could ask the same question, get the same answer and respond, instead, “we have excellent primary care providers in this office who specialize in helping you to manage your heart health and any other health challenges you might be facing, especially after having a baby. After this appointment, someone from their office will call you to schedule your appointment.” The patient nods and has no task to add to the to-do list, other than to answer the phone and make it to the next visit.

The key challenge, of course, is making sure the patient takes the action to attend the primary care appointment. Coordination and communication among specialties in the practice or network are crucial capabilities to build into the offering. Another concrete required action will be to deliver retraining of the prenatal providers to ask the question about a primary care provider and share the value proposition of new parents seeking primary care.

Incentivize cross-specialty prevention

Healthcare providers are now routinely assessed and, increasingly, reimbursed based on the quality of the care they provide and primary and secondary prevention are important quality metrics for many specialties. Prevention can be a complex metric of quality, though, because the approach takes a speciality-focused, siloed view of a patient’s health when applied in the single-problem-single-solution context: a patient visits their cardiologist, the cardiologist delivers preventive cardiovascular care.

In a portfolio approach, though, prevention could be viewed across specialties. Could the prenatal care provider identify a dermatologic risk factor and coordinate an internal referral to a dermatologist? If the dermatologist then identifies an early-stage, highly treatable skin cancer that results in lower-cost care and better long-term health, could the prenatal care provider also be rewarded?

It may be difficult to implement a cross-specialty change like this because healthcare providers are already so constrained for time in their encounters with patients. It may be possible to leverage support team members to coordinate referrals, or introduce quick, high-level checklists that ask the provider to screen for the most common co-morbidities with their patients.

Consider patients’ non-medical needs when adding new capabilities to the network

As healthcare industry consolidation continues apace, integrated delivery networks are becoming more common as capabilities expand and extend. In addition to medical specialties and capabilities, however, integrated health networks could benefit from adding non-medical capabilities to support the non-medical health needs and objectives of patients.

For example, during and after pregnancy, many new parents are recommended to seek physical therapy to strengthen their pelvic floor. Physical therapy, however, is often not offered in an integrated care network and reimbursement may or may not be possible as many physical therapists do not accept insurance. Even when a patient can benefit from the integrated capabilities of an integrated care network, some care needs sit outside of the network’s capabilities, reducing access and worsening the patient experience.

If taking a portfolio approach, healthcare leaders could consider the non-medical services to add to their offerings as and when they seek to add to their existing service lines.

Like consumer goods companies, healthcare delivery organizations can take a portfolio approach, too, thinking of each patient encounter as an opportunity to earn a patient’s loyalty, and then to facilitate a continued and ongoing relationship. There are important consequences to take a single-problem-single-solution approach to care, including lost revenue, missed opportunities to deliver preventive care, and poorer health for patients. Pre-natal care provides a high-quality example of how integrated, cross-specialty care can be delivered, taking a portfolio approach to deliver improved outcomes across the stakeholder landscape.