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Growing Our Field Inside the Healthcare Industry Calls for Bold Strategy
Not every new business deal is a win. Some contracts are too small to sustain a company’s vision. I learned this years ago when a mega-corporation acquired our large company. Our new owner informed us as we implemented the merger that our sales pipeline was unusable. Their annual budget goals dwarfed the dollar amounts our deals could contribute to either top- or bottom-line targets.
This lesson is relevant for behavioral healthcare’s future. We can pursue safe or aspirational goals. Our field is being acquired by larger healthcare companies and integrated into their financial plans. The billions spent annually in the US on behavioral care are not paltry but are small relative to our $4 trillion total expenditures. What is our growth potential? Can we maximize it based on a realistic plan?
We must start by deciding which healthcare payers to cultivate. The closest payer is not necessarily the best. For example, we may wish to collaborate with PCPs in primary care, but who will pay for our work? PCPs are just getting by themselves, and they are seeing an erosion of patients to urgent care centers, retail nursing clinics, and virtual primary care products. Forget PCPs as payers.
Consider the provider alliances called accountable care organizations (ACOs). They are noteworthy for assuming financial risk for entire populations. Yet the history of ACOs as payers for behavioral healthcare is discouraging. They often fund only minimal behavioral services.
Our best strategy is to focus higher up the funding stream. While businesses and governments pay for healthcare and shape it in many ways, health plans have multiple responsibilities as both payers and administrators. To maximize revenue for our field, we should actively shape how health plans perceive our value. We should then dedicate ourselves to winning business based on that value proposition.
Good relationships are a prerequisite for fruitful negotiations, especially with top decision makers, and yet our connections with health plan executives are fading. Health plans have acquired the major behavioral payers (e.g., Magellan, Beacon), and the these acquired entities tend to shrink and diminish in influence over time. Their leaders leave or sink lower in the health plan organizational structure.
We need to designate high-profile leaders from various segments of our field to engage in discussions with leaders inside health plans. The topic: behavioral healthcare’s potential for improving the health of populations. Health plans have inordinate control over funding, and we need our top spokespeople promoting a bold vision that health plans will embrace and fund well.
Sales professionals know the importance of shaping the buyer’s perceptions early. When a request for proposal (RFP) is sent to prospective vendors, the purchaser has already determined which products and services to procure. The time for influence has passed—you must shape the RFP before it is issued.
We should apply lessons from strategic sales to advancing our field. The behavioral healthcare field can be slotted into a narrow specialty role or valued broadly for services embedded into medical settings to impact health outcomes. We need to shape the views and preferences of healthcare buyers so that RFPs (real or virtual) call out loudly for our capabilities.
Our goal cannot be achieved through the disparate sales efforts of individual companies. The usual focus of sales and marketing is existing products. There is a time for innovative solutions provided on a large scale, but sales of this sort are not typical. Success with a bold sales strategy relies on collaboration around a shared vision and a willingness by both parties to enlist all available resources.
These goals are lofty, possibly unattainable, but not unrealistic. Now is the time to show healthcare leaders we can work broadly in medical settings to change critical behaviors. We may be respected now for treating behavioral health disorders, but we can become a field admired for much more than this.
The marketplace will not naturally identify our field as providing more expansive solutions. Our leaders must take us there with a clear message that these are difficult yet feasible goals. Do we want our field associated with revenues in today’s range, or do we want to generate multiples of that amount?
Of course, a bleak future is also possible. A new phase of efficiency could arrive with an end to innovation and a relentless focus on pricing. Why not substitute less expensive digital products or virtual healthcare for in-person services? Why not try a lower cost provider network?
We need not resign ourselves to any fate. Our field has vast untapped potential. We can create and realize opportunities that break today’s mold. It will require cooperation among disparate stakeholders and a level of sustained action not seen since the passage of federal parity legislation. While this goal will not take an act of congress, it will require similar grit and leadership.
Ed Jones, PhD is currently with ERJ Consulting, LLC and previously served as president at ValueOptions and chief clinical officer at PacifiCare Behavioral Health.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
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