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Clinical Laboratories and Pathology Groups

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JAMA Study Shows American’s with Primary Care Physicians Receive More High-Value Care, Even as Millennials Reject Traditional Healthcare Settings

Clinical laboratories that help patients access care more quickly could prevent declines in test orders and physician referrals

Millennials are increasingly opting to visit urgent-care centers and walk-in healthcare clinics located in retail establishments. And those choices are changing the healthcare industry, including clinical laboratories and anatomic pathology groups, which traditionally have been aligned with the primary care model.

However, research published in JAMA Internal Medicine suggests outpatients with primary care doctors have better healthcare experiences and receive “significantly more” high-value care. These findings come on the heels of a Kaiser Family Foundation (KFF) Health Tracking Poll which revealed that 26% of 1,200 adults surveyed did not have primary care physicians. And of the millennials polled (ages 18-29), nearly half (45%) had no primary care provider.

Why is this important? High-value care include many diagnostic and preventative screenings that involve clinical laboratory testing, such as colorectal and mammography cancer screenings, diabetes, and genetic counseling. 

And, as Dark Daily reported in “Millennials Forge New Paths to Healthcare, Providing Opportunities for Clinical Laboratories,” the increasing popularity of retail-based walk-in clinics and urgent-care centers among millennials means traditional primary care is not meeting their needs. That’s in large part because of time.

And, this is where clinical laboratories can help.

In the Millennial’s World, Convenience Is King

Millennials are Americans born between the early 1980s to late 1990s (AKA, Gen Y). And, as Dark Daily reported, they value convenience, saving money, and connectivity. Things they reportedly do not associate with traditional primary care physicians.

According to the KFF poll:

  • 45% of 18 to 29-year-olds,
  • 28% of 30 to 49-year-olds,
  • 18% of 50 to 64-year-olds, and
  • 12% of those age 65 and older, have no relationship with a primary care provider.

Thus, it’s not just millennials who are not seeing primary care doctors. They are just the largest age group.

When this many people skip visits to primary care doctors, medical laboratories may see a marked decline in test volume. Furthermore, shifting consumer preferences and priorities means clinical laboratories need to reach out and serve all healthcare consumers, not just millennials, in new and creative ways. 

“We all need care that is coordinated and longitudinal,” Michael Munger, MD, FAAFP, a family physician in Overland Park, Ks., and President of the American Academy of Family Physicians, told the Washington Post. “Regardless of how healthy you are, you need someone who knows you.” (Photo copyright: American Academy of Family Physicians.)

Consider Changes in Lab Business Model

Dark Daily advises clinical laboratory leaders to consider changes in how they do business to better serve busy consumers. Here are a few ways to appeal to people of all ages who seek value, fast service, and connectivity:

  • Offer walk-in testing with no appointments.
  • Create easy-to-navigate online scheduling tools.
  • Enable patients to request tests without doctors’ orders as the lab’s market allows.
  • Make results quickly available and in easy-to-understand reports.
  • Post test results online for patients to securely access in patient portals.
  • Make it easy to interact with personnel or receive information through lab websites.
  • Collaborate with telehealth providers.
  • Post prices of the most commonly ordered tests.
  • Use social media to promote the lab and respond to online reviews.

Younger Americans Do Not Perceive Value of Primary Care

The JAMA researchers studied 49,286 adults with primary care and 21,133 adults without primary care between 2012 and 2014. The methodology entailed:

  • 39 clinical quality measures,
  • Seven patient experience measures, and
  • 10 clinical quality composites (six high-value and four low-value services).

“Americans with primary care received significantly more high-value care, received slightly more low-value care, and reported significantly better healthcare access and experience,” the JAMA authors wrote.

Healthcare Dive notes that the JAMA study may be the first time researchers have substantiated the higher value of primary care, which generally provides services for:

  • Cancer screening (colorectal and mammography),
  • Diagnostic and preventive testing,
  • Diabetes care, and
  • Counseling.

“Poor primary care supply or access may be hurdles, or some Americans do not perceive the potential value of primary care, particularly if they are younger … and healthier,” the JAMA researchers noted.

An earlier study published in JAMA Internal Medicine titled, “Comparison of Antibiotic Prescribing in Retail Clinics, Urgent Care Centers, Emergency Departments, and Traditional Ambulatory Care Settings in the United States,” suggests that prescriptions for antibiotics written to patients that visit non-traditional healthcare settings are increasing.

The study found that “Only 60% of outpatient antibiotic prescriptions dispensed in the United States are written in traditional ambulatory care settings [defined as medical offices and emergency departments]. Growing markets, including urgent care centers and retail clinics, may contribute to the remaining 40%.”

A Washington Post analysis of this JAMA study reports that “nearly half of patients who sought treatment at an urgent-care clinic for a cold, the flu, or a similar respiratory ailment left with an unnecessary and potentially harmful prescription for antibiotics, compared with 17% of those seen in a doctor’s office.”

This drives home the importance of having a primary care doctor.

“Antibiotics are useless against viruses and may expose patients to severe side effects with just a single dose,” notes Kevin Fleming, Chief Executive Officer of Loyale Healthcare, a healthcare financial technology company, in its analysis of the earlier JAMA study. “Care that’s delivered on a per-event basis by an array of unrelated providers can’t match the continuity of care that is achievable when a patient receives holistic care within the context of a longer-term physician relationship,” he concluded.

Clinical laboratory leaders and pathologists are advised to regularly engage with primary care physicians—not just oncologists and other specialists—and keep them informed on what the lab is doing to better attract millennials and develop long-term relationships with them based on their values.

—Donna Marie Pocius

Related Information:

Comparison of Antibiotic Prescribing in Retail Clinics, Urgent Care Centers, Emergency Departments, and Traditional Ambulatory Care Settings in the United States

For Millennials, a Regular Visit to the Doctor’s Office is not a Primary Concern

Quality and Experience of Outpatient Care in the United States for Adults With or Without Primary Care

JAMA Study Makes Case for Investing in Primary Care

Millennial Expectations Fundamentally Changing Healthcare Landscape

Millennial Patient Challenge: Earning and Keeping, the Next Generation’s Business in a Post-Loyalty Marketplace

Millennials Forge New Paths to Healthcare, Providing Opportunities for Clinical Laboratories

Generation Z Will Soon be Looking for Employment Opportunities in Clinical Laboratories and Anatomic Pathology Groups

Gen Z values differ from previous generations’ values and medical laboratory managers should know in advance how members of this generation are likely to view their new workplaces

Medical laboratories managers and pathology group stakeholders have long been concerned about the looming retirement of Baby Boomers working in America’s clinical laboratories. With more and more members of this age group leaving the workforce, and with the following Gen X and Gen Y workers moving into positions vacated by Boomers, the next generation of workers—Generation Z (Gen Z)—is arriving to fill the gap.

This newest, youngest generation brings unique attributes and values to the clinical laboratory industry. Laboratory managers, pathologists, and business leaders need to understand those characteristics to work with them effectively.

Gen Z Values Reflect the Turbulent Times We Live In

With the addition of this newest age group in corporate America, there are now four distinct generations simultaneously working in the marketplace:

1.     Baby Boomers (born early- to mid-1940s to early-1960s;

2.     Generation X (born mid-1960s to early-1980s);

3.     Generation Y (Millennials: born mid-1980s to early-1990s); and

4.     Generation Z (Centennials: born mid-1990s to the mid-2000s).

A poll conducted by Ernst and Young LLP (EY) of London for the US Oil and Gas industry found that members of Gen Z have “fairly traditional” career priorities, however their values have been shaped by the nation’s struggles.

“When asked which three considerations are the most important in selecting a future career, both Millennials and Generation Z, as whole, prioritized salary (56%), good work-life balance (49%), job stability (37%), and on-the-job happiness (37%),” the EY survey reported.

Even though they are often clumped together with Millennials (Gen Y), recent research shows that the two generations are vastly different.

“Gen Z employees bring unique values, expectations, and perspectives to their jobs,” Paul McDonald, Senior Executive Director at staffing firm Robert Half, stated in a news release. “They’ve grown up in economically turbulent times, and many of their characteristics and motivations reflect that.”

Move over Baby Boomers! You no longer are the largest proportion of the population of the United States. According to the US Census Bureau, Generation Z (AKA, iGen and Post Millennials) make up about 25% of the US population or approximately 70-million people. However, it is estimated that by 2021, Gen Z will total 40% of all consumers in the US and account for one-fifth of the workforce. This youngest generation is now entering the clinical laboratory workforce in growing numbers. (Graphic copyright: Oklahoma Minerals.)

Though Millennials represent the largest portion of the workforce in America, Gen Z is the largest population of people overall and it’s growing. The oldest members will have reached the age of 21 in 2016-2017. Many will be graduating from college and seeking employment opportunities.

Gen Z Members are Technically Savvy; Seek Job Security/Stability

Members of Gen Z are familiar and fluent with computers, technology, and the Web. Therefore, business websites and social media presence are things they will examine when researching companies for job opportunities. Living in a world of perpetual updates and real-time communications makes them quick at processing information. Centennials also tend to be first-rate multitaskers, capable of focusing while numerous distractions occur around them.

“This group of professionals has grown up with technology available to them around the clock and is accustomed to constant learning,” McDonald stated in the Robert Half news release. “Companies with a solid understanding of this generation’s values and preferences will be well prepared to create work environments that attract a new generation of employees and maximize their potential.”

Stability and job security seem to be more important for Gen Z than it is for Gen Y. A recent study by staffing firm Adecco found that 70% of Gen Z prefer a stable work environment over one that offers passion, but little security.

“They saw their grandparents have to go back to work or their parents have struggles during the financial crisis,” noted McDonald in a MarketWatch article. “They want to work for companies long-term in their career.”

Where millennials are known to change jobs frequently, a 2015 study conducted by Robert Half found that centennials plan to work for only four companies in their entire careers. The same study also found that Generation Z prefer to work in business office environments instead of working remotely.

Centennials are also more interested in the values and fairness of their bosses and the company mission statements. Equal pay, promotions, and accolades need to be equitable across all genders, races, and other differences. Generation Z is also entrepreneurial and creative and they desire to interact with people in person.

“Be prepared to spend time with them face to face,” McDonald stated. “They want to be mentored and coached. If you coach them, you’re going to retain them.”

Gen Z Politics are Mixed

Generation Z also differs from Millennials in the political arena. In a New York Post column, Jeff Brauer, Professor of Political Science at Keystone College in La Plume, Penn., indicated that Generation Z is liberal on some issues while being conservative on other issues.

“Politically, Generation Z is liberal-moderate with social issues like support for marriage, equality, and civil rights, and moderate-conservative with fiscal and security issues,” Brauer stated. “While many are not connected to the two major parties and lean independent, Gen Z’s inclinations generally fit moderate Republicans.”

Brauer’s research found that members of Gen Z tend to value economic stability and security higher than the previous generation because they have grown up in an era peppered with terror threats, a shaky economy, and mass school shootings.

“This generation is different, and they are about to have a profound impact on commerce, politics, and trends,” stated Brauer in the NY Post column. “If politicians and business leaders aren’t paying attention yet, they better, because [Centennials] are about to change the world.”

As Generation Z comes of age, more of them will be working in the medical professions. Clinical laboratories and anatomic pathology groups would be well advised to prepare their businesses by adjusting leadership, adapting recruiting efforts, and shifting marketing to attract Centennials and remain relevant and successful in the future.

—JP Schlingman

Related Information:

The Secrets to Hiring and Managing Gen Z

Why the Generation After Millennials Will Vote Republican

Move Over Millennials, Members of Generation Z are Ready to Work

Eight Key Differences Between Gen Z and Millennials

Gen Z White Paper: The State of Gen Z 2017 National Research Study

What is Generation Z, and What Does It Want?

Gen Z Nothing Like Millennials, Prof Warns Liberals

Generation Z is Entering the Workforce: What does This Mean for Management?

Births: Provisional Data for 2016

The Six Living Generations in America

Wisdom of Hiring Across the Six Living Generations in America and the World

Generation Z: Five Surprising Insights

Startup Oscar Health Finds Big Partners in Ohio’s Cleveland Clinic and Nashville’s Humana Inc.

Two different deals aim to bring a new style of healthcare insurance to individuals and small businesses

Designed to be a new model for health insurance, the much-watched Oscar Health (Oscar), founded in 2012, has just inked deals with both the Cleveland Clinic and Humana, Inc. What makes Oscar worth watching by pathologists and clinical laboratory managers is that the innovative insurer was founded and is run by Gen X and Gen Y (Millennial) executives.

Oscar Health is billed by its Millennial cofounders as a new type of health insurance—one that “curates” or coordinates members’ care with the help of health information technology (HIT) on the Internet, a smartphone app, and personalized services by concierge teams. So, it is interesting for pathologists and medical laboratory leaders to note that New York-based Oscar is partnering, through two different deals, with well-established Cleveland Clinic and rival Humana to enter the Ohio and Tennessee healthcare markets.

As Dark Daily reported in a previous e-briefing, Oscar aims to leverage sophisticated technology solutions and data to challenge complexity and costs associated with traditional healthcare insurance. An approach no doubt driven by the modern thinking of the company’s young founders. We alerted lab leaders that the insurance startup could be the latest example of technology’s power in the hands of Gen Y and Gen X entrepreneurs.

And while Oscar has reportedly experienced financial challenges, it is moving forward with the widely publicized new partnerships, as well as additional plans to expand insurance coverage in more states. Therefore, it’s important for clinical laboratory professionals to follow Oscar, which soon could be a healthcare payer of clinical laboratory and anatomic pathology services in more regions of the country.

Why Is Oscar Teaming Up with Cleveland Clinic, Humana?

In short, Cleveland Clinic is making its debut into the health insurance market with Oscar. And Oscar is moving into Ohio on the coat tails of this nationally prominent healthcare provider. The co-branded Cleveland Clinic/Oscar Health insurance plan will be offered to northeast Ohio residents in the fall for coverage effective Jan. 1, according to a Cleveland Clinic news release.

“This is a rare opportunity to work with the Cleveland Clinic to deliver the simpler, better, and affordable healthcare experience that consumers want,” said Mario Schlosser, Oscar’s Chief Executive Officer and cofounder in the news release.

 

Josh Kushner (left) and Mario Schlosser (right) cofounded Oscar Health, a New York-based health insurer that employs computer technologies, a mobile app, and concierge-style healthcare teams to provide members with a modern health plan experience and easy access to quality healthcare providers. (Photo copyright: Los Angeles Times.)

The coverage will be sold on and off the Ohio Affordable Care Act state exchange. Here’s what consumers will receive, noted statements by the Cleveland Clinic and Oscar Health:

  • Access to primary care providers affiliated with the Cleveland Clinic, and an Oscar Health concierge team (a nurse and three care guides) that can refer patients based on their needs to other providers in the care continuum;
  • Virtual care visits enabled by Cleveland Clinic Express Care Online and Oscar’s Virtual Visits;
  • Smartphone technology to make it possible for members to explore their health needs, find options, and review costs.

“We are looking to build a new relationship among payers, providers, and patients. This relationship goes beyond the traditional approach of getting sick and seeing the doctor,” noted Brian Donley, MD, Cleveland Clinic’s Chief of Staff.

In an article on the partnership, Forbes suggested that narrow healthcare networks like the Cleveland Clinic/Oscar model might be just what the ACA exchanges need to remain operational.

However, a Business Insider article suggests that Oscar—already active in New York, Texas, and California health exchanges—could be adversely affected by a successful replacement of the ACA, currently being debated by Congressional lawmakers.

Nevertheless, Alan Warren, PhD, Oscar’s Chief Technology Officer, told Business Insider that the Cleveland Clinic/Oscar Health insurance plan would go forward even if Obamacare did not.

Formal Rival Humana Now Oscar’s Partner in Small Business Insurance

Meanwhile, the partnership with Humana takes Oscar, which launched Oscar for Business in April, 2017, further into the small business health insurance market. Humana and Oscar will sell commercial health insurance to small businesses in a nine-county Nashville, Tenn., area effective in the fall, according to a joint Oscar/Humana news release.

“The individual market was a good starting point. But it was clear from the beginning that the majority of insurance in the US is delivered through employers,” Schlosser stated in a New York Times article.

As to who does what, Beth Bierbower, Humana’s Group and Specialty Segment President, explained in an article in the Tennessean that Humana will contract with hospitals and doctors for small business insurance, while Oscar’s technology solutions will help small businesses and their employees manage healthcare benefits and gain access to providers. “These people [at Oscar] are on to something,” she noted. “They are doing something a little different. Maybe this is a situation where one plus one, together, might equal three.”

Future Growth Planned by Oscar

The New York Times called Nashville “a new step for Oscar,” and noted that it follows Oscar’s recent loss of $25.8 million during the first three months of 2017—47% less than Oscar lost during the same period in 2016. Since its inception, however, Oscar has raised $350 million in investment capital, much of it from Silicon Valley investors.

Also, Oscar’s small-business health insurance plans, which started in the spring in New York, might launch in New Jersey and California as well, an Oscar spokesperson stated in a Modern Healthcare article that also reported on Oscar’s intent to increase individual plans sold in the ACA Marketplace from three states to six in 2018.

Clinical Laboratories Benefit from Increased Consumer Access to Health Providers

Could Oscar succeed with its new Cleveland Clinic and Humana partners? Possibly. Both deals are pending regulatory approval as of this writing.

In any case, the whole idea of making insurance more palatable for consumers is something clinical laboratories, which are gateways to healthcare, should applaud and support. It is good to know that insurers like Oscar are using technology and personal outreach to ease consumers’ access to providers and help them explore options and costs.

—Donna Marie Pocius

Related Information:

Cleveland Clinic, Oscar Health to Offer Individual Health Insurance Plans in Northeast Ohio

Introducing Cleveland Clinic Oscar Health Plans

Oscar Health Partners with Cleveland Clinic on Obamacare Exchange

Oscar Health Partners with Cleveland Clinic

Oscar Health to Join Human in Small-Business Venture

Humana Oscar Health Pilot Small Business Insurance Partnership in Nashville

Oscar and Humana Team up to Sell Small-Business Plans

Insurance Start-Up Oscar Seeks to Shake Up Healthcare Through Its App

Gen Y Entrepreneurs Launch Oscar, A Consumer-Friendly Health Insurance Company in Bid to Disrupt Traditional Health Insurers

 

 

Gen Y Entrepreneurs Launch Oscar, a Consumer-Friendly Health Insurance Company in Bid to Disrupt Traditional Health Insurers

In New York City, innovative clinical laboratories have the opportunity to become a network provider for the region’s newest health insurance company

Three Generation Y entrepreneurs are ready to take on traditional health insurers with their own innovative health insurance company. They claim their novel start-up can better meet the new consumer expectations and behaviors within the insurance industry. If correct, their venture could disrupt the post-Obamacare insurance world.

Game-changing Health Insurance Company?

The Gen Y trio is made up of Josh Kushner, Kevin Namezi, and Mario Schlosser. They recently launched Oscar Health Insurance, based in New York. Kushner is the founder of the tech investment firm Thrive Capital. Kevin Nazemi, Oscar’s president, is a former director of healthcare for Microsoft Corp. (NASDAQ: MSFT). Mario Schlosser is a former McKinsey & Company computer scientist. (more…)

When Recruiting and Training Generation Y to Work in Medical Laboratories, U.S.A and U.K. Face Same Challenges

DATELINE—BIRMINGHAM, ENGLAND: Workforce issues in medical laboratories received special attention here at the 10th Annual Frontiers in Laboratory Medicine (FiLM) conference that ended last week. Probably the major concern going forward is how to attract, train, and sustain adequate numbers in the medical laboratory workforce.

Two speakers addressed medical laboratory workforce issues at a strategic level, with an overview about developments in the United Kingdom and the United States. Speaking about the United Kingdom was Professor Sue Hill, OBE, Ph.D., Chief Science Officer for the National Health Service. Speaking about the United States was Elissa Passiment, Ed.M., CLS (NCA), Executive Vice President, American Society of Clinical Laboratory Science (ASCLS). (more…)

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