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Intro: The following SHSMD podcast is a production of DoctorPodcasting.com.

Bill Klaproth (Host): On this edition of the SHSMD podcast, we are talking with Chris Bevolo, Chief Brand Officer at Revive, and he is going to share five potent predictions on how consumer health engagement may change over the coming decade, which range from exciting and promising, to ominous and discouraging.

Uh, oh, better pull up a chair. Pour yourself a cup of Joe. Joe Public that is. See what I did there. Strap yourself in and let's get to it people, right now.

This is the SHSMD podcast, Rapid Insights for healthcare strategy professionals in say it with me, planning, business development, marketing, communications, and public relations. I'm your host. Bill Klaproth. And in this episode, we talk with Chris Bevolo, Chief Brand Officer at Revive. Chris is an award winning author of six books, including Joe Public Doesn't Care About Your Hospital, which became a field guide for driving transformation in hospital marketing departments across the country.

And in this episode, Chris shares five key ways consumer health engagement may change over the coming decade. Information from his new book, his seventh book, Joe Public 2030. And this episode sponsored by Revive, an agency that works with brands who lead the way in health. Learn more at reviveagency.com. Chris, welcome to the SHSMD podcast. As you know we start every episode of the SHSMD podcast with Rapid Insights. One quick tip someone can use to make their marketing communications better today. Chris give us your Rapid Insight.

Chris Bevolo (Guest): My Rapid Insight today, Bill is the degree to which the world has changed around you, should tell you the degree to which you need to change your approach to what you're doing today. And that is a big change today.

Host: That is very profound. I love what you just said there. That is a great Rspid Insight, Chris, thank you so much for that. And thank you for your time. It's always a pleasure to talk with you. So, I love reading your books and I love talking to you because you force us to think about healthcare in different ways. So, you are back with five key predictions about the future of healthcare, covering many things and we're going to talk about five of them today. First off, how did you come up with what we're going to talk about today? Tell us how you canvassed the landscape of healthcare to come up with these.

Chris: Yeah. We actually went through a pretty rigorous process. That was a process used by an author who has a series of books called the Non-Obvious. He makes predictions on an annual basis. And in one of the last time he put this out, he shared his process. So, we followed an actual process to go through, to figure out well, if we want to understand how consumers are gonna engage in healthcare in 10 years, what is the best way to do that?

So, that was about a two or three month process. It involves a group of about 12 people, all of them with healthcare expertise of one kind or another, a lot of diversity built into the group to make sure we had great perspectives. And then we brought in all kinds of inputs. So, anything we could get our hands on to read, any kind of research. The resulting content actually supported by more than 250 resource citations. We interviewed 22 people out in the industry. So, this was everybody from CEOs to Venture Capitalists, to Physicians, to Entrepreneurs. We talked to people from organizations like Mayo Clinic, Geisinger, Bain Capital, CVS Health, Henry Ford, just the top of the top brands and together; all of that kind of on the table started to the process, allows you to coalesce around key themes and ideas, which is where we landed on our five.

Host: Absolutely. So, a lot of viewpoints, a lot of insights, all boiled down into this, which is great. And you're going to share with us five key predictions about the future of health care, covering everything from consumer centricity to consumerism, new competition, the politicization of healthcare and growing health disparities.

So Chris, let's take each one of these, one by one and you can explain them to us. So, let's start with consumer centricity.

Chris: Yeah. We call this the Copernican consumer, because I think we talk a lot about consumer centricity and patient centered care and all those good things. But usually that means when somebody comes to us, how do we put them at the center of the experience? And that's great. What this is really about, is having the consumer be at the center of their entire health world. So, that's not just healthcare, that's everything. And that means everything that is brought to them, content, services, care is where they are, when they need it, in a way that they want it. And those are very significant potentially changes for the future. And these are enabled if this, this idea, this vision is enabled by all kinds of advances in technology.

So, monitoring, for example, the ability to monitor people remotely is growing, in terms of the ability to do it, what it can cover, what you can monitor, how easy it is to monitor people. You've got AI, that's going to play a role in this. You've got cool ideas like digital twinning, where you create a digital version of a human, and then you're able to use that digital version, to really understand what may or may not work with them.

You've got digital therapeutics, which is basically software, this driven in a large part by AI that can manage a chronic disease, blockchain, which can, imagine right now, Bill, if all of the different things that holds some kind of health information about you were able to all of a sudden be connected and updated real-time and accessible to anybody. So, that can range from your EMR data to your health plan information, to your Peloton, to your refrigerator, to your Apple watch, to anything that might contribute to a profile of who you are as a human, health-wise. And that is automatically updated, every time you ride the Peloton, every time you go to the doctor, every time, if you wanted, you ate at Taco Bell, it's all in there. And then you're able to manage that. And you have sources to help you manage that, that are catered to you in a very different way than I think we see today.

Host: I had a Chalupa and my Apple Watch recognized it. Let my doctor know.

Chris: If that's what you want. Yes. I'm not, sure many of us want it, it's there.

Host: Right. Oh my God. I see you've had five chalupas in the past six days. Well, doctor, I am addicted to Taco Bell. What can I say? But this is amazing and I love what you said there, where they are, when they need it. And that really puts it into perspective. That's for sure. So, consumer centricity and then another one, consumerism, which we've all heard you talk about, which I love. So, talk to us more about that.

Chris: Well, this is a great example of why the process we followed was super important because as you said, Bill, I've been talking forever. In fact, my favorite thing to kind of make that point is I used to use a picture of my daughter in her high chair, where she was eating like spaghetti and she had it on her face and she had this look and I was like, that's the healthcare consumer.

She's looking at you. And she's like, I don't like how this tastes. I don't like the experience I'm getting. Well, we're still talking about consumer and that daughter just graduated high school in June. So, whatever that is, 18 years, I have always been pushing and pushing and pushing that hospitals and health systems in particular, need to understand and adapt to consumerism, which essentially means to us, consumers become more empowered to shape things in the way that they want. So, they want more transparency, more access, better experiences, more convenience, all of those things. And they want more choice. The truth is, and this prediction is actually a little bit negative and that is, that consumers are going to become constricted over the coming decades that it's already constricted. And that's also an interesting point about these predictions.

All five of them are already in some way emerging or with us. It's the extent to which they're going to grow and change, that makes them interesting. And so when you think about one of the greatest insights from this was talking to experts, who said, you know, the reason consumerism hasn't really had the disruptive impact that we thought it would, is because we're thinking about the wrong consumer. The individual, you and me, Bill, we're not the real consumers. If by consumer, we mean the people with purchasing power. Because in most industries, that consumer is the one that will drive prices up or drive demand up or all that. But the real consumers in this industry are the payors and the employers. And then when you look at where real change has happened, significant change has happened, real disruption; it's as a result of what they want, as opposed to what we want. And there's all kinds of examples of that. That's only going to grow. So, when you think about it from those terms, you can start to see how patients for example, are going to have more limited choices. They're going to be tiered and they're going to be steered and they're going to be kind of forced through a mouse maze of this is where you got to go for these reasons. Sometimes those reasons are for their benefit. Sometimes they're not. This is all compounded by the fact that we, as individuals are really not equipped to understand this market or move it in the way that we'd want anyway.

It's very similar to people saving for retirement. If you want to be your own financial kind of investment advisor, that's a part-time job. Most people are not equipped to understand the markets and the laws and the tax changes and all the things that happen to be a savvy investor. So, they hire somebody else to do it well. We've put them in charge of their own retirement with 401k's. A lot of this is going to happen with consumerism and we're just not there. We just don't understand how the system works. So, it becomes very hard for us to, to move it to our advantage.

Host: So, you said we might have less, the consumer might have less choice in the future. They're going to be forced to jump through more hoops or into little boxes that goes against consumerism then, right?

Chris: That's exactly right. And you know, you can think about consumers in a couple of ways. One way is kind of a, it's a force, it's a political force. We're going to leverage consumerism to drive change. You'll hear politicians talk about that quite a bit. Most of the experts we talked to said, that's a bunch of bleep. That's not how it works. Cause basically what that means is, hey consumer, you spend more money and by you spending more money, you'll drive the change. It's not how it works. We're spending more money. We've been asked to spend way more money out of pocket, we're not driving that change.

The other side of it is kind of the result of things. And if things move the way they were supposed to, you would see more choice. And instead, you're seeing consolidation on the provider side. You're seeing consolidation on the payer side, you're seeing restrictions on where you can receive care. All of those things are gonna lead to actually less choice, which by the way, I should say, if it's not clear already these five predictions are not meant to paint a mosaic of the future.

There are independent of each other. You can see the relationship, but you might be thinking, wait a second, you said that consumers are going to be at the center a second ago, and now we're saying that choice is going to be restricted. Both of those could be true. But it's unlikely that both of them come forward and fully but it's going to be one or the other probably.

Host: Right. But we, at the local level, individually, we need to pay attention to consumerism. You said, consumers want to have the power to shape things, how they want, well we need to meet them, where they are. Right. We need to meet them, how they want things at our individual local levels to pay attention to consumerism and foster that type of environment. Is that right?

Chris: Yes. I mean, that's what we've been saying for 20 years. The twist here is that the reason why we're not seeing it as much as we should, the fact that there are still hospitals and health systems that don't have online scheduling says everything that we need to say about the ability and urgency of providers to meet consumers where they're at, because if you were serious about that, every single provider, five years ago, this would be a default to be like, yes, we have have a front door to our hospital that opens and closes. Like, it's that basic, but we still have providers without that. And that shows you that there are other forces in play that are counteracting that drive to support consumerism.

Host: So, we're lagging in this area in certain circumstances. Got it. Okay. So let's talk about new competition.

Chris: Yeah. This plays right into that. And we actually titled this prediction, the funnel wars. So let me, let me explain quickly what that means. If you imagine care is a funnel, the top of the funnel is kind of the first things that a patient might do. The easier encounters, urgent care, virtual care, primary care, sometimes emergent care, right?

And then you flow down, you flow down to specialty care, you flow down to surgical care. You go down to tertiary care, even maybe quaternary care. That's how people progress through the clinical funnel. And most hospitals and health systems are focused in the middle of the funnel because that's where their higher revenue, higher margin services are, but it's a funnel.

So, to get more people in the middle, you have to pull them through the top. You have to have more people come through primary care, urgent care, all of those things. And then they will, proceed accordingly as needed down funnel. That's the model. And that's been proven. That's how it works. The new competition, if you want to call them new, we do. But some of them have been around forever. They are coming for that top of the funnel. That's where they want to play. So, Walmart Health, Amazon, Apple, CVS, Walgreens, Optum though Optum goes all the way down funnel, all of these folks; plus the myriad of venture capital backed One Medicals, Oak Streets, those types of things.

They want the top of the funnel. The challenge here is if you own the top of the funnel, you might own the patient relationship. And that has profound implications for legacy hospitals and health systems. Because if you lose the patient relationship, you're now beholden to somebody else for that key down funnel care.

And so in talking to experts and in looking into this, this is going to be almost like a market to market battle. You're going to see some markets, depending on the shape of the competition, the number of health systems, the power of payers in that market, where you may see some systems shrink in size because they lose that top of the funnel. You might see other markets where you've got a very powerful health system, that's been able to kind of hold these new entrants at bay. So, think like an Inner Mountain or a Geisinger, that has a fuller continuum of care, that's been focused on this kind of stuff. They may win in their market.

But these funnel wars are going to shape the next 10 years. And they're really going to help show where people are going to end up, where are they going to be oriented for their care. It may not be the hospital and health system anymore, even though those will never go away. Let's, let's be clear. Like Walgreens is not going to start doing surgery, but that's not the point. The point is if Walgreens owns the patient experience, you as a hospital in that market now have to figure out how you're going to get them to send a patient your way instead of your competitor.

Host: Yeah, that is a really interesting one. When you think about new competition, like Walmart and Apple and Amazon. Wow. Okay. Now I've got to compete with these people as well, and maybe a way to combat that is to pay more attention to what we're just talking about, more consumerism and where they are when they need it kind of a thing. All right, so here's another big one. The politicization of healthcare. Oh my gosh talk to us about this.

Chris: Yeah, so we actually titled is prediction, the rise of health sects was, which looks a lot better in print than in audio. I have to spell that is S-E-C-T-S. But what we're talking about here is clearly we've all seen the politicalization of healthcare. That's been with us for a while, by the way, we don't get into that, but it's not like it's a brand new thing, but the level to which it's exploded since COVID, is unprecedented. So, anti-vaxxers, non maskers, COVID deniers, all of those things. What this could end up with is almost like with religion, where you have a primary religion and then you have a sect break off because they believe something different. So, imagine that we actually see medical or health sects emerge.

So you've got like, the mainstreamers, like mainstream healthcare, right? That's where everybody theoretically has been. Of course there's people that don't agree with everything, but there's one set of hospitals. There's one health system. There's regulatory bodies, all that kind of stuff. Then imagine there's like a group that breaks off called progressives.

So, they follow minimal medical intervention, complimentary and alternative medical solutions, or a set called contrarians. They deny mainstream medical thought. They create their own set of alternative facts in everything from vaccines to childbirth, to end of life care. All of that. We're already starting to see, not starting. We see the differences that I just described. What could happen, is those differences actually coalesce around actual groups. So, imagine that political worldview of the contrarian turns into somebody launching a series of clinics to actually appeal to those. So, here's a clinic that's staffed by doctors that doesn't care whether your vaccine is not going to push vaccines, that's where we could end up going with this. And what's hysterical, scary. I don't know. I'm from Minnesota, I don't know if everybody remembers one of our house of representatives, Michelle Bachmann, who was not known for her kind of common sense thinking, just a few weeks ago, not making this up. She was on I'm sure some, you know, politically oriented meat outlet saying we are going to have to create a separate health system in this country because of how horrible the existing system is in trying to make us do things like wear masks and take vaccines. So, we have so many examples of where this is popping up. It is awfully scary to consider.

Host: Yeah, that is scary. Michele Bachmann. Why even put that out there in the universe so people can pick up on it and then talk about that. How our existing healthcare is not good.

Chris: It's just a matter of time. I mean, honest, it's a good business idea. You've got a segment of the population that would sign up tomorrow, unfortunately. So, there you go, Bill, if you want like a different retirement path.

Host: See, you're bringing me down here, Chris. Sorry. Okay.

Chris: It's not going to get better, but we'll, we'll end on a positive note.

Host: Okay. Good. I am always looking for your positive note at the end Chris. That's good. Okay so let's move on the next one is another big one as well growing health disparities. Tell us about that.

Chris: Yeah. So the title of this one, brace yourself is called Disparity Dystopia. And what we mean here is we refer to it as the health gap, because there's a, there's a distinction between things like health inequities, health care inequities, health disparities, those all mean different things. We're talking about those collectively and basically our research and talking to experts, what we believe is the gap between the haves and the have nots when it comes to health and healthcare is going to get wider, not closer. COVID-19 is a big reason for that. COVID-19 actually broadened the gap, in many ways, but it's not just COVID-19, it's a lot of different things. And so if you really want to get depressed, some of the reasons behind this are climate change, which disproportionately affects people who are disadvantaged in all kinds of ways in our society.

The aging of America. A growing gap in an understanding technology and healthcare affordability, all of those are not getting better. They're getting worse. And all of those, unfortunately, drive disparities in their own right. And collectively, you kind of put all those up against the efforts of all of the organizations, both governments, private, provider, payers, health insurers, do stuff for this that are trying to combat health disparities and the health gap.

Unfortunately, they're kind of, they're kind of David versus Goliath with these monumental forces that are, that are aligned against it. And so, it's really going to take something that we just don't think is going to happen. And that would be a dramatic shift in our country, societaly. I've got a great quote, that we use from an expert from Europe, in fact, it's amazing. He's been all over the place, he has got an amazing pedigree and the quote is "healthcare is to a large extent of cultural notion." And so what his point is, your healthcare system reflects your country's culture. And so if our healthcare system is so broken in terms of health disparities, that's a reflection of who we are as a culture.

To change the health gap, we're going to have to change who we are as a culture. I don't know about you Bill, but I don't see that moving in the right direction anytime soon. So yes, that is yet another one that is look, here's how we put it, when we talk about these things, the first step in solving a problem is admitting you have it.

So, we can't dust these things under the carpet, and just pretend health disparities aren't a problem. And politicization is not a problem. And all of these things, they are real challenges. And the only way to really address them is be honest about them. Paint a picture of where they could go. So, at the very least, people can understand what are we going to do about it, you know, in face of this and maybe inspire folks to do something about changing that.

Host: Right. We can't sweep our problems under the rug. We have to recognize them and address them. All right. So five key ways consumer health engagement may change over the coming decade. Thank you for sharing those with us. All right. Leave us with your optimistic note here. What can we do? I'm sitting in my marketing director chair at a hospital, like listening to this podcast, thinking, oh boy, I gotta think about these things. Where do I start? Wrap us up with your optimistic thought, where can we go from here to make all of this better?

Chris: The whole intent of putting this content out from our perspective, is to drive conversation. We didn't know where we were headed with all of this qhwn we started. The fact that the majority of these sound kind of depressing or negative. It is what it is. Right? So, start a conversation, dig into this content and try to understand which of this do I think is most relevant to me, which do I believe. We don't expect folks to agree with all of this, but at a minimum, it should drive conversation.

And have that conversation, spark bigger conversations. It's going to be almost impossible to put this content in front of a leadership group in an organization say, okay, we got to do something about this. It's too big. There's too much. So, pick your spot, figure out, look this one hits me the most or drives me the most, to try to figure it out, to understand it, to be able to respond to it, to change it potentially.

But it starts with having conversations, so that you can get people thinking about this proactively. None of these things are new. None of these things should be surprises in terms of what the focal points are. But the picture we've painted of the next 10 years is what should get people to sit up and notice to go, okay, the potential we could go even halfway this way is not going to be good for our organization or for our society. What are we going to do about it?

Host: Right. So I love that. Start having conversations. Part of having a conversation is listening to the other side, right. We all need to listen to each other a lot more and try to understand differing points of view. So, all of that makes sense. And then try to work together to solve these problems. And as you've laid out, we do have some problems on the horizon that we do need to address.

So I love that. Start the conversation. And Chris, always talking to you, gets us thinking about those things and hopefully we will start those conversations. So, thank you for all the work that you've done in bringing these to us. We really appreciate it. And thank you for your time as always.

Chris: Yeah, thanks for having me, Bill. It was a great conversation.

Host: And once again, that is Chris Bevolo, from Revive. And this episode is sponsored by Revive. We thank them for that. You can learn more at reviveagency.com and to learn more about SHSMD, you can visit shsmd.org. That's S-H-S-M-D.org. And visit our education page to learn about our upcoming programs at shsmd.org/education. And if you found this podcast helpful and come on now, how could you not, please? Oh, that's my watch. It's reminding me that it's Chalupa time. So, so remember what you're watch doesn't do that for you. Please share it on all of your social channels and please hit the subscribe or follow button to get every episode. Very helpful on Taco Tuesday. Get that little watch reminder. This has been a pro, I'm going to go now. This has been a production of Dr. Podcasting. I'm Bill Klaproth. See ya.