Beyond Quality
Beyond Quality makes the case that quality isn't a department, a program, or a checklist, it's a reflection of how an organization shows up and behaves under pressure. Hosted by Rex Wallace, with a rotating co-host from the RWC team each episode, the show brings in industry experts to go above, below, beside, and beyond quality to discover what's actually driving it across organizations, teams, and industries.
Beyond Quality
From Fragmentation To Flow
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Every health plan and provider is investing in a better experience — so why does healthcare still feel so disconnected to the person living it?
In this episode of Beyond Quality, Rex Wallace is joined by three leaders who spend their days inside that gap: Heidi Salerno of Rex Wallace Consulting, Jason Wolf of The Beryl Institute, and Amber Maraccini of Medallia. Together they unpack where the healthcare experience breaks down, why trust erodes at the handoffs between plan and provider, and what coordinated care actually looks like when an organization designs for it on purpose.
The conversation keeps circling one idea: there's no "member experience" and no "patient experience." There's a human experience — and right now, we've made that human responsible for holding a fragmented system together. The panel digs into the data behind fragmentation, why handoffs are a patient safety issue and not just a satisfaction one, and whether plans and providers should finally share accountability for the whole journey instead of just their slice of it.
Essential listening for quality leaders, member and patient experience teams, and executives across Medicare Advantage, Medicaid, and provider organizations who want healthcare to work end to end, not door to door.
Guests:
Heidi Salerno — Member Experience Consultant, Rex Wallace Consulting
Jason Wolf, Ph.D. — President & CEO, The Beryl Institute (theberylinstitute.org)
Amber Maraccini — Healthcare Executive Advisor, Medallia
Connect with Rex Wallace on LinkedIn and follow Beyond Quality so you never miss an episode.
Hey everyone, as you know, season one of Beyond Quality is is um in collaboration with our friends at Rise. And quick note on a couple of upcoming conferences that I hope to uh I hope to see you at. So one is Rise Qualapalooza. This is coming up right around the corner uh June 28th through the 30th in Frisco, Texas at the OmniPGA uh Frisco Resort and Spa. Great conference, all quality focused, obviously. Lots of focus on stars, lots to discuss this year around clover and the recalculation and um and a million other things. Also, right around the corner is uh in September, September 2nd through the 4th is Rise West. This is a huge conference um and really more broad than Kualapalooza. This is where we get into risk adjustment, quality, compliance, and and beyond. Not too big, not as big as Rise National, um, a good, you know, a good amount of people to have great conversations. So it's in San Diego and hope to see you there. Thanks. Quality improvement in healthcare. It's typically described as a framework for systematically improving care. In reality, it's an endless struggle to align policy, data, and processes with human behavior. Join the RWC team and guests from across the industry as we tackle the toughest challenges facing quality today. From culture to capital, from strategy to technology. Join us as we go beyond quality. Hey everyone, welcome back to Beyond Quality. Today we're gonna we're gonna explore the healthcare experience in the eyes of a member and or a patient. And we're gonna dig deep into a topic that's come to define the healthcare experience, um, fragmentation. Um as an industry, we've you know, we've invested a lot, right? We've we've made so many improvements as an industry um trying to improve the healthcare touch points. So, you know, when you think of provider interactions and call center improvements, care management, digital tools, right? Like so many things we've done, but many members still have experiences that are confusing and disconnected and difficult to navigate. And the question is if healthcare organizations are improving this much and investing this much individually, why does the overall experience still feel so fragmented? Today we're gonna dig um into that. We're gonna explore where that disconnect happens, how it impacts trust, how it impacts outcomes, and what a coordinated experience actually looks like when organizations intentionally design for it and execute on it. Um I'm thrilled for our guests today to have our guests today. So, first off, uh we have my co-host today and our member experience consultant here at RWC, Heidi Salerno. Heidi, welcome to the show.
SPEAKER_02Awesome, happy to be here.
SPEAKER_01Second, we have second, we have the CEO of the Barrel Institute, Jason Wolf. Jason, great to have you today.
SPEAKER_00Thanks, Rex.
SPEAKER_01And then finally, Healthcare Executive Advisor from Medallia, um, Amber Maritini. Amber, great to see you again.
SPEAKER_03Great to be back.
SPEAKER_01Hey, can each of you take just a moment, a few moments, and talk a little bit more about who you are and the work you do, just so our listeners are more familiar with you. Heidi, can we start with you?
SPEAKER_02Sure. So, like you said, I am our member experience consultant at Rex Wallace Consulting. Um, came directs from 15 years at Cigna, actually leading member experience, um, and especially caps and hawks is really where my heart lies. Um, so working with uh currently working today with Medicare plans, Medicaid plans, just improving that member experience, provider experience, um, and strategy. So happy to be here.
SPEAKER_01And Amber, yeah, thanks, Rex.
SPEAKER_03Um my name is Amber Maritina, Leader of Healthcare Practice at Medallia, and my work is really focused on helping our organizations listen better, connect with the patients and members they serve, but ultimately action on the feedback that they're delivering to uh the organization across their care journey. Um I'm based in Reno, I'm a mom of three, and um just a proud advocate and um enthusiast for enhancing trust and healthcare more broadly.
SPEAKER_01Yeah, I think we had Amber on um another podcast episode last year, and I think I I think I referred to you as a fellow trust enthusiast.
SPEAKER_03That's right, that's right.
SPEAKER_01Yeah. And Jason, how about you?
SPEAKER_00Well, I love the idea of a trust enthusiast. Um I know we're gonna get into that a little bit today. Uh Jason Wolf here. I guess first I'm uh a husband and dad of two, a soccer dad as well, so as you can all imagine, sometimes you feel like you do that more than you work, but that's probably the best thing you can do. Um I've had the honor to be uh start and build the Burial Institute now over 16 years. We're a global community of practice working to transform the human experience in healthcare, in healthcare institutions, organizations, and systems around the world. Um so we bring together 80 plus thousand people in 80 plus countries in conversation around how we can transform healthcare at all touch points as human beings caring for human beings. Um came out of the delivery side of care myself first, um, found myself on this journey, and it's been quite an amazing one to see how committed people are to transforming what healthcare can and should be in the face of a lot of the buffeting winds we have faced and continue to, both from a systems policy and structure standpoint. So look forward to digging into that one as well.
SPEAKER_01Yeah, I think I I'm excited because the different perspectives that we have on today, I I feel like we cover the the most important points, right? So you know, Heidi with um deep experience on the payer side, the health plan side, Jason a lot of experience on the delivery side. I know you do more we all do more than than this, but Jason, you know, deep delivery side experience, I feel like. And then Amber, this kind of voice of the customer, voice of the patient, right, looking across all the signals and the data and to help help connect it all. So I I think yeah, I'm excited about our conversation too. So Jason, let's let's start with you. Um when we think about the healthcare experience, I think most of us most of us you know kind of immediately go towards our experience as a patient in the delivery system, right? It's much bigger than that, but that's where that's where we usually start thinking about the experience, I think. So um, but from your sp exp from your perspective, what what happens when you get outside of that system and you start you know interacting with other parts of the ecosystem?
SPEAKER_00Yeah, I mean I I appreciate the question because I think it's an important one that we're still learning uh from the healthcare delivery lens that experience isn't just simply in clinical boxes or physical buildings, right? Um in fact, more of the experience people have in healthcare in our system here in the United States and in many places reaches well beyond um the boundaries of those clinical spaces. So I think to your point, I even think healthcare consumers, patients, um they look at their healthcare experience as a much more integrated journey than the system tends to operate it, uh operationalize it, if I would say. And so I do think that um we have huge opportunities and there's clearly gaps in the way people learn about healthcare institutions and either are led there by referral, by word of mouth, or by what their insurance says they can do. Um it lasts well after their clinical encounter to the stories they tell, to the problems they might have in dancing around billing situations, to the follow-up that they do or do not get from their specific care encounter. So I do think um the idea of health care being a continuum focus and experience really being from the beginning to the end of that continuum of someone's care journey, awareness of an institution to the fact that they start talking about it to someone else is the is the lens that we should take in dealing with experience. Um I I've always said, and I think probably was guilty of it in my operating days, we tend to compartmentalize healthcare operationally to survive the chaos of the system we built. That is actually counter to the needs, I think, or even the wants of the healthcare consumer traveling their health journey. So we have some work to do still in rewiring the system in a way that meets exactly the challenges I think you're asking about, Rex. And that's where I'd start. We really have to think about it from you know end to end, not door to door, if that makes any sense.
SPEAKER_01Yeah, yeah. When you know, when I when I first started, you know, even thinking about what to say at the beginning of this to kind of tee up the episode, um, you know, in my notes I had, you know, we're gonna be looking at this from the you know, through kind of through the eyes of a member, and then I put slash patient, and then I put slash beneficiary, and then I put slash well customer or or or memor um consumer, right? Like there there are so many roles I feel like a person plays as they go through this journey. That that that complicates it, right? We're not just a customer of a retail store, you know, in in healthcare. You you're a patient of this organization, a member of that organization, a beneficiary maybe to the government, and as you're picking a Medicare plan. Anyway, it's um I feel like we kind of inject some identity crisis in into the into the problem. Um Heidi, as that member of a health or that, sorry, as that as a patient of the healthcare system typically is also a member of a health care plan, right? Um, you know, they sometimes become the middleman, right, between those two fragmented organizations. What is can you kind of paint that picture of what that looks like from a pain point perspective?
SPEAKER_02Yeah, absolutely. I mean, totally agree uh with what was said. I think one of the biggest pain points is that whether you want to say member, whether you want to say patient, they experience healthcare as one system. But a lot of times we are kind of operating as a multiple disconnected organizations. Um, so we think about it a little bit differently. I think health plans are thinking in terms of benefits, in terms of you know, authorizations, networks. Um, and then you've got the provider piece thinking about clinical care and their workflows. But when we think about the member, they truly don't, you know, distinguish between those two different things. They just want to know, was it easy to get the care that they need, or did that did we make that difficult for them? Um so I think when that fragmentation exists, that's where the members kind of left to be that coordinator. So they're making multiple phone calls, they're repeating their story, they're trying to understand you might be they might be getting conflicting information from the plan, from the provider, um, or like navigating delays between information that needs to flow between providers and plans. Um and I also think you know it's not always tied to like one big failure or one catastrophic moment. It's kind of, I think it's a lot of little things that compound. So you you get you call in and it's like you need to call your doctor, or the doctor says you need to call your plan. Then they go to the pharmacy and it's their medication's not covered. Um, so those things might be small individually, but then when we collectively bring that all together, that's where they're starting to lose trust, I think, in the entire system. And we underestimate how much that impacts perception. So even looking at a physician, they might have an excellent physician, but if their primary authorization is delayed, their benefits are confusing, that starts to even spill over into their provider relationship. And then I think the reverse is true too, right? Like pri poor provider communication, that impacts their perception of the health plan. Um, so from their perspective, I don't think there's a payer experience and a provider experience. It's their healthcare experience, their their human experience. And I think that's where we still have some work to do there.
SPEAKER_01Yeah, and and um Yeah, organizations that are that are the payer and the provider both, they have it figured out, right? There are no pain points there. So we should just all be fully integrated, right?
SPEAKER_02Yeah, yeah. No, it's uh I got the joke.
SPEAKER_01Yeah. You would think, right? Like like there there should be an advantage there, but there's not always, I know it's not not that easy. Amber, from uh from a listening and insights perspective, you know, what does the fragmentation data look like? What does it look like in the data?
SPEAKER_03Yeah, I and this is I just another opportunity to just really commend the work that the Beryl Institute has led and set the foundation for for the industry is they have a model where we're looking at a patient, consumer, and then ultimately the human experience. And so how do we continue to elevate and make more meaningful the work that is happening within these individual boxes, but also keeping an elevated view at the overall human experience level, right? And the big piece when we're talking about fragmentation from a data perspective is you really need both views, right? We do need the ability to concentrate and get focused and targeted on how to improve those different channels or interactions, but we also need to be making sure that we're framing data at an overarching perspective so that we can ensure that it all cascades and aligns down from the human experience that we're trying to drive. So on the member perspective, we might have a good call center interaction, right? A patient might have a good provider visit. So Jason's talking about the door-to-door. The portal itself might technically be working, but when we think about connecting those moments, that's when we start to see where the confusion, the repetition, the delays exist on the overall human experience and aspects of the journey. So in the data, when we're talking about how do we identify these moments, you'll often see it in terms of comments, right? So when we think about I had to repeat myself or I was bounced around, or it was incredibly frustrating. And this is why Medallia really focuses around the unstructured feedback because scores can tell us one thing, but they're not going to tell us how to fix it or why it mattered to the human aspect of the experience. And if we're trying to drive and keep anchored on improving the human experience and not just the moment of patient experience or communication between the provider and patient directly, we have to think about the data more holistically and centering it back around the human ways that we can capture voice. And uh just one other note here, it's not just important how we're capturing that for the humans that we serve in the industry, but also the humans who are serving other humans. Um, and being able to integrate learnings because on the employee side, on the caregiver side, on the contact center agent side, they're also experiencing a lot of friction, right? A lot of frustration, a lot of burnout that tends to be anchored on the experiences they're delivering to those humans in the first place. So thinking across the journey from our data points holistically for those that we serve, but also for those who are serving is really important when unifying the data story.
SPEAKER_02Totally agree, Amber. I mean, honestly, just your guys' ability to take that the voice of the member, that unstructured feedback, like when you are mapping out those member journeys, I feel like that gives so much context that surveys alone, you just don't capture that. And you know, that's where a lot of like the low-hanging fruit comes out of because you just you're not aware until you have that. Um, but okay, speaking of um the member journey, uh Jason, I'm curious from your perspective on this, do you think that healthcare systems today are truly designed around member journeys, or are they they still largely built around the way organizations internally operate?
SPEAKER_00I always thought a bad podcast answer was no, but that's the answer. I mean, the um, you know, you know, I think picking up on what Amber was saying, I mean, I think, you know, we define experience through the institute lens as the sum of all interactions that people have based on organization culture that influence patient, family, caregiver perspective, a cross-ling team of care. And I think to Amber's point, really, the human experience is that at its core with the workforce experience that Amber said is so important, and then the community experience in which our health systems operate, and all those things need to be connected. And I would say that none of us would disagree. The experience of someone traveling through their own personal health care journey is unfortunately a disconnected one. And we've created gaps because we've built the system with seams. And the question that I continue to scratch my head about, and I think organizations do as well, is that everybody knows that, but I'm not sure people are clear or engaging with one another on who's accountable to make sure people don't fall into the middle, right? And so I think back to what we've been saying, and I think you all every one of us has said it, right? A patient, their family member, their care partner, they're on a journey that doesn't end, right? They don't stop at the edge and kind of figure out how to get across to the next thing. They're assuming that's going to be managed for them. And and so when you actually probably, you know, and Amber could attest to this a lot, a lot of the disconnect, especially in the data that's collected, which is in stories. I think sometimes we forget actually stories are as important data as a number on a survey, um, are stories about people falling in those spaces. It's not the doctor was bad or even the you know my pre forms or you know, getting approvals might have been frustrating, but but it's all those transition points at each of those steps along the way. So I do think you know, to your question, I mean that we have an opportunity to figure out how to fill in those seams. I I was jokingly talking to someone the other day, like the the idea that whoever had that made that little foam piece that you stick between the washer and dryer where the socks don't go anymore. I mean, in some ways we're missing that, right? And the only reason the only way we deal with that is either with someone coming in with an insight around how to build the how to bridge those gaps or the different components of the system actually working together to make sure that those transitions work. Um it's not incumbent on the consumer to figure that out or the or the member, right, to figure that out. Yet, you know what we've done, we as a system have actually told them it is their job. And that's a problem. And I think if you begin to look at what's created issues around trust, concern around fragmentation, we could even get deeper and talk about the cost that the system carries that gets passed back to patients, um, primarily happens at those points. And I do think we have a bigger opportunity, um, a bigger responsibility as healthcare operators out there across all pieces, right? Um, to make sure that those gaps are filled in a way that people can see the bridges between one step to the next.
SPEAKER_01I I love that analogy with the phone. Me too. And it makes it makes me think, you know, I was um had uh was, you know, a consulting engagement with a with an integrated plan a few years ago. So, you know, they were working closely with the health system. Um we were launching quality improvement initiatives and and uh they had this they launched this um this system where they called it the buddy system, right? Where every initiative had one person from the health plan and one person from the delivery side co-own that initiative. And it still wasn't perfect, but it was I felt like it took us so far in improving the coordination between between the two, which is such a missing piece frequently. And there aren't those yeah, those those those buffers that are that are catching the things that are that are trying to fall between the cracks that you're talking about, Jason. And um but that but that helped, but it but to your point it wasn't, you know. No one's created the perfect uh system for that yet, but uh there's a lot more we can do, I know. Amber, I'm curious, um like you know, as you're looking at organizations and signals across right, across um catch capturing these stories and these pain points, you know what what can organizations do to better identify and prevent these experience breakdowns?
SPEAKER_03Yeah. So when when I think about the listening structure and the components that we're designing in a system, in order to avoid fragmentation, we need to think beyond the moments where we're collecting surveys, right? Because surveys represent touch points, those moments in care. And the broader conversation around trust and the way that we're framing really the trust crisis that has been existing in healthcare, it takes me back to the patient safety movement and the two errors human report. And when we were talking about communication errors, human-induced medical errors, how is the third leading cause of death, right? 50% of these are happening between communication errors, with a large majority happening at handoffs. So when we think about experience moments and building trust, we really need to be thinking of those handoffs, right, in care. And it's those in-between the moments between the provider and the health plan, between the digital and the human support interactions, between the scheduling and the care delivery. Those are the moments that we've identified as the critical intervention points to improve patient safety. And they're the same moments from the patient point of view where can where we can be improving patient trust. So when we think about the integration around data and signals and how we're bringing those together across those separate moments, it's the intersection between the survey feedback, the conversational data happening in contact center, the digital behavior, your complaints, and how do we integrate that across the journey so that you can see what is rising from a volume perspective and an impact. Perspective on the overall experience and the way that we're building or either breaking down trust across the journey. So data is a significant impact in the way that not only we're able to understand what is impacting the patient experience, the human experience, right? The workforce experience, but ultimately how are we driving trust? And by using words and topics that align with what we're trying to drive from a human point of view, that can help us understand where we have the greatest opportunity to action and make change across the journey.
SPEAKER_02100%. I totally agree. I feel like what's so important is being able to use that data and use it to drive that coordination. So I mean, when we think about what coordination looks like kind of in the health plan environment, I mean, that's where I feel like the member, you know, they don't have that feeling of that they have to manage themselves. Um, so their experience feels connected and we're able to identify that through the data, you know, and the unstructured feedback that you're referencing, Amber. Um, but I feel like, you know, the member doesn't have to repeat their information over, they don't have to get the conflicted uh answers or be bounced between departments or vendors, right? Um, I think operationally, in order to have that coordinated experience in the health plan, it requires a few things. So when I think about that first, I think shared visibility is a big piece of that. Um, so different parts of the organization, whether we're thinking through customer service, care management pharmacy, they need visibility into that same member journey and pain points. So I think being able to have that information handy where everyone can kind of access that, so important. Um, which you know, I work with so many organizations that their biggest downfall is that they're operating in silos and they're not thinking of this member journey or human, you know, human journey really as one continuous journey between departments, between providers and vendors. Um I think second on my mind is really around kind of that closed loop process. So we talked about authorization issues, so I'm just gonna go there, referrals, um, pharmacy problems. I think there needs to be ownership through resolution with those members, not just a handoff, right? It's it's not a plan issue, it's a provider issue, or it's a pharmacy issue. Um, you know, there just needs to be full ownership. And I think the biggest driver of dissatisfaction, at least from what I see, is when members feel like really no one's trying to be accountable once once the issue's kind of been stated. Um, and I think third, having having that information, right, that allows the experience to be, and this is where I see plans really starting to make this big shift is it be a proactive experience, not such a reactive experience. Um, the strongest organizations I'm working with, they're identifying that friction before the member even encounters it. So it could be a disruption in their medication ask excess, it could be high-risk transition to care, struggling to navigate benefits, but they're not waiting for those complaints to come in or a member to like raise their hand like I'm confused or a poor survey outcome. They intervene before that ever happens. Um, and I think last, it it just we keep we keep hitting on it. So the alignment right between the health plan and the provider ecosystem. So the member, they really don't care where the breakdown happens. They just want to know that they're getting the help and it's all hands on deck to make that possible. Um, but I think you know, when the coordinated experience works well, it's it's almost an it's invisible to the to the member what's going on behind the scenes. Um Jason, I am curious uh from a human experience perspective, what what changes when coordination is done well?
SPEAKER_00You give me all the easy questions today. I'm sorry, you know, the re the reality w with this one, no, I mean I think and I think it's a lot of what you touched on, right? I mean, I think when we create a coordinated system, we actually enable a patient to be a patient. We enable a family member to be a caregiver rather than a navigator or a stressed-out traveler, right? And I think there's a big difference. Think if we want to I'm a metaphor guy. So if you think about what it's like the day you get to the airport and you can get through security and it goes well, and you get to the gate and nothing's delayed, and you get on the plane and you're comfortable and they take care of you, and you get off and your bag shows up, and the car takes you where you need to go, and you end up there and everything's ready for you. And it just that level now, mind you, those systems aren't connected, right? And sometimes that works really well. We are actually in a system that could be that connected, and imagine what it could be like for someone then if we really all worked with this idea of the human in the middle of the experience that was really traveling, maybe one of the most vulnerable, confusing, p petrifying moments in their life, right? And instead we tell them you have to manage the system. Um and you know that's that is truly on us uh uh as pieces and parts of the system overall. So I think when it goes well, you know, someone is not even thinking about this, right? Like you said, anticipated authorizations. I've already got your record, so nice to see you. It looks like these things are already taken care of and we don't even have to worry about it. We want to make sure you can get into your appointment or you can heal. We follow up with you later to know things are taken care of. Your bills don't require weeks or years of argument or embattlement over fifty dollars. You know, I mean those kind of things. Um it does, I think, the you know, in the in the inverse of your question, I think uh oftentimes people feel like the system, which is back to the trust issue, Amber, you were touching on, is not b built in the interest of the people it's serving. Right? And we're the only industry that I know that actually is like that. Um whereas uh we have quote unquote consumers, yet we make them carry the burden in an uncoordinated way. So I think when we create a coordinated experience, people uh unfortunately might be a little surprised, um, but they would be joyous and they would be able to focus on, like I said from the start, their healing, their well-being, and their personal journey of what's needed for them. I think we'd have ultimately a healthier society, a safer healthcare system, better outcomes, and a and a lot less sick people overall.
SPEAKER_02Absolutely. Yeah, absolutely. All right. Yeah, I mean, Jason, totally agree with what you said, and I think in this conversation, like my favorite thing right now is like we are all bringing such a unique perspective, but the one thing we keep saying is human experience, and it is not a member experience, it's not a patient experience, it is a human experience. So I love that we're on the same page with that. Um, Amber, you know, we've talked a lot about you know, member experience or even human experience being truly coordinated in your in your mind. Like, what does that look like? What does that feel like for members when it is coordinated well?
SPEAKER_03Yeah. Yeah. So um, I mean, Jason, it's so easy to align with your your messaging. And when you talk about having an experience where the efforts are coordinated, it allows the patient to be a patient in their care. And with my my background in patient safety research, the most important member of the care team is the patient because they are most informed on their history. And when they're not blocked by all the additional stresses and and concerns around what's happening in their care, they're they're empowered to advocate, they're empowered to act, they're empowered to engage in their care. So when we talk about a coordinated experience, Heidi, what comes to me, what comes to mind for me is clarity and confidence. And on the member side, you're more likely to engage and be proactively engaging in the behaviors that ultimately contribute to those health outcomes, right? You're more likely to be empowered to ask questions around benefits and coverage and how to use and leverage the plan to support the care needs that you have. Health literacy is not something that we offer formally as an education or practice, but this industry is the most difficult to navigate as a consumer and human. So the vulnerable aspects of the experience are one thing. But even just as a consumer and um paying right member of these plans, it is difficult to ensure that you're leveraging all the benefits that are available to you. So when we think about a patient or a member, it's coordinated care is not having to repeat yourself. It's the organization knowing who you are before you call, knowing that you understand what was covered and you're ending conversations feeling more empowered to act in the best interest of your care. So that confidence is really what creates trust. It's not the expectation of perfection in any sense, but it is the expectation of follow-through. And when feedback is being shared about those experiences, these humans being the with the operating within the most vulnerable industry of the verticals that we are familiar with, they expect you to act and let them know that you are acting on the information they're sharing.
SPEAKER_02Agree. Totally agree. Um, and just to pivot a little bit and think through if we think through measurement, right? We think through right now, I mean, healthcare tends to measure performance, I think, so siloed. Um, plans measure plans, providers measure providers. Um, and we keep hitting on a lot of the biggest pain points happen during these handoffs, these transitions. So interested in your thoughts. Do you think plans and providers should somehow be measured together in some way? Jason, I'll I'll let you take that one first.
SPEAKER_00I know Amherst thought on this one as well, but I mean uh um yeah, I mean, yes. I mean, if we believe a system should operate as a system, I mean that's the biggest misnomer, right, in in in US healthcare is that we have a system, right? The they should. I mean, they're and you know, there should be a level of shared accountability. I mean, I understand the need to assess and evaluate each segment of the system for how they're performing around their tasks, but I mean, the ultimate outcomes are the is like we said, is sort of the ease of the journey. I love what you talked about, Amber, right? Clarity, confidence, not having to repeat yourself. They know you, you're empowered to act, they fundamentally leave you with trust. Those are there you go, there's your questions, right? That if you could ask people about their journey and every person on that step of the journey was responsible for those things being done well, imagine how different it would be. That means that we talked about what we talked about before, the gaps that existed would be the first place they would work together to fix, right? And so I I I I would love uh somebody to make that call. That's that here in the United States is a policy decision, and there'd be a lot of pressure never to move in that direction. And there is right now, because everyone's operating in independent, you know, operating models with their own PLs and their own need to drive either volume or membership rate and volume of members. I mean, so the the incentives right now for those pieces and parts of the system aren't aligned either. And so until those can be aligned, measuring them collectively is going to be challenging. So I think there's a piece even before on how do we begin to find the right incentives for what success looks like in our healthcare system. Use that word again, right? Um, so that we can measure back to I think the really brilliant points that Amber was talking about before.
SPEAKER_03I agree. Agreed entirely. I I mean when we think about when we think when we're thinking about how to understand this shared experience, we need to start thinking about it at that aggregated level, at that humanistic level. And then of course there's going to be ways of cascading how we can each control and bear influence. But ultimately, it shouldn't just be anchored on these scores around moments of care, but ultimately, Jason, as you mentioned, around the experiences we're trying to drive more holistically. So the trust, right, component, the confidence component, the health outcomes component, how is this relationship existing? And within healthcare, there's been a historical reliance on caps programs and benchmarking for those CAPS programs. There's a lot of focus on what how I compare to others, but the reality is these systems, these health plans, they have nuanced populations that they serve. And so their focus and strategy should be anchored around how they're driving health in the community that they are serving. And I think back to my work within a nonprofit health system. And you know, one of the responsibilities of a nonprofit health system is they have to have a community health improvement plan, right? And every three years, they're evaluating the impact on how they're driving improvements of the particular community that they serve. And that feels like such a better aligned practice. So you're having an assessment of the population you serve, the humans you serve, and then developing a plan specific to that audience. So it's less focused on what we're doing across the nation, and it's more focused on the community that you're responsible for.
SPEAKER_02100%. Yeah. And I mean, I think about the measurement, it's like that shouldn't be one giant scorecard. It just doesn't make sense. Like, you know, everyone's striving for for different things, they're incentivized on different things. Um, I think they have different constraints, right? But there is uh that opportunity for more shared accountability to your point. You guys have made excellent points there. What do you think that could realistically look like?
SPEAKER_00It's a good question. I I would come back, I mean, I think to Amber what she what Amber was mentioning. I mean, I think there are certain things like if we would we would uh need to build something that talked to people about their experiential moments, right? Not you know, you know, we get so granular, you you know, Amber mentioned the CAPS programs and all the deep dive stuff, which is great if you're looking for, you know, organizational level or departmental level improvements around specific pieces, but you know, the journey map of a of a human being in our healthcare system is not something we've really captured. And so I do think how clear was the process? Did you feel your handoffs went well? You know, did you have to only say your in give your information one time on your journey? I mean, there are things I think if we sat in a room for an hour and brainstormed, we'd know exactly what would make sense for people to say this is actually what a comfortable caring journey looks like through my health care experience from well before I enter clinical space to well after I leave. Um I think that's a really interesting and intriguing exercise. If we even don't get there to say what would those be. Because I think if someone even just said, if we were to do it, and even you know, Amber, maybe we need to write this paper. If we were if we I've heard already if if we were gonna have a system that did these things, these are the things that people really care about. Imagine if we could create an integrated, connected system that actually asked these things and we got them right on a consistent basis. What it can be.
SPEAKER_03Yeah. Yeah, I mean, at at Beryl Elevate this year, Jason, there were so many conversations. Like if we if Beryl operated a health system, right? And if if Beryl and we use these fun fundamental principles that we're using to guide human experience and human beings caring for human beings and serving human beings, what that would shape. And when we elevate that conversation and when we we talk about this, I think it starts with shared visibility, but also shared visibility is what stems for shared accountability. And a lot of when we think about the silos and data sharing, if we just elevate the way that we are elevate, I keep saying elevate, and it's probably because I keep seeing seeing you, Jason, in the screen, but looking at the insights at a higher view. So when we bring about voice of patient, voice of member plus operational data, plus that workforce feedback, it gives us a different view and a lens that allows us to step back a bit and bring it back to the human centricity around the conversation. So for me, it it again goes back to the data and and how we're able to elevate the conversation by viewing really across the journey that doesn't just start and end within one particular organization. I think there's a huge opportunity within a lot of the pay viter organizations where they're privy to a lot of this. But I also have seen examples. Um, Blue Cross Blue Shield Alabama is one example where they actually are doing a lot of work from the health plan perspective where they're investing in the education of the providers that serve within the community. And so we're starting to see a lot of this more innovative work and relationship building between health plans and provider networks. And when they're able to collaborate and learn from each other, that's where I think the magic happens. Um yeah, yeah. So more partnership, more shared visibility, more accountability.
SPEAKER_00And I would and I would add to your point, Amber, that that is actually I I would add that that is a good business model. So if you are still operating a payer organization from the mindset of we have to manage our dollars to hit certain marks, actually those actions, let's work on community education, let's work on on partnership models that lead to greater outcomes, it's gonna actually have those those pay organizations, right, probably reap greater benefits operationally and financially if they do that well. So it's not like uh Yeah, we get stuck managing our own little pieces and we lose the chance to actually grow our capacity or our impact in the partnerships and collaborations that we create to have a better chance of achieving where we're exceeding our goals operationally and financially. And I think that gets missed significantly. So I think you hit on something really important there.
SPEAKER_03Yeah, there's been some great publications that have come out of the um the barrel publication, the patient experience journal that talk about the ROI on patient experience. And when you start to see the intersection between not just the financial impact, but the safety impact, right? All of these measures are correlated. So when we can start removing those barriers for patient empowerment, patient engagement, you ultimately see those operational, financial, and safety type of changes that these organizations are also committed to advancing. By being able to identify one of those pillars to focus on, you can truly impact all areas from the business point of view.
SPEAKER_02I think that transparency you hit on though is is huge. And I think that's just a major opportunity there. Just one more thought for me, really, to get some of these some of the health plans I'm working with thinking around this too, is I think that shared accountability, like when we think through KPIs, rather than a scorecard, a shar a scared a shared scorecard, I think just working towards uh alignment on things like access to care, you know, referral turnaround times, things like that. I think those are where we need to sit down and we need a partner and say when we do this together, what does this look like when it's done well and what is our goal here? Um, and really start to map that out with our partners. Um, I think this has been um an amazing conversation. I'm so glad you guys took the time to sit down, talk through us. I know we lost Rex. Um, but just closing thoughts here, wanted to say, you know, if you could change one thing about how healthcare organizations approach member patient experience today, what would that be? And Jason, I'm gonna turn that to you.
SPEAKER_00Is it just one thing? I mean, I think we said it today. I I think we really did say it today. I think we have to have a lens of we have to have the a lens of approaching this from an integrated approach, right? From a human experience lens, that it's about the patients we care for, it's about the people who show up to work in healthcare, it's about the communities we serve. And if we operate with that as our focal point, um, we'll make sure the gaps go away quickly rather than our independent needs in a system in a disconnected system. And so I think coming back to that um is a really critical piece for people to consider moving forward.
SPEAKER_03Yeah, I would I would just add that for me it's looking beyond scores and beyond moments and thinking about more humanistic experiences. So even just the way that we frame feedback, is this positively or negatively impacting trust? Not is this driving NPS up or down, right? And and when we think about framing conversations in a way that's meaningful, not just to the humans we're serving, but also to the humans who are serving, that's critically important because ultimately they're the ones that are looking for feedback that will drive the changes they're looking for to drive trust. So um I I've just seen so much great impact by connecting with providers around how the impact they're having on patient trust versus the hospital's likelihood to recommend them as a provider. And if we can again just start anchoring back to the human element of the industry that we serve, um, I think we would have such a stronger impact.
SPEAKER_02Agree. And Rex, I see we got you back. Um curious in your thoughts there too.
SPEAKER_00So we were hitting on the timing, yeah. Welcome.
SPEAKER_01Yeah, so sorry. Yeah, my uh so the the wonders of technology, right? In these virtual podcasts, but my my power completely went off uh for the whole area and was off for almost 15 minutes. So I missed a lot and uh don't even exactly know where we are. So yeah, no, car carry on, carry on. Are we Heidi? You finna please uh keep us going here and I'll jump right back in.
SPEAKER_02Yeah, I think we're we're right to the end though, Rex. So if you want to um hopefully we can get this part edited out, but if you want to close us out, I think we've pretty much gone through all the questions. We didn't do the book. I don't know if you want to hit on on your book question.
SPEAKER_01Yeah, sure. That's my one of my favorite parts anyway, right? So let's uh um this is where I get my my reading list. So yeah, you guys are the experts in this space. So what's what's one book everyone should read? Um yeah, Amber, we can start with you.
SPEAKER_03I am not just recommending this because Jason is on the call, but um Return on Experience um by Jason and Stacy. Um I genuinely think is a book for this industry that captures where healthcare needs to go. Again, it's elevating it back to that human level. Um, and it reminds us that experience is not just about satisfaction, as it has was initially introduced as an industry, but it's about this integrated care experience of humans caring for and serving humans. So it feels especially relevant to this conversation and um an industry.
SPEAKER_00I'm excited. Well, that's that's kind of you, Amber. Now I'm blushing. But uh I appreciate that. I appreciate that. You know, it's funny because I'm a culture guy first, you know. I'm a old diplomat that found my way to healthcare through uh, you know, being a purveyor and student of organization culture, and I like the the classics in some ways. I mean, I I believe everybody should read Believe it or not, Leading Change by John Cotter. I mean, I just think in a world of healthcare where we live in such static, undynamic sometimes, yet we're always changing because of the chaos. Just some of the basic fundamentals of what it means to understand that we are in a world of constant change and having a structure in which to operate, either as an individual or as an organization, is fundamental in solving all the things we talked about today and actually making choices that are better for others. And so, you know, there's some fundamentals like that. There's great books out there right now, and I appreciate what you said, Amber. But to me, sometimes it's some of those really foundational principles that we can use to apply and how we lead as people in life and in healthcare that is really critical. So that's what I'm saying.
SPEAKER_02I think for me, um several years ago, I had a manager who recommended a book called The Power of Moments. Um, and she I feel like she has actually put me onto so many different books that were insightful, but that one really stood out for me um just from the member experience lens. And it's it's actually really relevant, I think, across industries, but particularly it resonated with me in healthcare and trying to solve some of these caps problems and member experience problems. Um, but I think it really it kind of challenges the idea that experiences are built through big initiatives. It really goes down to those granular, more specific moments, so like where members can be confused or vulnerable or frustrated and show how that kind of disproportionately shapes how members or people would remember an experience in general. Um, so I think for healthcare, like I said, I found it very relevant just because that is so emotionally charged, right? This is your health we're talking about and your care journey. Um, so I felt like I just I took so many things away from that book and and applied it to the way that I approach member experience.
SPEAKER_01That's great. I I've read a billion books, I haven't read those any of those three, so I'm I'm excited to uh to get those on the list. And yeah, yeah, thank you. Did you guys um just as final question here, did you guys already talk about like we we will publish this episode, we'll put it on LinkedIn, we'll tag you guys and your organizations. But if people wanted to follow you or learn more about your work, can you did you already say kind of how people can do that? If not, can you say that real quickly? Jason, you want to go first?
SPEAKER_00Yeah, no, I would I mean I'd invite people, so you know, the the the Beryl Institute, our site's the barrel institute.org. Um I also appreciate Amber mentioned our journal. We publish an academic journal called Patient Experience Journal, um, which is also fully open access to read. So a lot I hope people find a lot of resources that they can apply, whether they're members of our organization or not. And I think the one thing I'd just say is the tapestry of people that are engaged. I I what's exciting, and I think maybe some of the work, Rex, you and how do you do it? I mean, we're actually seeing a big influx of uh pair organizations really being interested now and coming into the community around engaging in the experience conversation. So I do think it's catching fire, and we reflect a tapestry of people from patients to experienced champions and healthcare leaders to great people like Amber who are bringing really innovative solutions to the market in you all. And you know, so that that is who we are, a community that comes together to try to impact change in healthcare.
SPEAKER_03There's also some additional regional roundtable events coming up this fall for the Beryl Institute. Um, hope to see some new uh registrants there, but it's a great way to connect with other organizations. And um, I would love to connect with anyone on on LinkedIn. Um I I tend to share a lot about uh my personal experiences with healthcare and and trying to keep the conversation human as much as possible. So would love to connect with anyone who has that shared interest.
SPEAKER_01Great, and Heidi?
SPEAKER_02Yeah, well, you can go through Rex or you can go through our website, and you can definitely find me on LinkedIn. So happy to connect.
SPEAKER_01Okay, hey, thanks so much, you three. Really appreciate the conversation. Can't wait to go back and listen to the recording to to know to know what all was said. So uh, but great perspectives and um really, really, really important topic. So thanks so much for being on, and we'll talk next time. Thanks, everyone.
SPEAKER_02Thanks, guys. Thank you. Thanks so much for being with you all.