Blog

01/30/19

Wale Friction

I saw a rack of corduroy pants at the store the other day and had no idea the heavy ribbed fabric is back in style.  Some of our readers knew that; like me, some are surprised to learn it; one guy – you know who you are – just looked down at his trousers and smiled.  Dude, your wardrobe is so old it is now hip again.

The ridges, cords, are called ‘wales.’  Ask your hipster IT guy wearing cords if those are 8 or 16 wale.  He’ll freak. Seeing these again took me back to the question every boy forced to wear the indestructible pants in the 70’s asked himself: ‘If I hold my legs close enough together and run fast enough, can I generate enough friction with my cords to set my pants on fire?’

Yes ladies, we think these things.

Ironically, friction has been on my mind because it is a random topic that has shown up in several conversations lately.  Here are three, all concentrated in a very specific area and all from just the past two weeks.

A practice called looking for a consultant to help on the front end of their process because it is taking them 15 days to get their patients pre-authorized for surgery.  That is slowing cash flow and leaking some patients away forever.

A buddy who works with big pharma shared about one of his clients, maker of a cardiovascular drug, struggling with sales because physicians are having so much trouble getting patients approved for the drug by the insurance company that they just give up and write for something else.

On behalf of one of our clients, we got a couple of their tech wizards on a call with a friend of mine who is a hotshot at one of the big payers responsible for helping improve the claim transactions with providers.  We all were looking for ways to reduce the friction in the pre-auth/pre-cert process as it is killing both sides of the handshake – providers and the payers – as cost, delays, errors pile up everywhere.

These stories, all from the one task of getting approval to provide care to a patient, have two things in common:  humans and complex data.

The humans on one side have information: who the patient is, what we learned about their condition, what we want to do to help.  The humans on the other side have information: coverage the member has, what the approval protocols say.  Getting them connected, putting the information through the magic box, and deciding to get on with it generates more heat than a fat hippo running the 100-yard dash in 16 wale pin cords.

When we say healthcare is still way behind in technology, this type of friction is a great example of what we mean.  Industry – manufacturing, retail, financial services, media, everyone – solved the equivalent of these exchanges back in the 90’s.

Finally, here we come, the chubby semiaquatic mammal in the cut pile fabric jogging suit.

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ALN

Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.

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