The Killer C’s

The Killer C’s

by Bob Teague

Let’s say you have the most amazing technical solution for healthcare in history. Curing disease. Better care. Cheaper. More efficient. Even a CPT code.

Why won’t providers and payers buy and adopt it? And if they do, why does it take 1-2 years? Becoming a standard of care takes years. Why?

More often than not, it’s the Killer C’s. Healthcare customers, usually provider or payer institutions, are notorious for moving judiciously related to these three barriers to sale.

Cost. Complexity. Change.

To be successful, objections real and manufactured in these three areas must be addressed effectively. This comes after there is general acceptance that your technology could be useful and that you have healthcare credibility and experience and have market staying power. 

Up-front costs are always a barrier especially for not-for-profit healthcare provider organizations, the one often writing the check. Even in the for-profit world, large capital expenditures outside of budget cycles are uncommon. The more payments can be managed through cash flow or an expense item on the P&L, the less of a barrier it becomes. Service models are attractive.

Cost resistance may also arise from established purchasing and supply chain relationships. Knowledge of existing methods and relationships is necessary and is basic to understanding cost resistance.

Complexity arises from adding new work to users or a requirement to learn new workflows. The burden of technology benefits realization falls to the frontline clinicians or sometimes to the procurement, supply chain team. While there may be demonstrated efficiencies with your product or service, if adding it to standard operating procedure causes more work or is perceived to do so, acceptance will likely meet resistance.

Healthcare delivery is famous for its resistance to change especially at the process level. Large provider institutions are not known for their change management expertise in general. Your new product or service is displacing something that works now even if that something is suboptimal.

Change invariably causes additional costs by inflicting the learning curve. Clinicians through long years of education and training learn what works for their patients and for them as a practitioner. Asking them to change may add perceived and actual risk at least in the short run to care delivery methods they believe already work and deliver high-quality care.

As with all friction in the introduction of new technology The Killer C’s are not an insurmountable barrier. Awareness is required to understand both the context and perspective of buyers, users, and who benefits as each perceives the value of your product or service in the context of the Killer C’s. 

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