EXECUTIVE SUMMARY
Spiraling healthcare costs have been of grave concern to prominent segments of industry, government, and the public for at least 50 years. And while the cross-sector battle rages on over the appropriate strategy for addressing them, there is one fact upon which clear-eyed industry analysts agree: There can be no solution to the healthcare crisis that does not address America’s unchecked epidemic of chronic disease, which afflicts more than half our citizens and consumes 86% of the exorbitant $3.2 trillion spent each year on care.
But our traditional healthcare delivery system, designed to excel at episodic acute care, has not made a dent in the problem. To prevent and reduce the cost of managing chronic disease, the system must learn to facilitate change in individual behavior, which has the greatest impact on health of any contributing factor, including healthcare. The Theory of Jobs to Be Done is a powerful tool toward this end.
Jobs Theory explains that everything people consciously choose to do (including doing nothing), they do to make progress according to their own priorities, in a particular set of circumstances. We call this progress a “job,” and it motivates individuals to search for solutions. Based on this insight, the theory asserts that the way to unleash patients’ potential to better manage their health is not to try to get them to prioritize health goals over the jobs they’re already striving to do. Instead, it’s to understand those jobs, and help patients accomplish them in ways that enhance their health, rather than detract from it.
For instance, a person striving to feel less lonely might “hire” a cat, a walking group, more hours on Instagram, or smoke breaks with colleagues to do that job. Each of these solutions has health consequences, ranging from positive to negative. Jobs Theory provides a framework for creating solutions for patients’ jobs that also have positive health consequences.
A jobs-based approach to healthcare delivery is particularly suited to chronic disease management, for five reasons:
- Takes into account patients’ full capacity to change, so patient and provider can establish realistic health improvement goals, and craft health solutions patients can absorb considering their unique circumstances.
- Works with patients’ existing beliefs about health, rather than requiring immediate change in perspective, and thus reduces barriers to adoption of health solutions.
- Illuminates the broader determinants of individual health status, enabling development of health solutions that address them, likely in partnership with experts in sectors beyond healthcare, such as social services.
- Clarifies the real competition to healthy behavior, so patients and providers can craft health solutions to patients’ jobs that outperform unhealthy alternatives.
- Shifts unit of performance from outcomes to progress. Chronic disease management is a long game, so progress in health improvement, not episodic care outcomes, must be the ultimate metric of success. Because jobs represent the progress people seek, organizations capable of delivering jobs-based health solutions are optimized to deliver on the metric of progress.
In researching a diverse range of organizations for this paper, we identified five core enablers of jobs-based healthcare delivery. The most fundamental of these is what we call a health-centric purpose. That’s an organizational purpose defined in terms of patient health and wellness impact, not the types of services provided.
Others include an explicit process for jobs discovery, and the practice of hot-spotting. The former enables accurate definition of the progress patients seek at a given life juncture, and the latter focuses innovation and resources with exceptional intensity on patients whose health improvement will yield the biggest cost savings.
Astute resource integration means organizational skill in mobilizing resources across functions, sectors and geography, and it’s essential for tailoring health solutions to patients’ unique circumstances. And finally, community interaction mechanisms help keep patients connected with peers in health improvement, and thereby with the overall care and self-management process.
There can be no remedy for America’s healthcare cost crisis that does not aggressively attack the scourge of chronic disease that drives so much suffering, and the majority of cost in our system today. But there’s a cavernous gap between the kind of care people need to avert or address chronic disease, and the episodic, acute care our traditional healthcare system is designed to provide. Using the Theory of Jobs to Be Done, innovators can bridge this gap by creating health solutions patients have the capacity to embrace, and which unleash their potential to manage their health more effectively and independently.
