For all the faults of its roll out, the Affordable Care Act should ultimately provide more people with health insurance and thus a way to pay for basic health care. That implicitly assumes that there is enough health-care capacity to go around. There is a very real concern that there is not enough capacity — particularly in primary care — to properly cope with an influx of newly insured patients who will want to do basic things like see a doctor.
Cooper University Hospital is expecting a huge wave of patients starting next month, as millions of consumers get health insurance, some for the first time. The question for hospital executives in Camden, and around the country, is how to manage this new population. For one, there is a chance this new patient population will exacerbate existing problems at Cooper.
Today, “the patient no-show rate is in high 20s, 25, 30 percent,” says Jonathan Vogan, the associate director for financial and performance measurement at Cooper’s outpatient clinic, the Urban Health Institute.
The Urban Health Institute serves more than 8,000 patients, virtually all of them low-income. Vogan says the poorer the patients, the more likely they’ll miss their appointments. And that’s an expensive problem. But Vogan says the solution is simple.
“If not all of your patients show up then the easiest thing to do is, well, just book more of them,” he says.
I have a long-standing interest in Black Friday — less because I want to go shopping but more because it poses some interesting questions on how firms compete and how they manage customers. The news this year is that Black Friday is creeping evermore into Thanksgiving proper as retailers keep moving up their opening times. So why are they doing that? Two posts on Businessweek.com put forward theories. The first posits that this is being driven by customer segmentation (The Game Theory Behind Macy’s Thanksgiving Opening, Oct 15).
Traditions are being trampled on by the Corporate Retail Complex! Of course, consumers don’t have to go. Some won’t, and that’s precisely what the strategy folks at Macy’s are betting on.
The purists scandalized by the thought of shopping on the holiday itself aren’t likely to avoid Macy’s altogether. And with the die-hard bargain-hunters swarming the stores on Thursday, Friday shopping will likely be much more pleasant for those who are a little less committed.
It’s only a two-hour wait. An ordinary Thursday afternoon at Apple’s flagship UK store in Regent Street, London and a long line of customers snakes across the first floor. The hip technology brand is used to queues for the launch of its latest must-have product, but these people have come carrying faulty iPhones and malfunctioning laptops, desperate for help from one of Apple’s increasingly hard to reach “Genius” experts.
When it opened in Virginia in 2001, the first Apple store was hailed as a retail revolution, allowing shoppers to play with expensive technology without any sales pressure. The emphasis on service, with blue-shirted Geniuses on hand to answer queries and fix broken products, has become almost as important to the Apple brand as the aesthetic appeal of its products. But the whole experience is under pressure as a relatively small number of shops struggle to cope with rapidly growing customer numbers. …
The Regent Street outlet, for example, employs at least 120 Geniuses. Each sees up to 30 customers a day but it is impossible to book an appointment less than a week in advance. If the problem is urgent you can turn up and queue, but it could be a very long wait. This week, a gaggle of well-trained, polite and friendly staff worked their way along the line trying to answer simple queries and advise people on alternatives to queueing. But it is hard to redirect people when every nearby shop has its Geniuses fully booked for days on end.
The article goes on to note that this is not just an issue in London. It certainly can be an issue here in Chicagoland. While a quick check of my nearest Apple store shows that they currently have a number of appointments open for tomorrow, Friday morning already has no availability. There are even reports of scalpers hawking Genius Bar reservations in China.
So is there an easy fix to this problem? It seems like there are two issues here. First, to what extent should Apple accommodate walk-in customers? Second, is there any easy fix to expanding Genius capacity? These are related. If capacity is expanded then the ease of getting a reservation should take care of the walk-in issue. On the other hand, if capacity cannot be easily expanded, then there is a question of how to allocate it between walk-ins and appointments.
We’ve had a bunch of quick-service restaurant stories lately but this one on Panera is too nice to pass up. The Wall Street Journal reports that Panera has lowered its growth forecast in part because of poor customers service — long lines and messed up orders is costing them business (Panera Says It Can’t Handle Crush, Oct 23). So what are they looking to do about it?
Panera plans to modestly pare its menu, which will reduce preparation time. The company also plans to migrate phone orders to the Internet to save time for workers who have to “drop everything” to handle phone orders, Mr. Shaich said.
The company also plans to create dedicated catering hubs in existing restaurants to handle catering for a few restaurants in order to free up the cafes from handling catering orders.
Next year the chain plans to introduce a new menu structure that will group items by price so that people who are looking to save money can easily find lower-cost options.
In the basement of the Kellogg School, there is a cafe. It’s a busy cafe, which says more about the available alternatives than about its absolute quality. Because it gets busy and because a good number of its customers are polite enough to walk out of class five minutes early to beat the crowd, I and my colleagues have learned that it is a much better to plan to go down for a sandwich a little before noon than a little after noon. According to CNBC, Goldman Sachs faces similar issues with queuing in its cafeteria and it actively tries to manage the system (The creepy capital efficiency of Goldman’s cafeteria, Oct 17).
The most crowded time of the day to eat lunch is, naturally, during lunch time. For most people, this falls around noon. This creates the phenomenon of the lunchtime rush hour. You know this all too well if you’ve ever tried to stop in your local chopped salad place at, say, 12:30 in the afternoon.
Goldman didn’t like the idea of its people waiting on long lines to get their lunch. People are capital to Goldman. It wants to use its capital efficiently. Standing on line waiting for dumplings or salad or a burger is not an efficient use of Goldman’s capital. …
The cafeteria has a set of timed discounts. If you show up in the cafeteria before 11:30 or after 1:30, you get a 25 percent discount on your food. Goldman incentivizes employees to avoid the rush hour.
Check out this video of Steve Jobs talking about the origins of the iPad.
The text that appears as Jobs talks is how a computer program developed by a firm called Beyond Verbal is interpreting Jobs’ emotion. That is, the program is judging whether Jobs is feeling fatigue or nostalgia based not on what is saying but how he is saying it.
Kinda nifty, but does it have commercial applications? The claim is yes and it is in call centers.
I love self-service checkout, but it is again under attack. Here in Chicago, Jewel-Osco (one of the major local supermarket chains) is pulling self-service checkout lanes from some of its stores (Jewel scrapping self-checkout at some stores, Chicago Tribune, Sep 25). Their stated goal is to “reconnect personally with all of its customers.” Now the Wall Street Journal is piling on with an article declaring that computers just aren’t up for the job of letting people buy green beans (Humans 1, Robots 0, Oct 6).
The human supermarket checker is superior to the self-checkout machine in almost every way. The human is faster. The human has a more pleasing, less buggy interface. The human doesn’t expect me to remember or look up codes for produce, she bags my groceries, and unlike the machine, she isn’t on hair-trigger alert for any sign that I might be trying to steal toilet paper. Best of all, the human does all the work while I’m allowed to stand there and stupidly stare at my phone, which is my natural state of being. …
In a recent research paper called “Dancing With Robots,” the economists Frank Levy and Richard Murnane point out that computers replace human workers only when machines meet two key conditions. First, the information necessary to carry out the task must be put in a form that computers can understand, and second, the job must be routine enough that it can be expressed in a series of rules.
Supermarket checkout machines meet the second of these conditions, but they fail on the first. They lack proper information to do the job a human would do. To put it another way: They can’t tell shiitakes from Shinola. Instead of identifying your produce, the machine asks you, the customer, to type in a code for every leafy green in your cart. Many times you’ll have to look up the code in an on-screen directory. If a human checker asked you to remind him what that bunch of the oblong yellow fruit in your basket was, you’d ask to see his boss.
Let’s take this in two parts. First, if people prefer a conventional check out experience because that allows them to zone out then I have to wonder how Jewel’s plan to reconnect with its customers is going to work. I remember as a kid my mom having what seemed like endless conversations with cashiers. Of course, we were in a relatively small town and most of the women (they were virtually all woman) working the registers had either gone to high school with my mom or had a sibling who did. Now we live in a more class divided society. I suspect that none of the cashiers at my local Jewel are actually from the neighborhood or that the store’s staffing policies actually build in time for cashiers and customers to catch up on how their respective in-laws are doing.
But what of the claim that the information needed to run checkouts cannot be simply encoded for computers? (more…)
Fast food is supposed to be, well, fast. But is speed everything? If you think about how different chains advertise, they are often emphasizing price or some expansion of their offerings. Essentially no one ever says that they will get you on your way in two minutes. Speed is taken as a given but there has to be some interplay between the range of what a firm offers and how fast they can serve customers.
That gets us to QSR Magazine‘s annual survey of drive-thru lane performance (The Drive-Thru Performance Study, Oct 2013). Drive thrus matter since they can account for 60 – 70% of sales and QSR’s survey is something of an industry standard since they have been at it for 15 years. You can find information on their methodology here and a paper co-written by Gady that uses this data here. The most interesting insight from the survey comes from comparing data on service times (i.e., how long does it take from when you get to the order board until you have your bag of food) this year with last year.
As the data shows, service times are getting slower as a whole. The industry average went up about 5% from 172 seconds to 180. What’s driving the increase?
The problem seems to have started when an Aug. 9 flight from Stockholm to Berlin took off without loading any luggage. Almost 200 bags idled in the Stockholm airport; passengers’ inquiries were met with endless redirects. One customer even unveiled a Facebook group called Airberlin 8109 Stockholm to Berlin – Where are our bags?!?!? The somewhat reiterative description reads:
“A group for those who flew on AB 8109 from Stockholm to TXL on 9 August 2013. NONE of the checked luggage was loaded on the airplane—almost 200 missing pieces missing among the passengers. Little to no information has been provided. We filled out forms and were given baggage service numbers to call, but the phone line has no answer all day. Days later, still no information whatsoever, nobody to call, no information, not sure what to do. Baggage company says to contact airline; airline says to contact baggage company. Vacations & weddings ruined. We still can’t comprehend why the captain decided to take off before any pieces of luggage were loaded. We need support from Air Berlin—please get to the bottom of this. This isn’t one lost bag, it’s a whole plane of lost bags!”
Needless to say, people were kinda pissed. You don’t have to infer this. You can read about the long series of increasingly frustrated tweets reproduced in the article (including the one I took to be the title of this article).
A Slate article asks a very simple question: “Ikea is so good at so many things. Why is it so bad at delivery?”
The author tells the story of an item that was purchased from Ikea and was supposed to be delivered by a third party. While Ikea claimed to ship the item, the third party claimed to never receive it. Since Ikea claimed the item was shipped, the order could not be cancelled without incurring a hefty cost. Apparently, this is not a unique experience:
The nightmare of Ikea delivery is a truth so universally acknowledged that even the company cops to it. Chief marketing officer Leontyne Green talked about her own “very frustrating” Ikea delivery experience in a December 2011 Ad Age profile, which stressed the firm’s ongoing efforts to improve delivery and overall customer service.
In trying to explain the above conundrum, the author recruits several of our colleagues from Dartmouth and Harvard:
“With sporadic orders over a wide geographic area, Ikea would need a fleet of trucks that might be idle one day and not able to handle the load the next,” says Robert Shumsky, a professor of operations management at the Tuck School of Business at Dartmouth.
We have discussed several times, albeit in the context of grocery delivery, the fact that one of the main cost drivers of delivery services is density. Since Ikea tends to be quite far from urban and dense areas, it is usually difficult to build density and thus difficult to offer a cost efficient services. One may charge a high price for such a service, but given their target market, this may not be ideal. (more…)