© Oliver Wyman - Marsh & McLennan Companies...© Oliver Wyman NEW RULES, NEW ROLES: REDEFINING...
Transcript of © Oliver Wyman - Marsh & McLennan Companies...© Oliver Wyman NEW RULES, NEW ROLES: REDEFINING...
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© Oliver Wyman
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© Oliver Wyman
NEW RULES, NEW ROLES: REDEFINING HEALTH
All that will remain will be high acuity operations.
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© Oliver Wyman
THE OLD GAME: LOCAL DENSITY
Highly concentrated healthcare markets
2000 2017
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© Oliver Wyman
8%
10%
12%
14%
0 10 20 30 40
THE OLD GAME: NATIONAL SCALEPa
yer A
dmin
Exp
ense
Rat
io
Lives (MM)
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© Oliver Wyman
OLD STRATEGIES ARE NO LONGER WORKING
“We expect rapid expense growth tooutpace revenuegrowth.”
- MOODY’S DECEMBER 2017
“About 18% of U.S. hospitals are at risk of closure or performing weakly.”
- MORGAN STANLEY 2018
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© Oliver Wyman
DEMOGRAPHICS AND REIMBURSEMENT ARE RELENTLESSLY STRAINING HEALTH SYSTEM ECONOMICSProportion of operating costs covered
100%
150%+
50%-
Med
icai
d
Commercial
Medicare
Revenue
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© Oliver Wyman
DEMOGRAPHICS AND REIMBURSEMENT ARE RELENTLESSLY STRAINING HEALTH SYSTEM ECONOMICSProportion of operating costs covered
100%
150%+
50%-
Revenue
Med
icai
d
Commercial
Medicare
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© Oliver Wyman
EVERYONE IS NOW A HEALTHCARE CONSUMER…
Deductibles have grown
8 timesfaster than
wages since 2008
Average individual deductible in employer sponsored health plan
400
800
1,200
1,600
2006 2008 2010 2012 2014 2016 2018
Deductible for Single Coverage
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© Oliver Wyman
…AND THE REVIEWS LOOK GRIM
Net willingness to recommend, by industry
2018 Oliver Wyman Consumer Survey
-8
2
8
14
20
24
34
1
2
3
4
5
6
7
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RUSH FOR CONTROL OF THE UPFRONT RELATIONSHIP
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NEW ENTRANTS RUSH IN
Digital health funding
20132012
$5.8B
2014 2017
$4.3B
20162015 1H2018
$1.5B
$2.1B
$4.6B$4.4B
$3.4B
$6.9Bprojected
Source: Rock Health
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© Oliver Wyman
Economic Pressure
Technological Pressure
Consumer Pressure
Competitive Pressure
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THE MARKET IS PRIMED FOR DISRUPTION
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© Oliver Wyman
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© Oliver Wyman
FIVE NEW ROLES EMERGE
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FIVE NEW ROLES ARE EMERGING
AccessSpecialist
Rules to Win:• Consumer Delight• Simplification• Ubiquity
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FIVE NEW ROLES ARE EMERGING
AutomatedAgents
AccessSpecialist
Rules to Win:• Data Intelligence and
Sophistication• Clinical Insight
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FIVE NEW ROLES ARE EMERGING
Focused Factories
AutomatedAgents
AccessSpecialist
Rules to Win:• Industrial Discipline• Continuous Improvement• Best in Class Capability
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FIVE NEW ROLES ARE EMERGING
FocusedFactories
AutomatedAgents
AccessSpecialist
Unbundled Financiers
Rules to Win:• Product Management
Agility • Consumer Alignment
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FIVE NEW ROLES ARE EMERGING
Rules to Win:• Risk and Delivery
Alignment• Ability to Influence
Consumer
FocusedFactories
AutomatedAgents
AccessSpecialist
Unbundled Financiers
Integrated Care Managers
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VALUE WILL MIGRATE TO THESE NEW ROLES
AccessSpecialists
AutomatedAgents
FocusedFactories
UnbundledFinanciers
Integrated Care
Managers
Payers
Providers
Other (e.g., Tech, Retail)
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© Oliver Wyman
WHICH ROLE WILL YOU PLAY?
AccessSpecialist
AutomatedAgents
Focused Factories
UnbundledFinanciers
Integrated Care Managers
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