© 2014 BA Convention

Answering Healthcare Needs through

Technology

India Market Focused

Praveen Sankaranarayanan Deloitte

© 2014 BA Convention 2

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Agenda

Healthcare Industry Overview – Players in the Market

Industry trends and Challenges

Key takeaways

Lessons from other industries to achieve Patient Centricity in Healthcare

Managing Stakeholders in Healthcare Ecosystem through Collaboration

Fixing an unsatisfactory equilibrium in Healthcare using IT

Summary

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Understanding the Stakeholders in the Healthcare industry

Healthcare Industry Overview

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Industry customers and participants

Other Industry Participants

Health Plans

Providers

Biotech &

Pharma

Not for Profit

Organizations

Governments

Medical Devices

Customers for the Healthcare Industry

Patients

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The Healthcare systems of the world

Systems in which the national government owns,

operates and pays for the entire health care system.

– UK, Spain, Hong Kong, New Zealand

The government does not provide health care directly.

Instead, the government controls one or more national

health insurance plans that reimburse private health

care providers.

– Medicare of US

Individuals and their dependents receive health

insurance through health insurance plans provided

through their employer

– Germany

Not all countries offer universal coverage to their citizens

or residents. Residents in these countries can purchase

individual health insurance to cover some of their health

care costs.

Healthcare Systems

Socialized health care systems

National health insurance systems

Employer-sponsored health insurance

Individual responsibility

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Trends in the Indian Healthcare Industry

WHO has officially certified India as a Polio free nation

CIGNA TTK health insurance carrier’s entry

through promotion of Wellness programs

Aging population and increasing life expectancy drives demand

Health care professional shortage limits supply

Medical Tourism on the rise

Increase in incidence of lifestyle-related diseases

Growth in single specialty hospitals

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Changing Outlook of Providers in India

Sponsorships to perform free heart surgeries for poor children

Heart treatment camp for the poor and the needy at highly subsidized costs

Camp for arthritis patients providing X-Ray and other tests at discounted rate

Reach out to the lower income strata via 60 "tele-medicine" centers

Apollo Group

Hospitals

Lilavati Hospital Has a social service department called SEWA

– Free medical and surgical services including CABG, Valve replacement, Cancer and Orthopedic surgery

– Free OPD for 2 hours daily

– For senior citizens, hospital vans for examining BP and Sugar levels and giving free medical advice

– Mobile clinic providing free treatment to the slum areas in Mumbai. Group sessions like "Malaria Prevention and

Treatment", "Cancer Awareness", "Child Health Care“, etc are also held in these areas

Source: Hospital Websites, Press Articles

Corporate Social Responsibility Program

– Set up Primary Health centres offering free consultations, medicines and a 50% discount on diagnostics

Community Outreach Program

– Delivers heart & vascular care treatment to the unprivileged and educates community doctors

Max Healthcare

For-profit mindset supports the idea of making money…while still tending appropriately to

the needs of the lower strata who are at the bottom of the Pyramid

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Increasing growth of Payers in Indian Market

Source: Industry Discussions, Secondary Research

Higher Quality, Appropriately Priced Insurance

Products and new Disease-Specific Products

To..

Improved quality of insurance products/ offers

– Coverage beyond hospitalization to cover

OPD drugs, tests and treatment and flexible

(and even no) caps on cover limit

– More customized options

Insurers price and manage Group health

insurance products profitably

Health insurance providers open to discussing

new product options (disease-specific or

otherwise)

Emerging disease-specific products

From…

Limitations on coverage and typically have

caps on cover limit (~US$ 3500)

Limited options of insurance products

Unprofitable Group health insurance

products

Regulatory and Competitive Evolution in Health

Insurance Sector

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Role of Government in Indian Healthcare

Market

National Health Programs

National Cancer Control Program (NCCP) aims at prevention of tobacco related cancer; early detection of cancer;

augmentation of treatment facilities;

Universal Health Insurance scheme

Note: 1Program for Appropriate Technology in Health

Source: Secondary Research, Central and State Government Sites, Press Articles

Maharashtra

Specific focus on HIV/ AIDS and

Women’s health

Andhra Pradesh

Financial support for Hepatitis B

Model Immunization System for

Hepatitis B, a project in

partnership with PATH’s1 Children

Vaccine Program

Karnataka

Primary focus on Cancer and

Women-Child health

Karnataka Cancer Society provides

weekly free checkups

Research centre for cancer

genomics

Increased funding for patient

awareness, diagnosis and treatment

Kerala

Primary focus on Hepatitis B and

maternity care

Delhi

Primary focus on HIV/ AIDS and

water-borne diseases

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Lessons from Other Industries in the US

Operational Synergies- Perspectives of a

Winning Approach to achieve Patient Centricity

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Industry Supply Disruption in the US towards Consumerism

Reg

ula

tion

Economics

Te

ch

no

log

y

New intermediaries(Fidelity, Sears)

Product Innovation – Mutual Funds

Trends

Electronic

funds transfer

ATM

High Inflation Rates

Low returns on savings accounts

Shift of funds from traditional deposits

Deregulation Financial Services – 1980’s

Reg

ula

tion

Economics

Tech

no

log

y

New intermediaries(einsurance.com)

Product Innovation – HSA, HRA

Trends

Pharma

breakthrough

Internet,

ecommerce

Cost of healthcare increases

Employers shift cost burden

Increase in uninsured

PPACA

HiTech Healthcare –

2009-10

Telecommunications Act of 1996

Financial Services – 1990’s Healthcare – Late 2000’s

Airline Deregulation Act of 1978

Financial Services Modernization Act of 1999

National Energy Policy Act of 1992

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Connecting the dots for Solutions and Outcomes

Fixing an unsatisfactory equilibrium in

Healthcare using IT

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IT as an enabler in the Changing External Environment

CRM Collaboration

Analytics

Social Media

Channel Management

Portals, Content

management

Enabling Consumerism in

Healthcare

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Key Note

Breaking down barriers in Healthcare

Ecosystem through Collaboration

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Vision of Partnership /Collaboration between Provider and Pharma

The Collaboration Imperative

• Pursue rapid growth as health reform, and managed care expansion opportunities unfold

• Leverage best practices from two industries to create a framework for achieving greater scale and efficiencies

• Strengthen positioning and brand in the Healthcare market

• Sustain and strengthen value proposition for communities, and members

• Understand cultural similarities and differences to manage transitions, ease ƒanxiety, and minimize disruption

• Both hospitals and manufacturers have incentive to increase access to medications with improved outcomes

• Health care Providers provide patients with access to medications while manufacturers can vouch for the positive outcomes of their medications

Reduced

Healthcare Costs

Improved Patient

Satisfaction

Opportunities Principal Focus Areas

Considerations

Improved Patient

Outcomes

© 2014 BA Convention 16

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Vision of Partnership /Collaboration between Payer and Pharma

The Collaboration Imperative

Entry Point Offerings Evolved Offerings End State

Partnerships

End-to-End Patient

Centric Partner

Member Analytics and Diagnostics

Claims analytics

Care Analytics

Disease Management

Channel and Sales Analytics

Integrated Care Management

© 2014 BA Convention 17

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Summary

• Healthcare industry investment in technology lags behind that in other industries, but it will

begin to catch up soon !!!!

• Investments in Big Data and analytics can leapfrog the industry to improve the accuracy of

decision making at the point of care and to provide additional insights for clinical and

operational research.

A little foresight goes a long way!!

© 2014 BA Convention

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