Tom Main Health Market 2.0 Presentation

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    HEALTH & LIFE SCIENCES

    Health

    Market 2.0

    The patientto consumerrevolution

    Quantifiedself  

    Transparentconsumermarkets

    Smartcare teams

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    CHANGING THE

    CONVERSATION

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    THE PATIENT TO

    CONSUMER REVOLUTION

    WHAT HAPPENS WHEN THE CONSUMERJOINS THE CONVERSATION? 

    WE WANT TOUNDERSTANDWHAT MATTERS ABOUTOUR HEALTH

    WE WANTFEEDBACK ANDTOOLS TO HELPUS LIVE LONGER AND BETTER

    WE WANT TO BE ABLE TO MAKEINFORMEDDECISIONS ABOUTHEALTH SERVICES

    WE NEED TO BE ABLE TO STRETCHOUR DOLLARSBEYOND THEBENEFIT PLAN

    WE NEED OURCARE TEAM TOTREAT USHOLISTICALLY &HELP US LIVEBETTER

    WE WANT ANYTIME & ANYWHERE ACCESS TOCONVENIENTCARE

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    REFRAMING WHAT

    IS POSSIBLE

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    NoCoordination

    of Care

    Hard to fitpatients inschedule

    Lack resources tomanage chronic

    illnesses

    DoctorsWait weeks

    to see doctor

    Too manypatients, too little

    time

    No time or $ totalk end of life

    Emotionallyattached

    Byzantinebilling

    More billingstaff thannurses

    Hard to beideal doc

    Professionalfrustration

    MissAppointments

    Problems gounnoticed

    Can’tDrive

    Complicatedreferrals

    15-20medications

    Patient

    Expensivehospitalization

    Multiplespecialists

    Conflictingtreatments

    No holisticcare

    Emergency?Call 911

    Expensiveco-pays

    No end-of-life

    plan

    HealthPlan

    Redundanttreatment

    Hard to findquality docs

    Costly

    seniorcare

    Risk ofadverseselection

    death spiral

    Need tominimize

    costs Stafffocused on

    costs, notprevention

    Smallmargin forMedicarepatients Denial of

    coverage

    HEALTH MARKET 1.0 IS BROKEN

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    B 2 B 2 c

    B 2 B 2 C

    B 2 b 2 C

    yesterday

    today

    tomorrow

    WHAT IF THIS TIME WE STARTEDWITH THE CONSUMER?

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    +  HEALTHMARKET 2.0 = 

    TechnologyInnovation

    Capital

    Leadership 

     A $1TN OPPORTUNITY

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    HealthMarket 1.0

    HEALTHMARKET 2.0 

    Total cost reduction  20% 40% 

    Trend reduction  3% 5% 

    Consumer experienceimprovement 

    25% 300% 

    Value rotation  $100 BN $1 TN 

    Rate of innovation

    and dif fusion 100X 1,000X Extra years ofgood living 

    3 10 

    CREATING UNHEARD OF BUT ACHIEVABLE VALUE 

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    • MyFitnessPal• Jawbone• Zipongo• Livongo

    • Google• IBM Watson• Apple

    • Theranos• Hudson Alpha• Illumina• 23andMe

    • Castlight• WebMD• DocSpot• Amazon

    • Liazon• Bloom

    • Welltok• Audax

    • Teladoc• MDLive

    • HealthCarePartners

    • Iora• Qliance• CareMore

    • Evolent• xG Health• Optum• Healthagen

    • Weight

    Watchers• Whole Foods• McDonald's•GNC

    • Walgreens• Walmart•CVS• Rite Aid

    TECHNOLOGY

    ATTACK

    CONSUMER

    MARKETS

    HEALTH

    ECOSYSTEMS

    RISE OF

    RETAIL

    HealthMarket

    1.0

     Advanceddiagnostics

    Healthshopping

    Exchanges

    Engagementplatforms

    Telehealth

    Smart careteams PHM

    PHM

    enablement

    Food andgrocery

    Retail

    Mobile andmonitoring Tech – Big data

    IT IS ALREADY UNDERWAY 

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    • MyFitnessPal• Jawbone• Zipongo• Livango

    • Google• IBM Watson• Apple

    • Theranos• Hudson Alpha• Illumina• 23andMe

    • Castlight• WebMD• DocSpot• Amazon

    • Liazon• Bloom

    • Welltok• Audax

    • Teladoc• MDLive

    • HealthCare Partners• Iora• Qliance• CareMore

    • Evolent• xG Health• Optum• Healthagen

    • Weight

    Watchers• Whole Foods• MacDonald's• GNC

    • Walgreens• Walmart• CVS• Rite Aid

    HealthMarket

    1.0

     Advanceddiagnostics

    Healthshopping

    Exchanges

    Engagementplatforms

    Telehealth

    Smart careteams PHM

    PHM

    enablement

    Food andgrocery

    Retail

    Mobile andmonitoring Tech – Big data

    … AND BLURRING THE LINES 

    TECHNOLOGY

    ATTACK

    CONSUMER

    MARKETS

    HEALTH

    ECOSYSTEMS

    RISE OF

    RETAIL

    Benefitscoverageand risk

    Healthcaredelivery

    Healthyliving &

    wellness

    Long-termlife/health

    planning

    TECHNOLOGY ATTACK

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     R I S E

     O F

     R E T A I L

     C ON S UME

    RMARKET S

    EX CHA

    N GE S

    EN GA GEME

    NT

    PLATF ORM S

    HEALTH

     SH OPPIN G

    TELEHEALTH

     ADVANCED DIAGNOSTICS

    SMART CARE TEAMS PHM

     R E T A I L

     F O O D

     A N D

     G R O C E R Y

     MOBILE AND MONITORING

    MyFi t nessPal J awboneZi pongo Li vango

    TECH – BIG DATA

    PHM ENABLEMENT

    Googl e I BM WatsonAppl e

     Theranos Hudson Al phaI l l umi na 23andMe

     C  a s t l  i   gh t 

    W e b MD

    D o c  S  p ot 

    A m az  on

    L i   az  on

    B l   o om

    W el  l  t  ok 

    A  u d  ax

     Tel adoc MDLi veHeal t hCare Par t ner s I oraQl i ance CareMore

    Evol ent xG Heal t hOpt um Heal t hagen

       W  e   i  g   h   t   W  a   t  c   h

      e  r  s

       W   h  o   l  e   F  o  o   d  s

       M  c   D  o  n  a   l   d  s

       G   N   C

       W  a   l  g  r  e  e  n  s

       W  a   l  m  a  r   t

       C   V   S

       R   i   t  e   A   i   d

    HEALTH AND WELLNESS ECOSYSTEM

    • Billions in corporate/strategic investment – IBM, Google, Apple,Samsung, GE, Walmart, etc. – exponential growth in PE funding

    • Over 200m consumers engagedin their health through wearable devices, apps and web services

    • Close to 100,000 mobile health apps, with the top 10 generatingover 4 million downloads per day

    • Over 1,600 retail-driven convenience clinics and virtual-healthbroadly available everywhere

    • One hundred new predictive biomarkers and one thousandunder R&D

    TECHNOLOGY ATTACK

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     R I S E

     O F

     R E T A I L

     C ON S UME

    RMARKET S

    EX CHA

    N GE S

    EN GA GEME

    NT

    PLATF ORM S

    HEALTH

     SH OPPIN G

    TELEHEALTH

     ADVANCED DIAGNOSTICS

    SMART CARE TEAMS PHM

     R E T A I L

     F O O D

     A N D

     G R O C E R Y

     MOBILE AND MONITORING

    MyFi t nessPal J awboneZi pongo Li vango

    TECH – BIG DATA

    PHM ENABLEMENT

    Googl e I BM WatsonAppl e

     Theranos Hudson Al phaI l l umi na 23andMe

     C  a s t l  i   gh t 

    W e b MD

    D o c  S  p ot 

    A m az  on

    L i   az  on

    B l   o om

    W el  l  t  ok 

    A  u d  ax

     Tel adoc MDLi veHeal t hCare Par t ner s I oraQl i ance CareMore

    Evol ent xG Heal t hOpt um Heal t hagen

       W  e   i  g   h   t   W  a   t  c   h

      e  r  s

       W   h  o   l  e   F  o  o   d  s

       M  c   D  o  n  a   l   d  s

       G   N   C

       W  a   l  g  r  e  e  n  s

       W  a   l  m  a  r   t

       C   V   S

       R   i   t  e   A   i   d

    HEALTH AND WELLNESS ECOSYSTEM

    BLURRING THELINES

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    Undiagnoseddepression;

    pre-hypertensive

    Poly-chronic, severe mobilityimpairment, depression, in skilled

    nursing facility

    Overweight, diabetic,high blood pressure,

    undiagnoseddepression

       H  e  a   l   t   h  s   t  a   t  u  s  m   i  g  r  a   t   i  o  n

    Lifetime

    Psychologist catchesearly depression,

    addresses it

    Nutritionist helps craftbetter diet to promote

    good weightPCP addresseshigh cholesterol

    with an Rx

    Occasional home carevisits help maintain

    independence

    Over weight, diabetic,

    high blood pressure,depression, CHF

    Fully mobile

    Care team prescribescoaching, diet,exercise program

    Biosensors, light weighttraining, strength andstretch training

    Health Market 2.0

    Health Market 1.0

    GIVING US THE PROMISE OF TENMORE GOOD YEARS

    PhysicianCentered Sick Care

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    HEALTH MARKET 1.0 HEALTH MARKET 2.0

    Sickness Whole health and wellness

    Symptomatic response Prevention and prediction

    Transactional Personalized and relationalOffice hours Always

    Opaque with few standards Transparent with value metrics

    Fee for service – provider units Global budgets & consumer units

    Plan sponsor Consumer

    REFRAMING WHAT IS POSSIBLE 

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    ELEMENTS OF

    HEALTH MARKET 2.0

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    ELEMENTS OF HEALTH MARKET 2.0

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    HYPERTENSIVE

    NON-COMPLIANTDIABETIC

    OBESE

     ADULT

    HONDA

    Meet FRED 1.0

    ENGAGED

    COMPLIANTLIVING BETTER

    CONNECTED

    MORE GOOD YEARS

    Meet FRED 2.0POPULATION HEALTH PYRAMID

    • 15% of thepopulation

    • 60% of the cost• Failure of FFS

    sick care• Central to Health

    Market 2.0

    40% improvement in value --- 300% better experience ---infini tely more access --- ten more years of good l iving

    HONDAS, PYRAMIDS & GLOBAL RISK 

    $10k

    LIFESTYLE MEDICINE

    $25k

    STARTING WITH 1.0 BASICS

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    Quantif ied self  

    Healthylivingvalues

    Clinicaland healthconditionvalues

    Expense andbudget values

    Quantified self thebridge to apersonalized healthand wellnessmarketplace

    Social andexpert

    communities

    Health livingrewards exchange

    Exchanges andshopping market

    ELEMENTS OF HEALTH MARKET 2.0

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    Changing consumer’s health IQ and engagement level thru real timehealth/living feedback through a common sense mobile app

    Healthy living values

    • Steps or activity• Sleep• Nutrition• Stress• Weight

    Clinical and healthcondition values• Blood sugar• Weight changes• Blood pressure• Heart function

    • Blood oxygen

    QUANTIFIED SELF 

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    Healthy living values• Steps or activity

    • Sleep• Nutrition• Stress• Weight

    Clinical and healthcondition values• Blood sugar

    • Weight changes• Blood pressure• Heart function• Blood oxygen

    Real time personalized

    preventive health

    Quantified selfthe bridge to apersonalizedhealth and

    wellnessmarketplace

    Exchanges andshoppingmarket

    Smart personalized

    shopping

    Smart care teama personalizedecosystem

    Health livingrewards

    exchange

    Increased relevance

    and engagement

    through social

    communities

    Social andexpertcommunities

    Expense andbudget v alues• Affordability• Deductible status

    • Exposure• Pharmacy costs• Reward opportunities

    QUANTIFIED SELF 

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    WHAT IS NEW• Consumers get real time feedback on how they are living –

    steps and sleep now, key clinical values very soon

    • Explosion of real time information, driving consumerengagement, increasing awareness and ‘health’ and

    ‘benefits’ IQ• Heightened awareness and virtual clues create habit changing

    teachable moments

    • Quantified self makes personalized shopping and experiencespossible

    • Consumers share their quantified self information to enable smart careteams to help with monitoring and prevention

    • Quantified self enables a new consumer health currency throughbehavior based rewards

    QUANTIFIED SELF 

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    WHY IT MATTERS• Quantified self and mobile apps are mainstreaming – the ‘race is on’ to

    own the integrated consumer apps

    • Consumers will expect health plans and smart care teams to be‘q-self ready’

    • Quantified self is an information and personalization business designand moves at silicon speed

    • The shift from occasional asynchronous data capture to daily real timeinteractions is a game-changer; across the pyramid

    • Shared quantified self information leads to ten percentage points of

    increased value

    • Social communities are powerful and here to stay

    QUANTIFIED SELF 

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    Transparent consumer markets

    PersonalizedBetter Living

    Itinerary

    Crowd SourcedRecommendations

    Retail HealthyLiving Services

    Personal HealthEconomy/Bank

    ConvenientCare

    Major Diseasesand Conditions

    Surgical andDiagnosticProcedures

    Acute andComplex Care

    Services

    Annual DecisionProcess

    Plan YearMarketplace

    ELEMENTS OF HEALTH MARKET 2.0

    TRANSPARENT CONSUMER MARKETS

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    Crowd sourcedrecommendations

    Personal healtheconomy/bank• Benefits• Reward• Flex dollars• Cash/debt

    Insightsengine

     Annual decis ionprocess

    TRANSPARENT CONSUMER MARKETS 

    Consumers with advanced decision tools building personalizedconfigurable health solutions during annual enrollment

    Personalized

    better livingitinerary

    Smart care team

    TRANSPARENT CONSUMER MARKETS

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     Annual decisi on

    process

    TRANSPARENT CONSUMER MARKETS 

    • Cancer care• Inflammatory disease• Vascular and cardiac• Renal care

    Over t ime consumers and families having better information for makingtreatment decisions regarding serious diseases and complex care

     Acute and

    complex careservices

    Consumers

    making informed

    decisions about

    disease treatment

    and complex care

    Majordiseases and

    conditions

    Convenient careSurgical anddiagnosticprocedures

    Retail healthyliving services

    Plan yearonline shopping

    marketplace

    Crowd sourcedrecommendations

    Personal healtheconomy/bank• Benefits• Reward• Flex dollars• Cash/debt

    Insightsengine

    Personalized

    better livingitinerary

    Smart care team

    TRANSPARENT CONSUMER MARKETS

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    2525© Oliver Wyman | CHI-HLC06101-089

    Retail healthyliving

    services

     Acu te andcomplex care

    services

    Surgical anddiagnosticprocedures

    • Cancer care• Inflammatory disease• Vascular and cardiac• Renal care

    Consumers and

    families working

    with their smart

    care team and

    decision tools to

    make moreinformed

    decisions on

    acute and

    complex care

    Convenient care

    Real time shopping based on

    price location, waiting times and

    experience

    Consumers making informed decisions

    about disease treatment with support

    tools and their smart care team

    Bundled procedures with comparative price,

    value, experience and outcome information

    Retail health and wellness

    shopping with integrated rewards

     Annual dec is ionprocess

    Plan yearonline shopping

    marketplace

    Majordiseases and

    conditions

    TRANSPARENT CONSUMER MARKETS 

    Crowd sourcedrecommendations

    Personal healtheconomy/bank• Benefits• Reward• Flex dollars• Cash/debt

    Insightsengine

    Personalized

    better livingitinerary

    Smart care team

    TRANSPARENT CONSUMER MARKETS

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    WHAT IS NEW• Consumer’s personalize their annual health plan decision process;

    to fit life/health needs, engagement preferences and budget

    • Consumers shop during the plan year for health services (within networks)with price and value transparency

    • Consumers benefit from ‘smart shopping decisions’ by earning credits• Health plans re-contract with providers moving to new consumer economic

    units (e.g. knee replacement) with preset value metrics

    • Five new health services markets emerge – ranging from convenient care tomajor disease markets

    • Prices fall to the median and providers compete on value as spot marketsdevelop to match idle supply with consumer demand at the ‘right price’

    • The new health services market includes health and wellness productsand services

    TRANSPARENT CONSUMER MARKETS 

    TRANSPARENT CONSUMER MARKETS

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    WHY IT MATTERS• First generation transparent shopping apps are all ready in market with

    great access to capital

    • Mega-retailers will mainstream transparent shopping for convenient careservices and change the basis of competition

    • Consumers with quantified self and shopping apps will demandtransparent shopping and reward the best value competitors

    • This is an information business – moves at silicon speed andignores geography

    • Over a hundred millions of consumers are already shopping – at least for

    better information• Moving the surgical and diagnostic market to median pricing saves 10% of

    the total cost of healthcare

    TRANSPARENT CONSUMER MARKETS 

    ELEMENTS OF HEALTH MARKET 2 0

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    Predictive, personalized, preventive health,wellness and engagement system

    Smart CareTeam

     A Personali zedEcosystem

    Communicationplatform

    Biosensors andmonitoring

    Predictiveinsights engine

    Weight

    management

    Stressmanagement

    Nutritionmanagement

    Smartclinics

    Retailpharmacyclinics

    Coaching

    Telehealth

    Physical inthe community

    resources

    Virtual healthresource access

    Better livingprogramming

    IT enablementengines

    Complex Adaptive Workflow

    Personalized Health Itinerary

    Intuitive engagement model

    Real time biometric and dailyliving information

    Personalized connectedrelationship

    Smart care teams

    ELEMENTS OF HEALTH MARKET 2.0

    SMART CARE TEAMS

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    The smart care team building the foundation with full mult i-skill teamcomposition and a consumer better-living culture

    Retail pharmacyclinics

    Complex AdaptiveWorkflow

    Personalizedconnected relationship

    Smart CareTeam

     A Personal izedEcosystem

    Smart clinics

    Physicalin the

    communityresources

    SMART CARE TEAMS 

    SMART CARE TEAMS

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    Complex Adaptive Workflow

    Personalized Health Itinerary

    Intuitive engagement model

    Real time biometric anddaily living information

    Predictive, personalized, preventive health, wellness andengagement system

    Value based acute andcomplex care services

    Personalized connectedrelationship

    Smart care

    teams partnerwith consumers

    to navigate and

    coordinate

    acute and

    complex care

    Smart CareTeam

     A Pers onalized

    Ecosystem

    Communicationplatform

    Biosensors andmonitoring

    Predictiveinsights engine

    Weightmanagement

    Stressmanagement

    Nutritionmanagement

    Smartclinics

    Retailpharmacyclinics

    Coaching

    Telehealth

    Physical inthe community

    resources

    Virtual healthresourceaccess

    Better livingprogramming

    ITenablement

    engines

    Genomics andadvanced diagnostics

    Shared longitudinal andcollaborative health record

    SMART CARE TEAMS 

    SMART CARE TEAMS

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    WHAT IS NEW• Personalized and predictive using big data and insight engines for

    micro segmentation

    • Coordinated ecosystems facilitating multiple points of access andimproving convenience

    • Integrated virtual services making health resources available anywhereand anytime

    • Complex adaptive workflow aligning the care team to the consumer’sneeds across the ecosystem

    • Passive monitoring and real time feedback, eliminating most

    preventable acute events

    • Consumer health itineraries, proactive coaching and real timeengagement promoting healthier living

    SMART CARE TEAMS 

    SMART CARE TEAMS

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    WHY IT MATTERS• Consumers love smart care team ecosystems – extremely magnetic

    • Smart care teams improve ‘benefits value’ by as much as 40% andbecome the new front end

    • The next wave of value is information based, moves at silicon speeds

    and massively improves resource leverage• Consumers live better and feel more connected with their smart

    care teams

    • Smart care teams can leapfrog over medical homes; innovators havealready proven the model

    • National retailers could drive the model at scale

    SMART CARE TEAMS 

    Understanding the new profit levers

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    Consumerengagement

    Lifestyle

    medicine

    Big data andpredictive

    health

    Magnitudes

    illustrative

    Understanding the new profit levers

    THE FORTY PERCENT OPPORTUNITY

    Passivemonitoring &

    earlyinterventions

    HealthMarket 1.0

       H   E   A   L   T   H

       V   A   L   U   E

       I   M   P   A   C   T

       O   P   P   O   R   T   U   N

       I   T   Y

    Potentialprofit

    10%

    10%

    10%

    5%

    Smart careteam

    ecosystems

    5%

    HealthMarket 2.0

    Better consumerpricing

    THE NEW PROFIT DRIVERS

    Next generation PHMs will thrive on complex adaptive systems that are

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    Next generation PHMs will thrive on complex adaptive systems that arehighly-tailored to particular segments of the population

    End of life

    • Palliative care experts• Support for caregivers

    • Hospice centers

    • Legal/financial advisersfor family

    • Etc.

    Poly-chronic/complex• Dedicated “Extensivists”

    • Remote monitoring

    • Specialty clinics• Integrated behavioral health

    • Etc.

    Severe behavioral

    • Dedicated psychiatricNPs/MDs

    • Bio-monitoring ofRx adherence

    • Dedicated social workerand PCP

    • Etc.

    Chronic withsocial needs• Case worker embedded

    in care team• Dedicated coach focused

    on nutritional and mentalhealth needs

    • Etc.

    Early chronic/at-risk• Dedicated health coach

    focused on fitness, nutrition

    • Attention to behavioral health

    • Rewards for meetinghealth goals

    • Etc.

    Generally healthy• Affordable acute

    care options

    • Rewards and incentives

    • Social/mobile healthtracking tools

    • Etc.

    Potential

    Care ModelComponents

    Specialized care models will be supported by new population-specific ecosystems

    Quantif ied self  

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    3535© Oliver Wyman | CHI-HLC06101-089

    HEALTH

    MARKET2.0

    Qua t ed se

    Healthyliving values

    Clinical andhealthconditionvalues

    Expense and budgetvalues

    Quantified self the bridgeto a personalized healthand wellness marketplace

    Social andexpert communities

    Health livingrewards exchange

    Exchanges andshopping market

    Transparent consumermarkets

    Personalized BetterLiving Itinerary

    Crowd SourcedRecommendations

    Retail HealthyLiving Services

    Personal HealthEconomy/Bank

    ConvenientCare

    Major Diseasesand Conditions

    Surgical andDiagnosticProcedures

    Acute and ComplexCare Services

    Annual DecisionProcess

    Plan YearMarketplace

    Predictive, personalized, preventive health,wellness and engagement system

    Smart CareTeam

     A Personalized

    Ecosystem

    Communicationplatform

    Biosensors andmonitoring

    Predictiveinsights engine

    Weightmanagement

    Stressmanagement

    Nutritionmanagement

    Smartclinics

    Retailpharmacyclinics

    Coaching

    Telehealth

    Physical inthe community

    resources

    Virtual health resourceaccess

    Better livingprogramming

    IT enablement

    engines

    Complex Adaptive Workflow

    Personalized Health Itinerary

    Intuitive engagement model

    Real time biometric and dailyliving information

    Personalized connected relationship

    Smart care teams

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    UNLOCKING THEINCUMBENT’S DILEMMA

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    3737© Oliver Wyman | CHI-HLC06101-089

    The biggest problem inbusiness …

    is staying with yourpreviously successfulbusiness model two to three

    years too long.

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    3838© Oliver Wyman | CHI-HLC06101-089

    Why is it …that the mental model ofindustry leaders lags themarket by 2–3 years?

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    3939© Oliver Wyman | CHI-HLC06101-089

    The trill ion dollarquestion…

    how can you change themental model and thrive inHealth Market 2.0?

    CHANGE YOUR FRAME OF REFERENCE

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    4040© Oliver Wyman | CHI-HLC06101-089

    CHANGE YOUR FRAME OF REFERENCE 

    • MyFitnessPal• Jawbone• Zipongo• Livongo

    • Google• IBM Watson• Apple

    • Theranos• Hudson Alpha• Illumina• 23andMe

    • Castlight• WebMD• DocSpot• Amazon

    • Liazon• Bloom

    • Welltok• Audax

    • Teladoc• MDLive

    • HealthCare

    Partners• Iora• Qliance• CareMore

    • Evolent• xG Health• Optum• Healthagen

    • WeightWatchers

    • Whole Foods• McDonald's•GNC

    • Walgreens• Walmart•CVS• Rite Aid

    TECHNOLOGY

    ATTACK

    CONSUMER

    MARKETS

    HEALTH

    ECOSYSTEMS

    RISE OF

    RETAIL

    HealthMarket2.0

     Advanceddiagnostics

    Healthshopping

    Exchanges

    Engagementplatforms

    Telehealth

    Smart careteams PHM

    PHMenablement

    Food andgrocery

    Retail

    Mobile andmonitoring Tech – Big data

    DON’T GET BLIND SIDED BY THE

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    4141© Oliver Wyman | CHI-HLC06101-089

    Networkadvantage

    Value chaincontrol

    New industrystandard

    Productleadership

    True commodity

    Price position

    Priceadvantaged

    Abovemarket

    Market posit ion

    Multi-year leadLaggard

    Ecosystem

    Highlycoordinated

    Consumerbeware

    Point of design

    Consumer -health

    Physician -disease

    Transformative value

    Becomemagnetic

    Delightconsumers

     A new consumer

    economy with

    redefined value

    Priced based

    Competition and

    substitute economics

    DON T GET BLIND SIDED BY THESPEED OF CHANGE

    KNOW THAT IT IS NOT A LEVEL

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    4242© Oliver Wyman | CHI-HLC06101-089

    PLAYING FIELD

    Assetintensity

    Return oncapital

    Access tocapital

    WALL ST

    Marketvalue

    Speed

    InformationIntensity

    Regulation

    Geographicscope

    New Players

     Adjacencies

    1 new operatingtheatre a decade

    1 dollar of capitalfor a dollar of

    revenue

    25 new productreleases a year

    5 cents of capitalfor a dollar of

    revenue

    Incumbents

     AGILITY WEIGHTGLUE FUEL

     A capitalmarketsperspective

    UNDERSTAND THE HOT SPOTS 

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    4343© Oliver Wyman | CHI-HLC06101-089

    • Convenientand virtualcare

    • Smart careteams

    • Surgical anddiagnosticbundles

    • Predictiveanalytics

    • Real-time

    adaptiveworkflow

    • Next gendiagnostics

    DEMAND MARKETS

    • Passiveconnectedmonitoring

    • Personalizedprevention

    • Engagementand rewards

    market

    • Consumershopping tools

    • Product

    exchanges

    • Configurablehealth plans

    • In-networkshopping

    SUPPLY MARKETS

    IncumbentsGET INTO THE RACE

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    4444© Oliver Wyman | CHI-HLC06101-089

    Slow withheavyconstruction

    Protectthe fort

    Reinvent&

    Innovate

    Consumer configurablehealth plans

    Population based smartcare team ecosystems 

    FOR VALUE

    Slow withheavy

    construction

    Protect

    the fort

    Reinvent&

    InnovateWhere is your organization?

    Where is your organization?

    Provider

    Payer

    BUILD TO WIN IN HEALTH MARKET 2.0 

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    4545© Oliver Wyman | CHI-HLC06101-089

    Healthy livingcommunitystores +

    Transparentconsumershopping markets

    Health andwellness

    consumer banking

    Consumerconfigurable

    health plans 

    Personalizedbetter living

    ecosystems

    Population basedsmart care teamecosystems 

    Provider

    Payer

    Retail Pharmacy

    Credit/Debit Card

    Web Services

    Smart Phone +

    Incumbents Adjacencies New Players

    s   m   a   r   t Transparent consumercare team ecosystems

     s  h  o p p

    Consumer configurable health plans

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    4646© Oliver Wyman | CHI-HLC06101-089 Personalized better

     H  e a l   t   h  a n d  w e l   l   n e s  s 

       P   o   p   u    l   a

       t   i   o   n    b   a   s   e    d   

    Healthy living community stores +consumer banking

    p i   n g  m a r  k  e

     t   s 

        l   i   v   i   n   g   e   c   o   s   y   s   t   e   m   s

    THINK

    CONSUMERECOSYSTEM

    DON’T GO IT ALONE

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    4747© Oliver Wyman | CHI-HLC06101-089

    ?Health Market 1.0Incumbent 

    PASSIVEMONITORING

    BIG DATA ANDPREDICITVEMODELING

    MOBILE APPS

    RETAILPHARMACIES

    Health Market 2.0New Players 

    Selecting StrategicPartners from the

    Health and Wellness Jungle

    RUN SKIP-GENERATION PLAYS 

    http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=p0URnalUj-iRZM&tbnid=4sJyjF4DCnfFOM:&ved=0CAUQjRw&url=http://sketchup.google.com/3dwarehouse/details?mid=d58ef2d21b126ea87827edf8f3dcefd5&ei=vzdvUf2rHbHI4APjsoEg&bvm=bv.45368065,d.dmg&psig=AFQjCNGTIKTj0speaXpCeVYCkXu1SSi1cg&ust=1366329658582252

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    4848© Oliver Wyman | CHI-HLC06101-089

    Hospitalsystem

    Clinicallyintegratednetwork

    Patient centercare model

    1

    2

    3

    Smart care teamecosystem

    Predictive, personalized, preventive health,wellness and engagement system

    Smart CareTeam

     A Personalized

    Ecosystem

    Communicationplatform

    Biosensors andmonitoring

    Predictiveinsights engine

    Weightmanagement

    Stressmanagement

    Nutritionmanagement

    Smartclinics

    Retailpharmacyclinics

    Coaching

    Telehealth

    Physical inthe community

    resources

    Virtual healthresource access

    Better livingprogramming

    IT enablementengines

    Complex Adaptive Workflow

    Personalized Health Itinerary

    Intuitive engagement model

    Real time biometric anddaily living information

    Personalized connectedrelationship

    4

    Population based

    smart care team 

    Provider

    RUN SKIP-GENERATION PLAYS

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    4949© Oliver Wyman | CHI-HLC06101-089

    Health andpharmacy

    benefits

    Networkmodel – broad or

    narrow

    Value basedbenefits andrewards

    Network model –performance-based

    Value basedbenefits andrewards

    PPOs and narrownetworks

    Health Plan 1.0

    HealthPlan 1.5

    PPOs and h igh performancenetworks

    Health

    Plan 1.5

    Patient centered care models

    1

    2

    3

    My personalbudget and risktolerance

    Exchange baseddecision tools

    Exchange baseddecision tools Network model –

    performance-based

    ConvenientCare

     Acute andComplex Care

    Services

    Surgical andDiagnosticProcedures

    Major Diseasesand Conditions

    Retail HealthyLiving Services

    Transparent

    Markets

    Configurablebenefits and

    network

    In plan year(and network)marketplace

    Consumer configurable

    health plan

    Payer

    Health Plan 2.04

    d   s   m   a   r   t Transparent consumercare team ecosystems

     s  h  o p p i  

    Consumer configurable health plans

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    5050© Oliver Wyman | CHI-HLC06101-089 Personalized better

     H  e a l   t   h  a n d  w e l   l   n e s  s 

       P   o   p   u    l   a

       t   i   o   n    b   a   s   e    d

    Healthy living community stores +consumer banking

    i n g  m a r  k  e

     t   s 

        l   i   v   i   n   g   e   c   o   s   y   s   t   e   m   s

    The Scarcest Commodity

    LEADERSHIP

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    VIVA LACONSUMERREVOLUTION!!