Tom Main Health Market 2.0 Presentation
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Transcript of 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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22© Oliver Wyman | CHI-HLC06101-089
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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44© Oliver Wyman | CHI-HLC06101-089
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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55© Oliver Wyman | CHI-HLC06101-089
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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66© Oliver Wyman | CHI-HLC06101-089
+ HEALTHMARKET 2.0 =
TechnologyInnovation
Capital
Leadership
A $1TN OPPORTUNITY
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77© Oliver Wyman | CHI-HLC06101-089
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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88© Oliver Wyman | CHI-HLC06101-089
• 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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99© Oliver Wyman | CHI-HLC06101-089
• 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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10© Oliver Wyman | CHI-HLC06101-089 10
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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11© Oliver Wyman | CHI-HLC06101-089 11
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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1212© Oliver Wyman | CHI-HLC06101-089
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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1313© Oliver Wyman | CHI-HLC06101-089
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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1515© Oliver Wyman | CHI-HLC06101-089
ELEMENTS OF HEALTH MARKET 2.0
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1616© Oliver Wyman | CHI-HLC06101-089
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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1717© Oliver Wyman | CHI-HLC06101-089
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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1818© Oliver Wyman | CHI-HLC06101-089
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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1919© Oliver Wyman | CHI-HLC06101-089
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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2020© Oliver Wyman | CHI-HLC06101-089
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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2121© Oliver Wyman | CHI-HLC06101-089
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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2222© Oliver Wyman | CHI-HLC06101-089
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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2323© Oliver Wyman | CHI-HLC06101-089
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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2424© Oliver Wyman | CHI-HLC06101-089
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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2626© Oliver Wyman | CHI-HLC06101-089
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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2727© Oliver Wyman | CHI-HLC06101-089
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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2828© Oliver Wyman | CHI-HLC06101-089
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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2929© Oliver Wyman | CHI-HLC06101-089
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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3030© Oliver Wyman | CHI-HLC06101-089
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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3131© Oliver Wyman | CHI-HLC06101-089
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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3232© Oliver Wyman | CHI-HLC06101-089
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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3333© Oliver Wyman | CHI-HLC06101-089
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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34© Oliver Wyman | CHI-HLC06101-089 34
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!!