Ibmwhcc2012 presentation

Redefining Value and Success in HealthcareCustomer Centric StrategiesRedefining Value and Success in Health CareWorld Health Care CongressApril 16, 2012Harry ReynoldsDirector, Health Industry TransformationIBM Healthcare & Life Scienceshreynold@us.ibm.com IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareThe industry is changing, and so are its customers and participants  Provider consolidation is accelerating  Medical Homes are in demand  Accountable Care Organization (ACO) thinking is evolving and re-defining partnerships  Payers and Providers are merging and converging  New places for care and types of care are appearing  Mandates and compliance are occupying substantial resources  Quality is required for both processes and care  Consumer health will be the mantra with engagement and activation as key  More individuals will be buying their own insurance  Individuals will expect health care to integrate with their technologies The “end game” is not clear but the industry is engaged2 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareHealth transformation has many components aligning to three majorbusiness trends which are supported by two foundational capabilities HIE Reimbursement Medical Home Models High Care Quality ACOs Value Outcomes Meaningful New Delivery and more Use Models ICD-10 Information Readiness Evolution of Care Delivery Business Structure Modernization and Analytics Convergence of Payer and Provider Movement to the Individual3 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareOur payer and provider clients are adopting new business anddelivery models Increasing clinical risk and severity Accountable Specialty Episodes Increasing provider integration care organization care model of Care Patient centered medical home Clinical service factories Healthy, at-risk Early chronic Complex chronic Acute episodic Source: McKinsey Center for U.S. Health System Reform4 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareMoving from acute care to care-at-home provides the accountable “chain ofcare” leading to higher quality of life, lower costs and engage patients Home Care Independent, Comfortable Healthy Living setting $45 billion dollar industry projected to grow Chronic Disease Cost Management Effective Quality of Life  17M Nursing U.S. Residential Care home beds in 16K certified homes Assisted  82-85% Living occupancy Acute Care Skilled Nursing Facility Specialty Clinic Community Hospital ICU $1 $10 $100 $1000 $10,000 Cost of Care / Day5 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareA new set of transformation drivers is rapidly emerging Mobile revolution Social media explosion Influence Speed / Immediacy Transparency Always On Authenticity Location Aware Loss of Control Hyper digitization The power of analytics Inundation Sophistication Differentiation6 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareConsumers are empowered and expect flawless interactions “Listen to me”  More than half “Know me” of “connected” consumers state  Personalize “Serve me” social media offerings interactions  Personalize influence decisions experience  Top area for including spend  Personalize health plan services innovation: Convenience and Ease7 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareConsumers expectations are formed by a myriad of factors Technology “Everything is Known” Attitudes “Era of Open Minded” Expectations Influences “Be loyal to me” “Communities of We”9 IBM Proprietary © 2011 IBM Corporation

Smarter Consumer Profile > Attitudes Redefining Value and Success in Healthcare Consumers are open to share their personal information, with the exception of financial or medical data, when there is perceived benefit! Consumer Maintains Control of Data What is your willingness to provide information in exchange for something relevant to you (non-monetary)?100% 11% 12% 19%80% 37% 36% 20% 44% 44% 21% 29%60% 34% 33%40% 31% 31% 69% 67% 52%20% 25% 25% 29% 31% 0% Demographic Identification Media Usage Lifestyle (# of Location Medical Financial (e.g. age, (name, (e.g. Media cars, home Based ethnicity) address) channels) ownership) Completely Disagree Neutral Completely willing Source: IBV Retail 2012 Winning Over the Empowered Consumer Study n= 28527 (global) P04: What is your willingness to provide 10 IBM Proprietary © 2011 IBM Corporation information for each of the following items if [pipe primary retailer] provided something relevant to you in exchange?

Redefining Value and Success in HealthcareIn this new world with many options available, how can you establish ameaningful relationship with the consumer? Years to earn, seconds to break11 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareWe listened and found that consumers have different levelsof engagement Does the brand align with my lifestyle, emotional needs and values? Does the brand value my business and give me a reason to come back? How easy was it to do business with the retailer? Does the retailer provide 12 what I need for a good price? IBM Proprietary © 2011 IBM CorporationSource: Ken Lawler shopping Hierarchy of Needs

Redefining Value and Success in HealthcareThe language used by consumers varies with their level of engagementwith the brand Transaction Discussion Service Discussion Relationship Discussion Lifestyle Discussion13 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in Healthcare Questions Consumers are Pondering About Payers “I need an individual “Where’s a plan that “Can you connect “Since you know me so policy. How do I is simple to with me in the way I well, can you help me plan quickly see my understand and just want, when I want? for my future health and be options?” provides what I Let me decide.” my trusted advocate specifically across the health “I’m frustrated with want/need?” “Can you make it ecosystem?” the lack of response quick in trying to and connection with “Can you make the reach you? I don’t “As my needs change, can my current payer. application process have time to waste.” you bring me suggestions What are my other quick with no for changes in my plan?” choices?” surprises?” “Why does it have to be so confusing and “I’m overwhelmed with “Who really cares “How do I know my frustrating to being caregiver for an about me and my information is secure maneuver through elderly family member on needs?” with you?” the healthcare your plan. Can you make it system?” more simple, transparent “If I come back to “Can I trust you?” and connected for me to your plans, why don’t quickly help her?” you know me?”14 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in Healthcare Questions Consumers are Pondering About Providers “Where’s the best “Can you treat my “How do you make it “Will you be keeping up on place to get care time as valuable?” easy for me to all the advancements (based on who I connect with my happening in medicine and am)?” “Where can I get healthcare team ensuring my healthcare flexibility in seeing a when and how I team is personally “What have been the provider so that it fits want?” applying that insight to experiences of my my schedule and best care for me?” friends and family preferences?” “Will you help me with this provider? understand my “Should I be in an accident And what about the “Will you have all my conditions and the in a different state, will that opinions of others on information at hand personalized ER care team have the internet?” so tests aren’t expected outcomes immediate access to my duplicated and for each of my choice relevant health “What’s it going to decisions are timely options before we information?” cost me and could I and sound?” together decide next get better value steps?” “What personalized elsewhere?” “Are you keeping my support can you give me health information “Can I trust that my to help me take better care secure?” healthcare team has of myself?” my overall best interests in mind?”15 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in Healthcare Value-added healthcare requires an understanding of your ability to influence individual behavior • Which digital channels are the most effective to engage different segments? • Which segments can you influence the most? • Which processes, technologies and interactions deliver more consumer engagement? • Which make the most difference – medical homes, ACOs, retail health? Note: Bubble size is illustrative and not to scale. The conditions included in this figure as examples represent only a subset of the overall size of the segment.16 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareConclusion Listen and Learn Anticipate and Adapt Execute and Excel 1 1 1 Discover how you Create a single view Optimize marketing and your competition of the customer expense to target are known across all channels segments Understand the Leverage consumer sentiment towards insight to localize Match real customer you and your assortment and demand to inventory competition personalize marketing across the value chain Create an engaging Empower your service Leverage social media path to purchase that associates to allow to engage at a local or keeps consumers the customer to be community level shopping and buying king from your brand17 IBM Proprietary © 2011 IBM Corporation

Redefining Value and Success in HealthcareWhat An Exciting Time … We are barreling through unprecedented change in the Health Care industry It’s highlighted by the revolutionary change to the delivery of care, operational processes and the uses of health information along with unprecedented government leadership and significant partnerships Embracing this journey affords major opportunities while not engaging assures worrisome consequences18 IBM Proprietary © 2011 IBM Corporation

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