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Healthcare’s Evolution to 2025: Personalization, Without a Primary Care Physician


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The adoption of the accountable care organization (ACO) model is changing the way hospitals evaluate their structure, roles, activities and benchmarks. While much of the buzz is about the IT tools and investments ACOs are driving to support population health management and collaborative care, business process change is the biggest challenge facing healthcare providers today. For medical device companies, sales and pricing models must adjust to address decision making by committees and risk sharing models in pricing for solutions. Device companies need to determine how their products add value in a world driven by data and analytics, with the goal of providing a holistic view of the patient.

"What was once a payment is now a cost. What was once a cost is now a potential savings. Is this a revolution, or evolution with an accelerated adoption curve?" asked Frost & Sullivan Vice President of Healthcare and Life Sciences Greg Caressi, during the opening of his speech at the 18th Annual Medical Devices 2013: A Frost & Sullivan Executive MindXchange. Caressi continued: "Successful approaches must reduce fragmentation to align with the future. Are you part of the problem or part of the solution?"

For a copy of his presentation, Healthcare 2025: Personalization Without PCP, or more information on The 19th Annual Medical Devices 2014: A Frost & Sullivan Executive MindXchange, please email Britni Myers, Corporate Communications, at, with your full name, company name, job title, telephone number, company email address, company website, city, state and country.

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Healthcare’s Evolution to 2025: Personalization, Without a Primary Care Physician

  1. 1. Healthcare 2025: Personalization, Without PCP Greg Caressi Senior Vice President, Healthcare & Life Sciences, Frost & Sullivan 18th ANNUAL MEDICAL DEVICES 2013: A Frost & Sullivan Executive MindXchange
  2. 2. 18th ANNUAL MEDICAL DEVICES 2013:A Frost & Sullivan Executive MindXchangeGreg Caressi, Senior Vice President, Healthcare & Life Sciences, Frost& SullivanHealthcare 2025: Personalization, Without PCPKey Take-Aways:• Framework for the impact of the widening world of stakeholders in thefuture healthcare system• Roadmap for the coming alternative to primary care as we have known it• Insight on segmentation, stratification and individualization that willchange private payer plans #DEV13
  3. 3. Business Process Change is the Biggest ChallengeFacing Healthcare ProvidersThe adoption of the ACO model is changing the way hospitals look at theirstructure, roles, activities, how they measure themselves “What was once a payment is now a cost. What was once a cost is now a potential savings.” Is this revolution, or evolution with an accelerated adoption curve? What changes will challenge healthcare providers in this new model? Physician alignment  Risk-sharing for everyone  Leveraging lower-skilled – Look in the mirror clinical personnel and Data is everything (and technology to achieve everything needs to be  Mobility + security of more touch at lower cost data-driven) information  Patient engagement – Data integration  Core competencies vs Can the interaction gap be outsourcing Democratization of data closed?
  4. 4. Do You Have Strategies To Deal With These Key Issues?FRAGMENTATION– Are you part of theproblem or part ofthe solution? DATA INTEGRATION ANALYTICS ACTION Source: Frost & Sullivan analysis. SCALABILITYTECHNOLOGY APPS SOLUTIONS
  5. 5. Volume  ValueThe shift toward payments based on quality + cost over procedure-basedreimbursement will change the way medical technologies are evaluated andpurchased Decision by committee Slower adoption of new technologies – especially large capital purchases? Revolution versus evolution? Integration of information, analytics – holistic view of patient, eliminate administrative waste and unnecessary care Cost of adoption, impact on workflow New pricing models, sharing of risk
  6. 6. Realities of the New Market Product and tactical sales strategies are being evaluated for Fail Fast quick return, resource limitations constrain a company’s ability to support lagging business models. U.S. from Currently one of few the markets where the U.S. has a Exporter to significant trade surplus with the rest of world, shifts seen in Importer of Med other industries could play out as low cost manufactured Tech products supplant products currently made in the United States. Purchase decisions are moving away from clinicians to hospital- Deemphasize the based administrators and committees. . Most existing sales Clinician team structures and messaging were developed for a market that is quickly fading away. As products increasingly become commoditized and the tax Deemphasize burden is placed on medical product sales, companies are Products increasingly looking to build revenue mix from service, software, enhanced support, and other offerings.
  7. 7. Healthcare Without PCPs, Or At Least a Changing Role65,800 = Projected shortage of Meanwhile the world has changed Primary Care Physicians in 2025* * Retail Skype Social clinicsTraditional roles of the PCP networks Doctor Google Single holistic view of the patient Consum- Longitudinal tracking of patient erism Job Smart mobility record phones EHR Treat wide range of minor conditions, ailments Patient portals $80 HD First level screening, test and Mobile cameras diagnose health IBM’s Refer to specialist Watson Personal relationship with patient, Wellness Provider family consolidation Focus for behavior change due to Remote Telehealth factors above monitoring
  8. 8. Changing Consumer Attitudes Towards Care DeliveryAccording to a recent survey of 6,000 people in 10 countries (sponsored by Cisco)76% of patients say access to care is more important than physical human contact with their care provider70% of patients would trust an automated device to provide a diagnosis and determine whether or not they needed to see a doctor74% of patients are comfortable having their health records available in the cloud, assuming adequate security (excluding Germany and Japan)But…87% of patients would trade off time, money and/or convenience to be treated at a perceived leading healthcare provider, and gain access to trusted care and expertise
  9. 9. Designated PCPs Not Needed for AllBusiness model innovation among hospitals and care plans will require reducingcare costs and testing new modelsFor at least some portion of the population, a single assigned PCP is not seen as a have-to-have  Consumers have high levels of trust in technology tools  People expect more control over time and want convenience, avoid waiting  Changing attitudes towards personal interaction
  10. 10. No More Employer Contracted Health Plans?“Survey: Half Of Employers Will Stop Offering Health Coverage, Give Workers Cash For Plans Instead” “Sears, Olive Garden To Offer Employees Money To Pay For Health Care” “Employee Healthcare: More Firms Trading With Doctors, Dentists, Pharmacies” Factors driving change in healthcare coverage  Rising cost of care  Development of insurance exchanges  One size fits all is not consumer friendly  Micro segmentation drives personalization in choice
  11. 11. What Will The Future Look Like? Healthcare increasingly data driven and  Increased leveraging of tech and non- customized physicians Healthcare more like other service  More “generics” – technologies providing industries same value at lower price, stripped down Globalized care delivery feature sets New care models focused on  Increased use of analytics to define care collaboration, information pathways exchange/awareness, achieving health outcomes, especially with chronic disease care Increased development of standards of care and incentives to adopt them Personalization of treatment, interaction, coverage Increased patient engagement to manage disease via remote monitoring and mobile apps
  12. 12. Join Us The 19th Annual Medical Devices 2014: A Frost & Sullivan Executive MindXchange takes place March 9-11, 2014 at the Loews Coronado Bay Resort and Spa in San Diego, Calif. Participants will gain insight into the future of medical technology and healthcare delivery as they engage with other seasoned medical device executives driving the future of healthcare, as well as their company’s innovation and business strategy.
  13. 13. ContactBritni MyersHealthcare & Life Sciences (+1) 210.477.8481