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Transforming from Claims Centric to
Patient Centric Healthcare

          George Van Antwerp




1                                     © 2007 George Van Antwerp
Executive Summary
  The traditional healthcare model (delivery and
  insurance) is being challenged and will change.
  The graying and diversification of America make
  change more complex.
  Healthcare is massively ineffective and inefficient at
  driving consumer behavior.
  A research based approach to healthcare marketing
  using traditional marketing approaches will be
  successful for employers (wellness), managed care
  (CDHC), pharmacy (generics, mail), and providers
  (loyalty).



  2                                                © 2007 George Van Antwerp
The Healthcare Marketplace is Changing
Radically and will Continue to Change.

                         CDHC


 Smart Devices




                            VBID




                                      Hospital
       Telemedicine
                                     Experience


   3                                     © 2007 George Van Antwerp
Everybody Wants to Communicate With the Patient

                           PBM
              Pharmacy              Pharmaceutical Manufacturer


        Employer                            Internet Companies


                                             Disease Management
Primary Care Physician                           Companies

        Specialist                          CDHC Companies


              Hospital                  Health Savings Account
                                              Companies
                         Managed Care


    4                                                   © 2007 George Van Antwerp
BUT, Nobody Does It Well

           Could I have
                                                                   Who do I trust?
          saved money?
             Safely?



          Am I supposed                                                 What action
          to pay this bill?                                            am I supposed
                                                                         to take?


               Should I
                                                                        What is a ABEP
                                           Today’s Patient
            challenge this
                                                                      test? Is that what I
             suggestion?
                                                                          had done?



 “Consumer segmenation in the health-care industry is rudimentary at best”
 Health Care’s Retail Strategy, Strategy + Business, Spring 2007



      5                                                                              © 2007 George Van Antwerp
Information Isn’t Timely, Personal, or Clear




   6                                      © 2007 George Van Antwerp
The Patient Base is Becoming More Complex




  Example:
  • Hispanic households are 3.5x more likely to respond to a direct mail
    solicitation BUT
  • 60% of the direct mail sent to homes is in English and
  • 52% of the respondents speak only Spanish in their homes.


   7                                                                       © 2007 George Van Antwerp
Having a Age-Oriented Segmentation
Approach to Messaging Will Be Key




  8                              © 2007 George Van Antwerp
Segmentation is Critical



                                                                                      Each group
                                                                                     would require
                                                                                       a different
                                                                                      approach to
                                                                                     get them to be
                                                                                     compliant with
                                                                                          their
                                                                                      medications.




http://www.mckinseyquarterly.com/article_page.aspx?ar=1872&L2=12&L3=62&srid=6&gp=1

      9                                                                                  © 2007 George Van Antwerp
A Successful Shift in the Healthcare Market
Means Breaking the “Glass Ceiling”

“Employers are realizing that a
                                                        Emerging Healthcare
good health care strategy
                                                        • Employee pays expenses directly
includes health benefits and
                                                        • Employer / government contribution with safety net
programs that incentivize
                                                        • Unlimited options (location, treatment, timing)
employees to manage their own
health”                                                 • Price and quality information available
Larry Boress, chief executive of the Midwest
Business Group on Health




      Traditional Healthcare
                                                                            “Consumerism combined with
      • Employee pays copay
                                                                            health advocacy will be the
      • Employer / government subsidized                                    dominant trend.”
      • Limited choice                                                      David Cordani, President of CIGNA HealthCare
                                                                            Strategy + Business interview on 3/27/07
      • Limited transparency around price and quality



       10                                                                                              © 2007 George Van Antwerp
“There is tremendous potential for those
  players who empower consumers in this
  arrangement, with information, tools, and
 services that help them take control of their
 health care immediately and in the future.”
From “Health Care's Retail Solution” by David Knott, Gary Ahlquist, and Rick
              Edmunds in Strategy + Business Spring 2007




11                                                                   © 2007 George Van Antwerp

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Patient Centric Healthcare

  • 1. Transforming from Claims Centric to Patient Centric Healthcare George Van Antwerp 1 © 2007 George Van Antwerp
  • 2. Executive Summary The traditional healthcare model (delivery and insurance) is being challenged and will change. The graying and diversification of America make change more complex. Healthcare is massively ineffective and inefficient at driving consumer behavior. A research based approach to healthcare marketing using traditional marketing approaches will be successful for employers (wellness), managed care (CDHC), pharmacy (generics, mail), and providers (loyalty). 2 © 2007 George Van Antwerp
  • 3. The Healthcare Marketplace is Changing Radically and will Continue to Change. CDHC Smart Devices VBID Hospital Telemedicine Experience 3 © 2007 George Van Antwerp
  • 4. Everybody Wants to Communicate With the Patient PBM Pharmacy Pharmaceutical Manufacturer Employer Internet Companies Disease Management Primary Care Physician Companies Specialist CDHC Companies Hospital Health Savings Account Companies Managed Care 4 © 2007 George Van Antwerp
  • 5. BUT, Nobody Does It Well Could I have Who do I trust? saved money? Safely? Am I supposed What action to pay this bill? am I supposed to take? Should I What is a ABEP Today’s Patient challenge this test? Is that what I suggestion? had done? “Consumer segmenation in the health-care industry is rudimentary at best” Health Care’s Retail Strategy, Strategy + Business, Spring 2007 5 © 2007 George Van Antwerp
  • 6. Information Isn’t Timely, Personal, or Clear 6 © 2007 George Van Antwerp
  • 7. The Patient Base is Becoming More Complex Example: • Hispanic households are 3.5x more likely to respond to a direct mail solicitation BUT • 60% of the direct mail sent to homes is in English and • 52% of the respondents speak only Spanish in their homes. 7 © 2007 George Van Antwerp
  • 8. Having a Age-Oriented Segmentation Approach to Messaging Will Be Key 8 © 2007 George Van Antwerp
  • 9. Segmentation is Critical Each group would require a different approach to get them to be compliant with their medications. http://www.mckinseyquarterly.com/article_page.aspx?ar=1872&L2=12&L3=62&srid=6&gp=1 9 © 2007 George Van Antwerp
  • 10. A Successful Shift in the Healthcare Market Means Breaking the “Glass Ceiling” “Employers are realizing that a Emerging Healthcare good health care strategy • Employee pays expenses directly includes health benefits and • Employer / government contribution with safety net programs that incentivize • Unlimited options (location, treatment, timing) employees to manage their own health” • Price and quality information available Larry Boress, chief executive of the Midwest Business Group on Health Traditional Healthcare “Consumerism combined with • Employee pays copay health advocacy will be the • Employer / government subsidized dominant trend.” • Limited choice David Cordani, President of CIGNA HealthCare Strategy + Business interview on 3/27/07 • Limited transparency around price and quality 10 © 2007 George Van Antwerp
  • 11. “There is tremendous potential for those players who empower consumers in this arrangement, with information, tools, and services that help them take control of their health care immediately and in the future.” From “Health Care's Retail Solution” by David Knott, Gary Ahlquist, and Rick Edmunds in Strategy + Business Spring 2007 11 © 2007 George Van Antwerp