market insights for engaging consumers

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The healthcare delivery model is being transformed and each stakeholder has an integral part to play in its much needed success. Healthcare delivery organizations, payers, and employers have typically shouldered much of this responsibility, and now patients are being added to the mix as their consumer influence and purchasing power grows. Porter Research President Cynthia Porter will explore this evolution and the industry trends that have turned previously backseat patients into some of healthcare's most powerful drivers. Presented in April 2012 at Breakthrough 2013 - the Medecision Client Forum

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  • 1.2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and ConfidentialMarket Insights for EngagingConsumersCreated byCynthia Porter, President, andAllison Norfleet, VP, Business DevelopmentPorter Research1

2. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and ConfidentialThe new book, Engage!Transforming Healthcare ThroughDigital Patient Engagement -- editedby Jan Oldenburg, Dave Chase, KateT. Christensen, MD, andBrad Tritle, CIPP2 3. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 368% of Physicians Refuse to E-mail theirPatients That is a Problem, Topol ArguesNothing about me without me.That was the mantra of patient engagement and participation at HIMSS13 Having access to data will change how patients behave Physicians need to change their mindset. The medical field needs to change Recognize each person as an individual. We now have the tools to do that. Doctors should be teachers, and they and their patients should begetting information togetherRemote monitoring and telehealthSHOW ME THE DATADr. Eric Topol, MDKeynote speakerHIMSS May 2013 4. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 4MarketInsightsintoEngagingConsumers 5. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and ConfidentialWhy Its So Hard To Improve ConsumerEngagement In Healthcare?5Source:March 11, 2013George VanAntwerp 6. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential Moving from fee-for-service to value-based care Shift in payer/healthcare delivery organization relationships, Innovations in healthcare IT Role of employers6Market Insights into Engaging Consumers 7. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 7Market Background*Care Management Industry includes more than software such as professionalservices, call center operations, outsourcing and care extenders** Wyatt Matas, Care Management Market Assessment, April 2012 The Supreme Court ruling that upheld Obama Care (ARRA) has begun to provide greater certainty andlegitimizes the movement in focus towards preventative care and enhanced management of chronicdiseases in order to address the national cost conundrum. Accordingly, the Care Management industry and marketplace is undergoing rapid transformation new vendors are emerging, new customers are appearing (both payers and providers) and the governmentis beginning to set formal direction resulting in a new model known as Care Cycle management. Care Management software market likely to expand rapidly and could approach$4B to $6B in annualspend by 2017 (of the total expected growth from $18B to $90B of the Broader Care ManagementIndustry)* Healthcare industry leaders and policy makers have recognized that Care Management offers a positivereturn on investment for a specific segment of the populationthose patients that represent 83 percent oftotal healthcare $1.5T expenditures (or the sickest 25 percent of patients treated across care venues).** While spending on the sickest 5 percent of the population accounts for 43 percent of total expenditureson chronic diseases preventative care management practices are also needed for young adults andmiddle-aged healthy persons 8. 2013 Medecision Proprietary and ConfidentialRegulatory Market Trends Driving Transformationof Care Management > Healthcare Consumerism2012 2013 2014 2015 2016 2017Meaningful UseStage 1Meaningful UseStage 2Meaningful UseStage 3> 30 Pioneer ACOs~150 MSPP ACOs~150 MSPP ACOsPatient Protection & Affordable Care ActHealth Benefits ExchangeMedicaid ExpansionMandatory CoverageACA Implementation/OptimizationHIS OptimizationHealth Information Exchange StabilizationUtilization of HIX/HBEsICD-10 HIPAA6020Chronic DiseaseManagementHealth & WellnessCare ManagementMeaningful UsePenaltiesVBH PerformanceReportingWindow ofOpportunityARRA 9. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 9Consumers Role Within VBH Moving from Volume to Value Overwhelmingly, 75 percent of HC executives expressed support, but shared somelevel of reservation about the imminent transition to at least partial value-basedhealth operating model. Quietly, a number of providers foresee profits rising under value-based health,The rationale goes that hospitals will use value-based purchasing (VBP) to driveconsolidation that in turn will enable them to dominate markers and set prices Health insurers are beginning to implement value-based benefit design (VBBD),which involves customizing care to support needs of members to keep them ashealthy as possible. Payers offer personalized benefits to incentivize particularbehaviors for individual who have or are predisposed to certain chronicdisease. Consumer engagement, however, will be essential to building longer term, moreintimate relationships needed through innovative programs, to align healthcarestakeholders and reduce costs, while respecting patient preferences andresource considerations. 10. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and ConfidentialInnovation in Health Care Delivery Models Accountable care organizations and patient care medical homes are gainingtraction as a new business model for healthcare deliver costs quality care patient experience Constructing the new delivery model Technology Process People New Programs/Products10 11. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and ConfidentialHealthcares Movement to Consumerism Why Embrace Consumerism/Repositioning of HC costs quality service Who is the Consumer Physicians patients Health systems patients Health plans members Bio-pharma users Clinical trials subjects11 12. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and ConfidentialHealthcares Movement to Consumerism Who will need to Engage the Consumer Providers Health plans Employers Government12Sharing ofInformation atPOCEngagingConsumers(engagehealthybehavior)CoordinatingCare (acrosscare settings)Analytics(monitorproviders,systemsperformance)Foundation Elements 13. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 13Beneficiaries of Consumerism Employers (that support health benefits) Healthy, productive, stable workforce company growth, viability Employees seek job security HCbenefits Community Physicians, hospitals, pharmacies, testingfacilities, home health Health plans Community(lower per capita health costs) Individuals and families (purchase the services) Access to right information via right tools Benefit by driving more value within the provider health system 14. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 14 Consumers are interested in innovative health information technologies Enable self-monitoring (i.e., blood sugar, blood pressure, etc.) Facilitate information exchange and interchange with their care givers (i.e., videoconferencing) Support treatment adherence (i.e., medication reminders, tracking towards goals, etc.)Role of Technology Consumer ReadinessDeloitte 2012 15. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 15Use of Health Plan and Doctor Websites & Portal Use of health plan websites and enrollee portals currently more common than use ofdoctors websites and patient portalsConsumers say they value having access to portals and websites - access to Personal information about their health Appointment scheduling Medical history Prescription refill ordering Treatment plansSource: Deloitte Center for Health Solutions Consumer Survey, 2012 16. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 16Patients Should BeAble to Update EHR 82% of U.S. doctors want patients to activelyparticipate by updating their EHR. Doctors want patients to add information. Demographics (95%) Family medical history (88%) Medications (87%) Allergies (85%) Clinical updates to BP and glucose (81%) But only 31% want patients to have access totheir full record. Nearly half (49%) think patient access to EHRis crucial to effective care, yet only 21% allowpatients online access now.Source: Accenture Doctors Survey 17. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 17GenerationalConsumer Interestand Behaviors Our youngestgenerations appear tobe especially receptiveto taking a more activerole as health careconsumers.Source: Deloitte Center for Health SolutionsConsumer Survey, 2012 18. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 18Consumer Engagement is a Strategic Priority Providers and payers both ranked Consumer Engagement as a high priority initiative; as expected payers as agroup tend to rate this initiative as a higher priority than providers. This difference is reflective of who their customersare employers and members.(Source: Porter Research/Medecision VBH and Consumer Engagement Study 2012) 19. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and Confidential 19Innovations in Healthcare IT Driving More Coordinated,Consumer-Friendly and Value-Based Care So what is working? Has anyone found a technology, abusiness strategy or incentive that hasled to truly successful consumerengagement when it comes to caremanagement programs? Will providers and payers really have toresort to flyovers? Lets take a look at these questions bybreaking them down.* Cartoon courtesy of Imprivata 20. 2013 Medecision Proprietary and Confidential2013 Medecision Proprietary and ConfidentialDefining Consumer Engagement20Providers Payers Not just a portal or other technology but actually having the patientparticipating in education and interventions on their health. Having

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