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Market 2.0
The patient
to consumer
revolution
Quantified
self
Transparent
consumer
markets
Smart
care teams
CHANGING THE
CONVERSATION
WE WANT TO
UNDERSTAND
WHAT MATTERS
ABOUT
OUR HEALTH
WE WANT
FEEDBACK AND
TOOLS TO HELP
US LIVE LONGER
AND BETTER
WE WANT TO BE
ABLE TO MAKE
INFORMED
DECISIONS ABOUT
HEALTH SERVICES
WE NEED TO BE
ABLE TO STRETCH
OUR DOLLARS
BEYOND THE
BENEFIT PLAN
WE NEED OUR
CARE TEAM TO
TREAT US
HOLISTICALLY &
HELP US LIVE
BETTER
WE WANT
ANYTIME &
ANYWHERE
ACCESS TO
CONVENIENT
CARE
THE PATIENT TO
CONSUMER REVOLUTION
Oliver Wyman | CHI-HLC06101-089
REFRAMING WHAT
IS POSSIBLE
Costly
senior
care
Expensive
hospitalization
Complicated
referrals
Hard to find
quality docs
Denial of
coverage
No time or $ to
talk end of life
No end-of-life
plan
Emergency?
Call 911
15-20
medications
Staff
focused on
costs, not
prevention
Health
Plan
Small
margin for
Medicare
patients
Redundant
treatment
Expensive
co-pays
Need to
minimize
costs
No
Coordination
of Care
Byzantine
billing
Hard to be
ideal doc
Too many
patients, too little
time
More billing
staff than
nurses
Emotionally
attached
Patient
Problems go
unnoticed
Wait weeks
to see doctor
Doctors
Professional
frustration
Cant
Drive
Miss
Appointments
Hard to fit
patients in
schedule
Multiple
specialists
Conflicting
treatments
Oliver Wyman | CHI-HLC06101-089
No holistic
care
Lack resources to
manage chronic
illnesses
today
tomorrow
B2B2
B2B2C
B2b2C
5
A $1TN OPPORTUNITY
Technology
Innovation
Capital
Leadership
HEALTH
MARKET 2.0
HEALTH
MARKET 2.0
20%
40%
Trend reduction
3%
5%
Consumer experience
improvement
25%
300%
$100 BN
$1 TN
100X
1,000X
10
Value rotation
Rate of innovation
and diffusion
Extra years of
good living
Oliver Wyman | CHI-HLC06101-089
IT IS ALREADY UNDERWAY
RISE OF
RETAIL
Mobile and
monitoring
Retail
Walgreens
Walmart
CVS
Rite Aid
Food and
grocery
PHM
enablement
HEALTH
ECOSYSTEMS
Oliver Wyman | CHI-HLC06101-089
MyFitnessPal
Jawbone
Zipongo
Livongo
Weight
Watchers
Whole Foods
McDonald's
GNC
Smart care
teams PHM
Google
IBM Watson
Apple
Theranos
Hudson Alpha
Illumina
23andMe
Health
Market
1.0
Evolent
xG Health
Optum
Healthagen
HealthCare
Partners
Iora
Qliance
CareMore
TECHNOLOGY
ATTACK
Advanced
diagnostics
Castlight
WebMD
DocSpot
Amazon
Liazon
Bloom
Health
shopping
Exchanges
Welltok
Audax
Teladoc
MDLive
Telehealth
Engagement
platforms
CONSUMER
MARKETS
8
Mobile and
monitoring
MyFitnessPal
Jawbone
Zipongo
Livango
Retail
Google
IBM Watson
Apple
Walgreens
Walmart
CVS
Rite Aid
Theranos
Hudson Alpha
Illumina
23andMe
Benefits
coverage
and risk
Food and
grocery
PHM
enablement
Weight
Watchers
Whole Foods
MacDonald's
GNC
HEALTH
ECOSYSTEMS
Evolent
xG Health
Optum
Healthagen
Smart care
teams PHM
Advanced
diagnostics
Healthcare
delivery
Health
Market
1.0
Long-term
life/health
planning
HealthCare Partners
Iora
Qliance
CareMore
TECHNOLOGY
ATTACK
Castlight
WebMD
DocSpot
Amazon
Health
shopping
Liazon
Bloom
Healthy
living &
wellness
Welltok
Exchanges
Audax
Teladoc
MDLive
Telehealth
Engagement
platforms
CONSUMER
MARKETS
9
TECHNOLOGY ATTACK
MOBILE AND MONITORING
ADVANCED DIAGNOSTICS
MyFitnessPal
Zipongo
Google
Apple
Theranos
Illumina
Jawbone
Livango
IBM Watson
Hudson Alpha
23andMe
RETAIL
Walmart
Rite Aid
Whole Foods
GNC
Weight Watchers
McDonalds
RISE OF RETAIL
Walgreens
CVS
MDLive
10
CONSUMER MARKETS
Teladoc
Iora
CareMore
ENGAGEMENT PLATFORMS
TELEHEALTH
HealthCare Partners
Qliance
EXCHANGES
Evolent
xG Health
Optum
Healthagen
Oliver Wyman | CHI-HLC06101-089
Audax
PHM ENABLEMENT
Welltok
Bloom
Liazon
WebMD
Amazon
HEALTH SHOPPING
Castlight
DocSpot
TECHNOLOGY ATTACK
MOBILE AND MONITORING
ADVANCED DIAGNOSTICS
MyFitnessPal
Zipongo
Google
Apple
Theranos
Illumina
Jawbone
Livango
IBM Watson
Hudson Alpha
23andMe
Walgreens
CVS
Walmart
Rite Aid
RETAIL
Weight Watchers
McDonalds
Whole Foods
GNC
Audax
Teladoc
Iora
CareMore
MDLive
11
ENGAGEMENT PLATFORMS
Welltok
TELEHEALTH
HealthCare Partners
Qliance
CONSUMER MARKETS
Bloom
Evolent
xG Health
Optum
Healthagen
Oliver Wyman | CHI-HLC06101-089
EXCHANGES
Liazon
RISE OF RETAIL
WebMD
Amazon
PHM ENABLEMENT
HEALTH SHOPPING
Castlight
DocSpot
BLURRING THE
LINES
Psychologist catches
early depression, Nutritionist helps craft
better diet to promote
addresses it
good weight
PCP addresses
high cholesterol
with an Rx
Fully mobile
Undiagnosed
depression;
pre-hypertensive
Overweight, diabetic,
high blood pressure,
undiagnosed
depression
Over weight, diabetic,
high blood pressure,
depression, CHF
Physician
Centered Sick Care
Lifetime
12
13
ELEMENTS OF
HEALTH MARKET 2.0
15
$25k
15% of the
population
60% of the cost
Failure of FFS
sick care
Central to Health
Market 2.0
$10k
HONDA
LIFESTYLE MEDICINE
HYPERTENSIVE
OBESE
NON-COMPLIANT
DIABETIC
ADULT
ENGAGED
CONNECTED
COMPLIANT
LIVING BETTER
MORE GOOD YEARS
40% improvement in value --- 300% better experience --infinitely more access --- ten more years of good living
16
Healthy
living
values
Exchanges and
shopping market
Clinical
and health
condition
values
Expense and
budget values
Social and
expert
communities
Health living
rewards exchange
Oliver Wyman | CHI-HLC06101-089
17
QUANTIFIED SELF
Healthy living values
Steps or activity
Sleep
Nutrition
Stress
Weight
18
QUANTIFIED SELF
Healthy living values
Steps or activity
Sleep
Nutrition
Stress
Weight
Expense and
budget values
Affordability
Deductible status
Exposure
Pharmacy costs
Reward opportunities
Quantified self
the bridge to a
personalized
health and
wellness
marketplace
Health living
rewards
exchange
Smart personalized
shopping
Increased relevance
and engagement
through social
communities
Exchanges and
shopping
market
Social and
expert
communities
19
QUANTIFIED SELF
WHAT IS NEW
20
QUANTIFIED SELF
WHY IT MATTERS
The shift from occasional asynchronous data capture to daily real time
interactions is a game-changer; across the pyramid
21
Convenient
Care
Crowd Sourced
Recommendations
Annual Decision
Process
Acute and
Complex Care
Services
Plan Year
Marketplace
Personalized
Better Living
Itinerary
Surgical and
Diagnostic
Procedures
Major Diseases
and Conditions
Personal Health
Economy/Bank
Retail Healthy
Living Services
22
Crowd sourced
recommendations
Insights
engine
Personalized
better living
itinerary
Personal health
economy/bank
Benefits
Reward
Flex dollars
Cash/debt
Annual decision
process
23
Crowd sourced
recommendations
Insights
engine
Annual decision
process
Personalized
better living
itinerary
Personal health
economy/bank
Benefits
Reward
Flex dollars
Cash/debt
Smart care team
Surgical and
Convenientdiagnostic
care Retail healthy
living services
procedures
Major
diseases and
conditions
Plan year
online shopping
marketplace
Consumers
making informed
decisions about
disease treatment
and complex care
Acute and
complex care
services
Cancer care
Inflammatory disease
Vascular and cardiac
Renal care
Over time consumers and families having better information for making
treatment decisions regarding serious diseases and complex care
Oliver Wyman | CHI-HLC06101-089
24
Crowd sourced
recommendations
Insights
engine
Convenient care
Annual decision
process
Personalized
better living
itinerary
Personal health
economy/bank
Benefits
Reward
Flex dollars
Cash/debt
Smart care team
Plan year
online shopping
marketplace
Consumers and
families working
with their smart
care team and
decision tools to
make more
informed
decisions on
acute and
complex care
Retail healthy
living
services
Acute and
complex care
services
Oliver Wyman | CHI-HLC06101-089
Surgical and
diagnostic
procedures
Major
diseases and
conditions
Cancer care
Inflammatory disease
Vascular and cardiac
Renal care
25
Consumers shop during the plan year for health services (within networks)
with price and value transparency
Five new health services markets emerge ranging from convenient care to
major disease markets
Prices fall to the median and providers compete on value as spot markets
develop to match idle supply with consumer demand at the right price
The new health services market includes health and wellness products
and services
26
First generation transparent shopping apps are all ready in market with
great access to capital
Moving the surgical and diagnostic market to median pricing saves 10% of
the total cost of healthcare
27
Communication
platform
Biosensors and
monitoring
Predictive
insights engine
Smart
clinics
Physical in
the community
resources
Retail
pharmacy
clinics
Smart Care
Team
A Personalized
Ecosystem
Virtual health
resource access
Weight
management
Stress
management
Better living
programming
Coaching
Telehealth
Nutrition
management
28
Smart clinics
Retail pharmacy
clinics
Complex Adaptive
Workflow
Personalized
connected relationship
The smart care team building the foundation with full multi-skill team
composition and a consumer better-living culture
Oliver Wyman | CHI-HLC06101-089
29
Communication
platform
Biosensors and
monitoring
Predictive
insights engine
Smart care
teams partner
with consumers
to navigate and
coordinate
acute and
complex care
Smart
clinics
Physical in
the community
resources
Smart Care
Team
A Personalized
Ecosystem
Better living
programming
Stress
management
Virtual health
resource
access
Weight
management
Retail
pharmacy
clinics
Nutrition
management
Coaching
Telehealth
30
Personalized and predictive using big data and insight engines for
micro segmentation
31
Consumers live better and feel more connected with their smart
care teams
Smart care teams can leapfrog over medical homes; innovators have
already proven the model
32
10%
Magnitudes
illustrative
Better consumer
pricing
Passive
monitoring &
early
interventions
10%
Potential
profit
10%
Lifestyle
medicine
5%
Consumer
engagement
5%
Health
Market 1.0
Oliver Wyman | CHI-HLC06101-089
Health
Market 2.0
33
Next generation PHMs will thrive on complex adaptive systems that are
highly-tailored to particular segments of the population
Severe behavioral
End of life
Dedicated psychiatric
NPs/MDs
Bio-monitoring of
Rx adherence
Dedicated social worker
and PCP
Etc.
Chronic with
social needs
Case worker embedded
in care team
Dedicated coach focused
on nutritional and mental
health needs
Etc.
Potential
Care Model
Components
Poly-chronic/complex
Dedicated Extensivists
Remote monitoring
Specialty clinics
Integrated behavioral health
Etc.
Generally healthy
Early chronic/at-risk
Affordable acute
care options
Rewards and incentives
Social/mobile health
tracking tools
Etc.
34
Quantified self
HEALTH
MARKET
2.0
Healthy
living values
Exchanges and
shopping market
Clinical and
health
condition
values
Social and
expert communities
Transparent consumer
markets
Convenient
Care
Health living
rewards exchange
Communication
platform
Smart
clinics
Crowd Sourced
Recommendations
Annual Decision
Process
Biosensors and
monitoring
Predictive
insights engine
Physical in
the community
resources
Retail
pharmacy
clinics
Surgical and
Diagnostic
Procedures
IT enablement
engines
Smart Care
Team
A Personalized
Ecosystem
Personalized Better
Living Itinerary
Weight
management
Major Diseases
and Conditions
Stress
management
Better living
programming
Coaching
Telehealth
Personal Health
Economy/Bank
Retail Healthy
Living Services
Nutrition
management
35
UNLOCKING THE
INCUMBENTS DILEMMA
37
Why is it
that the mental model of
industry leaders lags the
market by 23 years?
38
39
Mobile and
monitoring
Retail
Walgreens
Walmart
CVS
Rite Aid
Food and
grocery
PHM
enablement
HEALTH
ECOSYSTEMS
Oliver Wyman | CHI-HLC06101-089
MyFitnessPal
Jawbone
Zipongo
Livongo
Weight
Watchers
Whole Foods
McDonald's
GNC
Smart care
teams PHM
Google
IBM Watson
Apple
Theranos
Hudson Alpha
Illumina
23andMe
Health
Market
2.0
Evolent
xG Health
Optum
Healthagen
HealthCare
Partners
Iora
Qliance
CareMore
TECHNOLOGY
ATTACK
Advanced
diagnostics
Castlight
WebMD
DocSpot
Amazon
Liazon
Bloom
Health
shopping
Exchanges
Welltok
Audax
Teladoc
MDLive
Telehealth
Engagement
platforms
CONSUMER
MARKETS
40
Become
magnetic
Physician disease
Consumer health
Ecosystem
Network
advantage
Consumer
beware
Highly
coordinated
Market position
Product
leadership
Delight
consumers
Point of design
Value chain
control
Priced based
Competition and
substitute economics
Transformative value
New industry
standard
Laggard
Multi-year lead
Price position
True commodity
Above
market
Price
advantaged
41
A capital
markets
perspective
Speed
GLUE
FUEL
WEIGHT
Regulation
Access to
capital
Asset
intensity
WALL ST
Information
Intensity
Incumbents
Geographic
scope
Market
value
Return on
capital
1 new operating
theatre a decade
1 dollar of capital
for a dollar of
revenue
25 new product
releases a year
5 cents of capital
for a dollar of
revenue
Adjacencies
New Players
Oliver Wyman | CHI-HLC06101-089
42
DEMAND MARKETS
Convenient
and virtual
care
Passive
connected
monitoring
Smart care
teams
Surgical and
diagnostic
bundles
Predictive
analytics
Real-time
adaptive
workflow
Next gen
diagnostics
Consumer
shopping tools
Product
Personalized exchanges
prevention
Configurable
Engagement health plans
and rewards
In-network
market
shopping
43
Protect
the fort
Payer
Oliver Wyman | CHI-HLC06101-089
Incumbents
Reinvent
&
Innovate
Slow with
heavy
construction
Reinvent
&
Innovate
Slow with
heavy
construction
Consumer configurable
health plans
44
Population based
smart care team
ecosystems
Payer
Consumer
configurable
health plans
Adjacencies
Retail Pharmacy
Healthy living
community
stores +
Credit/Debit Card
Health and
wellness
consumer banking
New Players
Web Services
Transparent
consumer
shopping markets
Smart Phone +
Personalized
better living
ecosystems
45
Transparent consumer
shopping markets
consumer banking
46
Personalized better
living ecosystems
THINK
CONSUMER
ECOSYSTEM
DONT GO IT ALONE
Selecting Strategic
Partners from the
Health and Wellness Jungle
BIG DATA AND
PREDICITVE
MODELING
MOBILE
APPS
RETAIL
PHARMACIES
PASSIVE
MONITORING
47
Patient center
care model
Provider
Population based
smart care team
Hospital
system
Clinically
integrated
network
Communication
platform
Biosensors and
monitoring
Predictive
insights engine
Smart
clinics
Physical in
the community
resources
Retail
pharmacy
clinics
Smart Care
Team
A Personalized
Ecosystem
Virtual health
resource access
Weight
management
Stress
management
Better living
programming
Coaching
Telehealth
Nutrition
management
48
Exchange based
decision tools
Health
Plan 1.5
Payer
Value based
benefits and
rewards
Health and
pharmacy
benefits
Network
model broad or
narrow
My personal
budget and risk
tolerance
Consumer configurable
health plan
Value based
benefits and
rewards
Exchange based
decision tools Network model
performancebased
Health
Plan 1.5
Convenient
Care
Configurable
benefits and
network
Transparent
Markets
Acute and
Complex Care
Services
Retail Healthy
Living Services
Major Diseases
and Conditions
In plan year
(and network)
marketplace
Surgical and
Diagnostic
Procedures
49
Transparent consumer
shopping markets
consumer banking
50
Personalized better
living ecosystems
LEADERSHIP
VIVA LA
CONSUMER
REVOLUTION!!