Monday 22 June 2015

Analyzing the HP Sales Approach



This month we've been looking at HP within the Healthcare sector. With so much activity going on at the moment including the company split, the acquisition rumors and of course the $11b DHMSM result looming, it's a very eventful time to be focusing on HP and so in this blog post, we are going to be looking at HP and a few of the characteristics of HP's go-to-market sales approach, enjoy!
  • Speak to the CIO whilst partners speak to the business: HP, like CSC, is seen very much as a technology player and it is happy to carry on fulfilling that role. Its in-road into a client is usually via the CIO, which is completely understandable. HP also has a strong partner network with vendors who speak more to the LoBs, such as Deloitte and so will rely on them to deepen the client relationship where necessary.
  • Solution-in-a-box: HP typically prefers to craft a solution that can be implemented easily, quickly and cleanly. Once this solution is formulated, it can then work on customizing it and pitching it to different vertical industries.
  • Leverage eHealth centers in India: As well as increasing headcount in India as part of its restructuring plan, HP is also leveraging its six eHealth centers in India. This has potential benefits both for the local communities as well as strengthening its value propositions around big data and telehealth for example.
  • Concentrate on maintaining and growing existing client base: As its core business continues to dwindle, HP is fighting to at least maintain its existing client base and capitalizing on the loyalty its clients have to EDS after its acquisition.
  • Capitalize on the regulatory environment: The ICD-10 deadline gives HP the opportunity to really push the value of its RCM and BPO solution portfolio.
Once again, many thanks for taking the time to read this blog post. If you enjoyed it and would like to see more then please share this on social media.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

Coordination > Consolidation

As we have seen over previous years, there has been widespread consolidation in the healthcare market. Both providers and payers alike have been making acquisitions within their locales. Their goals include improving integration across their organization while reaping other benefits such as expanding revenue streams. Although this may seem a viable option right now, this will present challenges in the near future and so here are a few reasons why coordination might be a better bet than consolidation:

Consolidation

  • Fewer options will result in higher cost for the patient: In some areas of the US, there are only one or two insurers. As competition decreases, the market drives towards a virtual monopoly and these payers are able to demand higher prices from consumers. This will drive consumers to seek out alternatives, and with this consumer demand will come new independent entrants into the market delivering a greater quality/value proposition, with whom the larger, consolidated health systems will struggle to compete.
  • The rise of telehealth: As payers and providers consolidate, they solely focus on their immediate locale. With the gradual increase in adoption of telehealth, these regional borders will start to fade and patients will be exposed to more future-ready and cheaper alternatives leaving the larger, more expensive networks behind. Although consolidated health systems have the ability to drive scale and invest in telehealth, they are likely to be increasingly subjected to competitors further afield who can offer cheaper telehealth services from remote locations for non-critical care.
  • Consolidation doesn't necessarily reap economies of scale: One reason why providers are looking to consolidate is to grow economies of scale. However, a 2012 study by the Robert Wood Johnson Foundation found that the main driver was to simply improve bargaining power with payers and so consolidation did not lead to true integration or enhanced performance.

Coordination

  • Remain agile: Formal and informal care coordination enables both payers and providers to leverage their partner networks whilst also remaining agile enough to respond to market shifts, new competition and consumer demand. Larger, consolidated systems will find themselves unable to compete on price in a market where already around 20% of Americans cannot afford health insurance. This is supported by the RWJ Foundation study which found that price increases exceeded 20% when mergers occurred in concentrated markets. 
  • Coordinated care encourages a value-based reimbursement model: As mentioned above, although consolidation seems to promote care coordination on the surface, it is usually due to financial reasons and so fails to achieve improved patient care. As the healthcare market progresses from a fee-for-service model to a value-based-care model, providers will be judged on the quality of care they are administering. A true effort to coordinate care will improve the quality of care whereas those purely looking for financial benefit may end up having to play catch-up.
  • A multitude of both financial and operational benefits: The benefits of care coordination range from empowering patients, improving the delivery of care and increased efficiency to reduced costs, streamlined workflows, reduced waiting times and improved patient outcomes. Providers who have not consolidated have still been able to reap the benefits of coordinated care and so it makes sense to integrate, coordinate and remain agile.


Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

Monday 1 June 2015

Bridging the Payer-Provider trust gap


Through my research into the Healthcare Payer market, it is apparent that there is a significant trust issue between Payers and Providers. In a market where we're seeing an ever increasing percentage of convergence between the two parties, this mistrust serves as an unwelcome roadblock to innovation and unfortunately the patients are likely to be the ones who suffer.

As we've seen in the recently published PayerView report by Athenahealth and ReviveHealth, although overall benefit reliability is improving, there is still a lot of work to do in regards to streamlining workflows, making processes more efficient and ultimately bridging the trust gap.

In this blog, I'm going to lay out a few recommendations for both Payers and Providers on how to build trust with the other party based on what I've come across during my research. Many of these points apply to both entities but for the purposes of this blog post, we'll look at them separately:

Payers
  • Remain agile: As can be seen in the PayerView rankings, the top two performers are small, commercial players. Although there's a general assumption that smaller organisations are more agile, regardless of the size, Payers must be able to quickly react to market shifts including regulatory changes.
  • Integrate and coordinate your data: Easier said than done but integrating and coordinating your data will have many benefits as it will streamline workflows, simplify claims processing and make transactions more accurate and efficient. Also, once your data is aggregated, this then enables you to analyze it for future improvements.
  • Communicate: Communication is vital with both patients and Providers. Technologies such as portals, patient accessible EHRs, mobile access and secure messaging will engage patients while clinical information sharing, timely pre-authorizations and a reduction of unnecessary procedures will bridge the gap with Providers.
Providers
  • Learn from Payers: Payers are well versed in areas such as patient engagement despite Providers having more direct contact. With the rise of technologies like telehealth, remote monitoring, mobile access etc, Providers should look at what Payers are doing to retain and engage patients and if appropriate, learn from them.
  • Invest in HIT: Payers are more likely to contract with Providers who deploy software and systems supporting clinical integration and Population Health Management. The associated analytical efforts based on these would help Payers in calculating more accurate insurance premiums as well as having many patient health benefits.
  • Discuss financial risk bearing: As the market embraces a value-based reimbursement model, one of the primary reasons Payers do not trust Providers is the unwillingness to accept financial risk. Once again, this is not an easy fix but clear and transparent communication on mutual goals will certainly help this process.
Once again, many thanks for taking the time to read my blog. I hope you found it useful and welcome any feedback you may have. If you enjoyed this post, please feel free to share it on social media with your friends and colleagues.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC
  1. Athenahealth, PayerView 2015, http://www.athenahealth.com/network-data-insights/payerview
  2. Managed Healthcare Executive, Best practices for payers and providers to cooperate in the era of convergence, http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/best-practices-payers-and-providers-cooperate-era-convergence, 23 Dec 2014
  3. HealthcareIT News, Engaging patients: 5 things providers can learn from payers, http://www.healthcareitnews.com/blog/engaging-patients-5-things-providers-can-learn-payers, 8 Sep 2014
  4. FTI Consulting, Gap Separates Payers and Physicians on Value-Based Arrangements, According to a New Study Released by FTI Consulting, http://www.fticonsulting.co.uk/global2/press-releases/united-states/gap-separates-payers-and-physicians-by-fti-consulting.aspx, 30 Jul 2014