Health Care Teams “Go to Market” at RECONVERGE:G2 Round One
Business success—and lives—hinge on innovation and agility in the healthcare industry.
The market team responded with decisive commentary in its interactions with Aurora WDC’s health care teams in a wargame Thursday afternoon, a competitive exercise simulating corporate strategies and market conditions in the ever-changing healthcare industry.
The objective of each of the five health care teams is to win over the market and gain status as the premier company in healthcare.
The market team is comprised of representatives from regulatory agencies, consumer-patients, doctors, researchers, congress, and others who have vested interest in their shared goal: to keep people healthy at a minimal cost.
The market adjudicates each team and deems the likelihood of acceptance and success of strategic proposals; calls out faulty reasoning and potential for failure; “pokes holes” in their respective arguments; offers encouraging feedback; and ultimately challenges each team to up their game in an environment susceptible to rogue waves.
The teams not only have awareness of one another’s activity, but opportunity to influence it with disruptive activity like collaborations or takeovers or other outcomes that may prove surprising in their impact to a few–or all–players.
A disruption was delivered to teams in the development of their corporate structures as the first planning portion of the exercise reached its halfway point: “Google announces plans to invest $5b to use AI to reinvent the $3 trillion US healthcare industry,” read a press release.
The “rogue wave” teams need to contend with is Google as a dominant player in the healthcare industry by 2023 in their bet that AI and structured data will redefine healthcare services in the realms of disease detection, treatment, and insurance coverage.
Indeed, conditions and circumstances are unpredictable in the healthcare industry. This Reconverge simulation demonstrates the necessity for all companies to not only respond accordingly to market demands, but to anticipate their future needs–all within the confines of limited time, resources, and a brutally competitive landscape.
Of course, each team also brings its unique advantages and experiences to the fore.
The five teams presenting their go to market strategies are: Mayo Clinics; Cardinal Health; an alliance between Amazon/Berkshire/JPMorgan; Johnson and Johnson, and Anthem Health—an insurance company.
Each team has eight minutes to make their initial presentations to the market.
“To inspire hope and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education and research.”
Mayo’s team led the lineup with the explanation they want to eliminate cancer and other disease via connecting technology and physicians in global networks. They envision global connections, or a GLOcal alliance that is:
- Global and local
- Waging a new awareness campaign to rehumanize wellness by engaging local caretakers and physicians with technology they need to collaborate
- Want to be a catalyst for holistic health
Three strategy points:
- Increase global partnering with a center of excellence
- Institutions: Cleveland Clinic, Dubai Healthcare
- Suppliers: Cardinal Health, Johnson & Johnson, Amazon; Distributors: Catholic Charities, Red Cross, and the Peace Corp
Technology will be available through the AI partnership with Googlecare, “We are giving them our unique expertise in medical knowledge, resources, and research,” which will provide incentive for their participation.
Mayo Clinic wants to use their unique abilities to bring expertise together for the better good.
Exchange and free flow of data: mobile healthcare, telehealth care—“myMAYO”
Utilize distribution channels—prevention in real time vs feedback.
Through partnering, use innovations to unify and stop the disparate competitive approach to healthcare via exchange of big data to help the patient.
The goal is to provide financially cost-effect healthcare, with no additional costs for consumers, healthcare institutions or the government.
- Save money currently spent on unnecessary treatments
- Will transition the healthcare model from destination healthcare to at home resourcing
- Partnering with investors will be mutually beneficial
Mayo is keeping patients, physicians, insurance, and government all in mind. The end goal is accessibility, affordability and innovation.
Mayo Clinics’ final driver is the free-flow sharing of information so the patient has access to the best advice from doctors.
Can you envision a “GLOcal” partnership?
Q: Sounds like a beautiful vision. How will Mayo make money to pay for resources and structures?
A: Mayo’s intellectual property is their expertise, research, physicians. It is a differentiator. Partnering with Google, who has AI, an information engine, and the ability to test recommendations they own.
Q: We like big data, how will you deal with the contradictory requirement of “sharing data everywhere but nowhere” at once? How will you protect data and patients?
A: Blockchain is secure. Mayo will share treatments via AI, the fact that all shareholders provide input will help. The objective for Mayo is shifting to sharing data about how to be healthy, sharing success stories instead of private information on how sick we are. That is the difference of global information vs targeted healthcare.
Anthem is one of largest insurance companies. They say the main problem confronting the industry is rising cost. Twenty-percent of GDP will be going to healthcare in next five years. Consumers have no idea of costs in the delivery of services.
Further, costs are shifting to consumers; companies are not paying as much. Patients can’t always choose their doctors and have no idea of costs beyond the expectations they will be high.
Anthem wants to “destroy the network.”
The way to do that is to offer consumers any provider at any time.
The new model will be:
- No networks
- Technology enabled choice
- Every doctor is accessible
- Patients will schedule appointments with a click
The lesser costs of healthcare as found in today’s cosmetic surgery services provide a good illustration. Health care costs and services provided must be transparent. This approach should be taken everywhere.
List services and costs in the marketplace, says Anthem. For those opting to choose another provider not in the database, the insurance company uses referenced costs as base pricing and will pay only that amount in determining reimbursements.
This technology enables choice; the API in existing records allows an interface.
The advantage for providers is that they get to deliver care and remain out of the business aspect of healthcare.
To facilitate this, Anthem will:
- Schedule billing, manage analytics
- Handle billing
- Create service whereby providers can block problem patients—an ability they already have, but one they need to administrate
The advantage of this model for consumers is the “price you see is the price you get.”
- No more uncertainty
- Pricing based on the full experience
- No unexpected bills
Anthem’s first step is to conduct a pilot project in the St. Louis market, partnering with public employees first, then within six months, conduct a second pilot with a key hospital partner.
Clevelend Clinic has already done a deal with Oscar Health, operating at cost within a margin. This serves as a model.
The incentive to the participating clinic will be the profit margin.
Q: Why would patients stay with you? This structure only works when doctors keep their patients.
A: The patient can go to any doctor whether or not they are on the system. If they’re on it, they know the price. If not, they will get a bill they’ll submit to Anthem and they will pay for whatever amount the company agrees to pay.
Doctors will come to the system because Anthem will drive volume by handling administrative duties of healthcare, with the ultimate goal for the patient being to have lesser costs, be healthier, and have the flexibility to choose their doctor.
Q: Providers can block problem patients. Explain this.
A: Provider satisfaction is a big issue. Doctors want to help but it’s a relationship with the patient and not every relationship works. Trust is needed for a productive relationship. Disruptive, uncooperative patients can get kicked out—this happens today.
“Leveraging the network to enable players towards better and preventive health outcomes.”
Cardinal Health connects pharmacies, hospitals, and other players to provide tools and services to patients.
Cardinal has noticed a focus on providing drugs in nearly every hospital. They have a big network of pharmacies, are already in 85% of hospitals, and the focus has been on providing tools and services in an integrated way to lessen costs.
Cardinal’s strength is connecting patients, providers, payers, pharmacists and manufacturers for integrated care coordination and better patient management.
This company wants to transform their supply chain company into an integrated health management ecosystem by focusing on leveraging data, analytics, providers, services, and equipment to drive wellness.
Cardinal is “already there” to leverage a network to add value to each player.
The ambition is to create a platform to add value to the network.
The benefits are many if endpoints have better information. If the doctor has better information on the user, treatments are more specific. If payers have more information it yields better plans, if information is available to the manufacturer they will have better product innovation, if information is available to the patient, we make better health choices.
Concerning how to deal with simultaneously sending/protecting information, Cardinal can share information on how tools use information but can restrict the information shared.
Cardinal will add technology to connect these endpoints; the focus is on serving their customers so they can serve their patients at a reasonable cost.
The company did a stakeholder analysis and discovered they work with everyone already. A key strength is in these relationships.
In the past Cardinal had a focus on drugs and distribution, but they want to take new approach and add other things to help.
Cardinal will take their expertise and relationships around the logistics in the pharmaceutical business and help customers create better outcomes and get proper reimbursement under value-based care.
There will be a preventative focus for some, and ways to address complex focus with integrated medicine for others. Cardinal wants to partner with their people to offer patients more information.
The idea is to use expertise to better train patients. Cardinal wants to be not just logistical but better connected, and to have joint ventures and partnerships—perhaps acquisitions?—to help keep patients in their homes using wearables, technologies for diagnostic health, etc.
The first stage will be to set up team of experts to find value opportunities, create strategy for business models, and figure out where to compete with Googlecare to differentiate.
Q: What is it that the Cardinal strategy is to explore?
A: It is a reinvention while keeping their base. We don’t want to just send out drugs.
Q: Cardinal has relationships with providers, hospitals, nursing homes, etc—how about on the patient side? There is less connection there.
A: Other offshoot companies already have that relationship, so Cardinal’s goal is to bring in more patients. We already offer things like CVS does—medication therapy management programs, specialty drugs, theory treatments. Patients will come in through other relationships they have. At Cardinal we “have the human touch going on already.”
Johnson and Johnson: Capturing the Biometric Data Market
- Johnson & Johnson has $79 billion in revenue.
- Core competencies are drugs, medical devices, and consumer goods.
The company will not change this model but evolve it.
The Future we see in healthcare is we know how costly things are but picture a future of the patient at home with interactive devices and shared information on patient visits–telehealth based. Costs will be reduced by meeting virtually with the doctor, and the company wants to cultivate that.
You need not go in person. The future is that a larger portion of time will be spent on healthcare management not sick care management.
Step 1: Global
- Address wellness on global scale
- Partner with the Gates Foundation to allow low cost vaccines on global scale
- Launch an education campaign
All this will address wellness on the global stage which opens the door to partnering.
Step 2: Low-cost home based biometric sensors
- Sensors to collect data for home monitoring
- Protected individualized biometric data
- To be used for monitoring vital health conditions at home in concert with virtual medical assistants and telehealth engagements
Partner with payers and technologies to leverage acceptance of biometrics by consumers. Partner will have access to sanitized aggregate data.
In this model, power resides with the patient, not with the payer.
The future needs are targeted home health care by remote monitoring. Telehealth will lower health care costs, protect data privacy, and prompt consumer health engagement.
Step 3: Sensors at the points of care
- Outfit existing device lines in provider facilities (hospitals and doctors’ offices) with the Internet of Things technology.
- Collect patient data, with access to and permission of the consumer.
- Aggregate clinical date and combine that with patients’ home-health data set.
We see the future state is to connect at home. This pairs well with the virtual medical assistant at home, at the center is a focus of monitoring health, but we want to create the place where data generated from those tools is to be used.
Q: How will you convince the end-customer—doctor, patient—that these devices work and are safe?
A: We’ll get the consumer to use it through low cost distribution channels. It will be commonplace. We will push sensors out and reassure consumers their data is theirs. We will use technology so consumers can lock their data and they decide to share it with their doctor. Aggregated data will not be personalized but providers can see what is going on in the industry.
Johnson & Johnson’s brand and consumer line has already established trust.
Q: Working with Gates allows you to help distribute vaccines and get money for it, how will you raise funds otherwise?
A: It will be done through goodwill. Data itself will generate funds as it is sold to tech companies and payers as they develop sensors.
Also–existing product lines are already generating revenue, Johnson & Johnson will keep them, but evolve them to next generation.
Q: How will you aggregate, store, and retrieve data? By partnering?
A: Not sure. Not one method is identified. There are chances to partner with tech companies, and we want to control some of that to protect consumers.
Amazon/Berkshire Hathaway/JP Morgan
ABJ is announcing their partnership in a nonprofit initiative to improve healthcare at home and around the world.
ABJ will address the shift to preventative healthcare—and help transition from reactive to proactive care and get doctors and the healthcare supply chain to act a new away.
- Siloed healthcare data is not accessible
- Lowering cost of drugs: limited access to trials grow costs, new distribution models are not focused on brick and mortar infrastructure
- Amazon Health will be leveraging existing connections with consumers
- Amazon Prevention Services will leverage employees to make better healthcare approaches to promote wellness vs addressing disease
- Amazon Rx Distribution
Amazon Health’s patient repository hub will capture and make anonymous consumer data from existing 310M users. There is also a consortium of research partners to drive data clinical trials: Alexa, etc. Finally, we can leverage Amazon analytics to recommend early detection.
Amazon Prevention becomes a consumer facing platform using existing Cloud data privately. We will tie wellness programs and incentives to deductibles, and partner with provider networks and medical training facilities, sharing access to data.
We will leverage payment models and innovate.
Amazon Rx Distribution
Amazon will partner with pharmaceutical companies and reduce cost of drug development as we leverage distribution networks and lower distribution costs.
Also, we can improve patient recruitment for clinical trials with our existing large consumer network.
Amazon will negotiate new pricing for an employee pilot to drive innovation in the buying of pharmaceuticals to drive costs down.
In conclusion: this is an epic opportunity for the partnership with a nonprofit goal to drive better prevention and leverage data to achieve better health. This has big potential.
Q: One of the places used to pull your info was “23 and Me”—in genetic testing places consumers give away data with no control over it. What is the delta between data access and access to no data?
A: There are already existing examples in clinical trials. Collection of anonymous data at the source of input would use the same model and would comply with regulations.
Q: Amazon analytics will be hosted where? Devise partnerships…?
A: Amazon would host on the already proven Amazon model. We would have partnership with providers, educational systems, and integrate and leverage their data. We would use Amazon collateral.
Q: How about lowering the cost of drug distribution?
A: The overall cost of development is an inability to recruit patients for clinical trials—Amazon could help with that and give access to trials and drugs patients don’t know about. The other piece is distribution costs. We can get drugs to patients. We have a fast distribution network already and can offer that to drug companies.
Q: Will you use doctors any more to provide access to clinical trials?
A: Clinical trial availability still through doctors but provide consumer another data source.