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Three risks payers and providers must take now to survive into 2024

The future of healthcare was all over MedCity CONVERGE 2014, and not just in the form of vague predictions about robot doctors and implanted sensors that track our every biological process. A doctor, an IT expert and a process improvement expert talked about what hospitals will look like in 2024, which ones will still be […]

The future of healthcare was all over MedCity CONVERGE 2014, and not just in the form of vague predictions about robot doctors and implanted sensors that track our every biological process. A doctor, an IT expert and a process improvement expert talked about what hospitals will look like in 2024, which ones will still be standing and how the measures of success will be different.

Jeff Terry, the managing principal of GE Healthcare Partners, said that one of GE’s big assumptions is that provider consolidation is going to be even more dramatic than what it looks like now.

“We are predicting that there will be 85 super-regional providers, down from 300 now,” Terry said.

These are the three changes that healthcare leaders need to make now to be among the survivors.

Justify your existence


No one gets a free pass anymore. Entrepreneurs have to show that their solutions will solve real problems that hospitals are facing.
Device companies have to show that new products will improve patient care and reduce healthcare costs. Pharma companies have to prove that they can do more than just sell pills. Hospitals have to show that they are providing high quality care at a reasonable cost.
There is no extra money to go around anymore and the stakes are high for hospital systems. To get decisions made faster – like whether to form new partnerships – entrepreneurs (and intrapreneurs) must start with convincing data and a strong business case.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

Unique partnerships are the key to success


Dr. Stephen Klasko suggested working with analysts who crunch numbers for athletics and sports teams. Dr. Vivian Lee of the University of Utah said that her cost analysis team worked with the business school to find a way to calculate the direct and indirect costs of providing care. Investors have said that partnerships are simply the way work gets done now.

Hospitals need to work with experience designers and consumer marketers and digital communications experts and parents and anybody else who could help them see the changes they need to make or who could bring in expertise.

Someone has to go first

During the Q&A part of Lee’s presentation about how the University of Utah has improved care and cut costs, one audience member said that it was too risky to put unfiltered doctor reviews online in a competitive environment like Philadelphia (implying that there’s not as much competition in the Salt Lake City market. Lee’s reply was, “Ever heard of Intermountain?”). Lee pushed back against the “it’s too risky” worry.

“I would challenge you to be the first, because this is an example of when leading the transformation is really an advantage,” she said. “I think competition and transparency are the best things for healthcare. And in an intense urban environment like Philadelphia, it couldn’t be better. It means the citizens of Philadelphia are going to get better healthcare than ever.”

During the wearables panel on Tuesday, there were questions about how to get clinical trial data to prove that tracking patient activity makes a difference. The companion question was, of course, who is going to pay for those trials? I suggested that hospitals do some of their own experimenting, as they are the ones that will benefit from fewer re-admissions, or even ask the wearable companies themselves to help fund the studies.

Someone has to go first with these new ways of doing business. If hospitals want to be one of the 85 survivors, they need to start partnering with startups and doing more experimenting.