Moving from innovation to impact in the healthcare industry

At the Oliver Wyman Health Innovation Summit in Chicago, Josh Michelson, co-director of Oliver Wyman’s Health Innovation Center charted a path forward to make real advancements in improving healthcare’s Triple Aim.

Healthcare does not suffer from a lack of innovation. The scores of new products, business models, technologies and methods of delivering care is a testament to that statement.

However, whether all of those new solutions, driven by untold millions in investment, has actually made a measurable impact on the so-called Triple Aim of healthcare: improving patient experience, cost measures and overall health.

Fittingly, the topic was a major area of focus the Oliver Wyman Health Innovation Summit held in Chicago from Sept. 16-18.

The theme of this year’s conference was Building for Impact, a nod to the necessity of the healthcare industry to make substantive changes and innovation to address the growing issues shaping organizations and healthcare consumers.

In a presentation, Josh Michelson, co-director of Oliver Wyman’s Health Innovation Center, sought to probe that innovation-impact disconnect and chart a path forward which can make progress on the more foundational issues in healthcare.

Worryingly the trendline is moving in the opposite direction, life expectancy is going down and costs continue to rise annually. Premiums for a family of four have nearly quadrupled over the last 20 years and the leading cost of personal bankruptcy in the country is healthcare.

“So we have created a consumer market, but we have not equipped consumers to handle that burden of choice and cost,” Michelson said, pointing to the relative underinvestment by the United States in social programs and services that lead to better health.

Michelson pointed to an analysis done by Oliver Wyman of the mission statements of the hundreds organizations present at the conference and found that they boiled down to around 40 words.

“That either speaks to a profound lack of creativity in healthcare, or perhaps a shared purpose,” Michelson said.

During last year’s conference, a poll of attendees found that they agreed that a majority of primary care visits would happen virtually by the next decade, mental health would be embedded in overall healthcare and consumers would own their own portable healthcare data.

Questions about the “big dials” in healthcare led to a much more pessimistic outlook. Some 30 percent of respondents said healthcare costs would never decline as a percentage of GDP or it would take more than 20 years.

One of the problems, according to Michelson, is the lack of a “yardstick” to get the industry moving in the same direction on what seem like large intractable problems.

As a starting point he suggested asking the question: what does great impact in healthcare look like that is measurable?

“We have to define the possible,” Michelson said. “We can’t wait for the innovators to scale a clinic at a time or 2,000 lives at a time, we need scale multipliers.”

Michelson said the onus is on incumbents to start making change in mass in operating, communication and clinical models. Additionally he said they should take a page from retailers to think about how best to reach and work with patients as consumers.

In an Oliver Wyman analysis that dissected the more than $3 trillion in healthcare spend to identify potential cost saving opportunities, as much as 35 percent of total cost improvement was highlighted.

Michelson posited that this can be achieved by three key transformations to the fundamental structure of the healthcare industry: adjusting the misalignment between how health plans and health systems work together, moving away from “sick care” and into sustaining health and confronting the major adjacent industries like pharma and post-acute care.

He breaks each of these targets into more manageable pieces with definable “levers” that can be pulled to create real impact.

Creating a more integrated healthcare industry can be done by expanding holistic, proactive care models that have been proven to work by organizations like CareMore Health and Oak Street Health.

Only around half a million lives are currently covered by these models which work especially well with those with chronic conditions, but many millions more would benefit from the shift.

Additionally taking action to control overhead costs and push care to lower cost, more appropriate sites is an important part of cutting waste and unnecessary spending.

When it comes to taking on what Michelson terms “adjacent industries,” much of what needs to be done is standardization and increasing efficiencies. Pharmacy spend can also be controlled by more effective and efficient prescription and delivery of specialty drugs.

Moving away from “sick care” means honing in on data-enabled approaches to personalized care and pushing out from the four walls of the clinic and into the patient’s daily life with insights gleaned through technologies like machine learning and genomics.

“I would implore you not just to think about metrics of success,” Michelson said. “Are we working on the things that feel urgent, or are we working on the things that are important?”

Picture: Sergey Nazarov, Getty Images