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Capitalizing on disruption in US healthcare

How organizations can avoid wasting billions

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Capitalizing on disruption in US healthcare

Healthcare delivery and payment as we know them are dead.

30%

Healthcare delivery and payment as we know them are dead. Five disruptive forces – economic, regulatory, digital, socio demographic and consumer behavior – are causing rapid and widespread disruption that will fundamentally change the industry.

In this report we examine how the industry is transforming and outline four key recommendations organizations should consider if they want to survive in this disruptive environment.

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Five healthcare disruptors

Economic
Regulatory
Digital
Socio demographic
Consumer behaviour
1. EconomicReduced reimbursements and the shift to pay-for-performance are impacting revenue, while increased medical costs and high existing cost structures are diminishing performance – with no clear end in sight.
2. RegulatoryRegulation is still a challenge for executives. Not only is deciphering new and changing regulations tricky, but complying with these regulations continues to burden companies’ existing resources.
3. DigitalThe healthcare world is increasingly digitizing and patients have greater access to information. To stay relevant, companies need to adapt quickly.
4. Socio demographicThe population is aging and a greater number of citizens are faced with chronic conditions. The rate and volume of elderly and chronically ill people are putting additional pressure on providers and payers alike.
5. Consumer behaviourConsumers have been empowered by their experiences in other industries and have adopted a “We’re not going take it” attitude to their healthcare. This has circled back in the form of regulation and economics as some payments are now tied to experience.

Four foundations for success

Our experience working with clients on their healthcare challenges has led us to develop four recommendations to help companies take a more pragmatic and disciplined approach to survive – and thrive – in the disruptive environment:

  1. Rethink your business model
    Executives will need to evaluate the current revenue concentration, but also explore new revenue sources. As payment models shift from "fee-for-service" to "fee-for-value", existing business models will have to change.
  2. Scrutinize existing cost structures
    A full view of costs in all areas from the bottom up is critical in understanding where opportunities are, as well as where there are gaps in accurate cost capture and reporting.
  3. Move to an "innovation-as-usual" mindset
    To control spiraling healthcare costs related to managing patients with chronic conditions, 70% of healthcare organizations worldwide will invest in consumer-facing mobile applications, wearables, remote health monitoring and virtual care by 2018.
  4. Execute flawlessly
    Once a business strategy is decided on, healthcare organizations must go to great lengths to effectively deliver the product on time and within budget.

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Our report provides a number of vital actions for healthcare leaders it covers:

  • How to apply the four foundations for success
  • Best practice examples from thriving healthcare organizations that are successfully challenging convention

Contact the author

  • Bret Schroeder

    Bret Schroeder

    PA healthcare expert

    Bret has over 20 years of business strategy and operations experience focused on helping companies leverage technology to improve business performance.

    Insights by Bret Schroeder

PA Consulting Group in the United States

Andrew Hooke

Andrew Hooke

George Botsakos

George Botsakos

Wil Schoenmakers

Wil Schoenmakers

Ritu Sharma

Ritu Sharma

Ron Norman

Ron Norman

Chris Steel

Chris Steel

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