Capturing Opportunities in Motion

Healthcare experienced an unprecedented rate of change over the past two years. Life-saving drugs were brought to market faster than ever before. Digital health leapt to the forefront of care delivery. Unique collaborations broke down silos across the industry. Organizations that build on those changes are most likely to thrive in the coming years as pressure mounts to deliver more value to consumers.

“We are past the time when big players and current incumbents are default winners, and incremental change is the norm,” Ashley Smith, Partner in Oliver Wyman’s Health and Life Sciences practice, said as she kicked off the Oliver Wyman Health Innovation Summit 2021 on Sept. 28. “Investment is creating motion, momentum, and challengers at scale.” This year’s Center Stage event – which kicked off the 7-week Health Innovation Summit – zeroed in on areas where leaders can drive innovation to reshape the industry. Here’s a look at some of the key themes that emerged:

Unleashing Opportunity

Smith identified a handful of areas as Opportunities in Motion—the theme of this year’s Summit. These areas are being disrupted at an accelerated rate by increased pressure from consumers and government, as well as new entrants coming into the industry. Capturing these opportunities demands strategies and solutions that can be scaled across markets::

• Care in the home: Telehealth is becoming a consumer expectation but adopting a virtual-first mentality with a physical wraparound presence “requires a whole different mindset,” Smith said. Currently, it is too disconnected from the rest of the delivery system and too fragmented with only a handful of players who can operate at scale.
• Behavioral health: There’s been a nearly four-fold increase in adults reporting symptoms of anxiety and depression since 2019, yet under half of the counties in the nation have a licensed psychiatrist, Smith said. Digital startups, retailers and payers are launching their own behavioral health platforms. Still, the industry needs to integrate behavioral health with primary care.
• Electronic medical record: It’s time to move beyond the transactional EMR, which Smith called “old technology.” The new version of an EMR must support integration and interoperability across care settings and provide real-time actionable data.
• Pharmaceutical population health and prevention: As our understanding of genomics evolves, “new market structures” need to emerge to handle new types of therapies. Along with this comes a more personalized approach to prevention. Or as Smith called it, “precision population health at scale.”

The Power of Science and Collaboration

Alarm bells went off on January 10, 2020, when reports emerged from Wuhan, China, of 41 cases and one death attributed to Covid-19. Those numbers were significant enough to trigger a call for a vaccine, Dan Barouch, MD, Director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, recalled.

Covid-19 and vaccine development presented a problem that required writing a new rulebook on how government, academia, science, and industry can work together, said Barouch, who worked as a lead scientist on the Johnson & Johnson vaccine.“That level of collaboration will ring true for future areas of global need,” he said.

Importantly, the process also validated the mRNA and viral vector platforms, which could help combat future pandemics more effectively, he said, adding that technology has “advanced to the point where vaccines could be issued quickly and safely.”

Thinking Like a Startup

“Healthcare is not defined as being super-fast moving or adventurous,” said Mario Schlosser, Co-founder and CEO of Oscar Health. But having a startup mentality has helped the digital health insurer, which launched in 2012, roll out new product lines. The company expanded its Medicare Advantage portfolio and partnered with Cigna in the small group market. That agility also came into play during the pandemic when the company was able to move quickly to waive co-pays for Covid-19-related testing and build out a testing database.

Still, the next few years will be critical for digital health companies to “prove they can lower costs and improve outcomes,” he said. Doing so could force future startups to rethink their target audiences.

A main criticism of many digital health innovations has been the focus on high-end consumers, noted Glen Tullman, Executive Chairman and CEO, Transcarent. “We don’t need another navigator for the top 5% of the population. What we need is to address the health of the bulk of the population.”

Another key is for organizations to grow their footprints in ways that drive integration across platforms, added Julie Yoo, General Partner at venture capital firm Andreessen Horowitz. She called this the “golden era for infrastructure players in healthcare,” with companies trying to own a patient’s end-to-end journey. Life sciences companies, she pointed out, are realizing that they need to better integrate into care delivery and payment models, as well as engage in patient monitoring.

Meeting Patients Where They Are

Roughly 90% of Americans live within 10 miles of a Walmart. That presents a tremendous opportunity to reimagine care delivery, according to Cheryl Pegus, Executive Vice President of Health and Wellness at the giant retailer.

The company is trying to create a uniquely convenient experience, one where patients can get their medical, behavioral health, dental, and eye care needs met under one roof. “They can get their immunization when they get their eye exam done,” she said. Or if a consumer orders online, why not have their medicines delivered along with their groceries?

Beyond improving access to care, she said Walmart is trying to drive out costs by using technology to take some of the “mind-bending manual tasks” away from pharmacists and clinicians.

Treating Racism

In the wake of George Floyd’s murder, healthcare organizations across the nation decried the systemic racism that permeates the industry. While those statements have been lauded, to truly tackle the problem leaders still need to confront a difficult truth: racism is an addiction, said Nzinga Harrison, MD, Co-founder and Chief Medical Officer of Eleanor Health, a mental health and addiction treatment center. Addiction, she said, is defined as continuing a behavior despite the negative consequences outweighing the benefits.

If leaders begin to understand racism as an addiction that results in chronic and invasive trauma, they can build new delivery systems that are more responsive to people’s needs. And it all starts with reliable data. She called on organizations to collect more comprehensive data sets on the race, ethnicity, and language preference of the communities they serve.

Building a Culture of Innovation

“Any revolutionary idea seems crazy until it is proven,” George Whitesides told Summit attendees. Whitesides knows a thing or two about revolutionary ideas. He’s the former CEO of Virgin Galactic and was chief of staff at NASA in the Obama administration.

Whiteside detailed how challenging it was to spur innovation in the space industry, especially with large capital outlays and intense criticism from all sides. But there were key lessons that healthcare can glean from space.

Space was dominated by a small collection of contractors and there wasn’t much innovation. But as new players burst on the scene, they drove innovation to become more widespread. “It comes down to leadership. It may take a little time,” he said. “You need a team that has faith that the destination is the right place to go.”

That sentiment was echoed by Tim Wentworth, CEO of Evernorth and the former president of Express Scripts and Cigna Services.

As Express Scripts and Cigna were embarking on their merger in 2018, the two organizations mapped out their cultures to understand how they could leverage their strengths, Wentworth said. That process enabled the combined company to break down silos and share human capital across the enterprise in exciting ways. “Opportunity is not standing still,” he said. “We have to work together with the marketplace and engage in an open architecture marketplace.”

He referenced a partnership between Evernorth’s Inside Rx and Amazon’s pharmacy platform. “We can wake up in the morning and say, ‘Amazon has gone into business with someone else, or they are our partner.’ Which would you want to be?”

The Health Innovation Summit continues with seven weeks of Digging Deeper sessions and concludes with a Closing Capstone on November 16th. Oliver Wyman Health will continue to share key perspectives throughout the event.