The Impact of New Norms, New Expectations

The past couple of issues of Oliver Wyman Health covered broad themes that emerged at the Oliver Wyman Health Innovation Summit — disrupting the status quo, restoring trust in healthcare, and betting on innovation to solve the industry’s biggest problems. Those topics — along with the new norms, new expectations that are reshaping healthcare — were dissected in greater detail during several Executive Sessions that took place during the three-day event. Below are some insights:

Building Consumer Trust

• Health and trust have an important relationship but it’s going to be on a continuum and it’s also different when you look at different subsectors, said Courtney Gray Haupt, US Health Sector Chair, Edelman. Hospitals have traditionally had the highest trust, but they’ve had ups and downs from pressures on the system.
• Barbara Montresor, Senior Vice President of Marketing and Consumer Experience, Healthfirst, noted that it takes a long time to build trust, but it can be lost instantaneously. During the pandemic, they also realized that the messenger is just as important as the message; it’s about creating real connections and interactions with communities.
• It’s critical for companies to be present in times of need for their customers — after a natural disaster, a death in the family, an accident — said Ameesh Vakharia, Executive Vice President and Chief Strategy and Brand Officer, USAA. That’s when an organization’s core value proposition comes through. At USAA, there’s no limit on call center phone time when those situations arise.
• Building trust requires people being empathetic, not just sharing data. In healthcare, it also requires taking down barriers to care, the panelists noted.

Rural Health Is Everyone’s Problem

• Partnerships with community organizations and providers are vital to extending care to rural communities, according to Robert Allen, Chief Operating Officer at Intermountain Healthcare. Extending telehealth has been extremely valuable, too. The industry needs to think about the communities they are serving, not just the economic models that support or don’t support rural health.
  
• Arkansas Blue Cross and Blue Shield has supported the Arkansas Rural Health Partnership, which is made up of 14 hospitals, to collaborate on such things as building a digital health network, according to Alicia Berkemeyer, Executive Vice President and Chief Health Management Officer at the insurer. Creating flexibility that allows providers to use value-based dollars creatively is also important.
• Aaron Friedkin, MD, Chief Revenue Officer, Homeward Health, said the company is betting heavily on assuming full risk in Medicare Advantage, but is also aligning its goals with other partners in the delivery system. Homeward was launched earlier this year by former Livongo executive Jennifer Schneider, MD, with the intent of improving access to high-quality, affordable primary and specialty care in rural communities.

What is Primary Care Anymore?

• Primary care will not look the same in three years. For instance, in Illinois, 40% of primary care providers are expected to retire over the next few years, said Megan Reyna, System Vice President, Practice Transformation and Quality Improvement, Advocate Aurora Health. We need a “massive” overhaul of the primary care payment model.
• The industry can’t continue to stitch together point solutions. Organizations need to create a more wholistic and unified approach to providing services to patients, according to Elana Schrader, MD, Senior Vice President, Healthcare Services; President, GuideWell Health, GuideWell.
• Jack Stoddard, CEO, Patina Health, a startup primary care provider, said there continues to be a lot of fragmentation in the industry, but there are opportunities to bring services together. Primary care needs to be the glue that pulls it all together.

Accessing Capital: When the Bubble Bursts

• A combination of macroeconomic trends — inflation, climate change, rising interest rates — have pushed investors toward healthcare, including generalists who typically eye other industries, according to Edward de Nor, Partner, GHO Capital Partners.
• If there’s increased uncertainty, there’s higher risk, suggested Robert Vorhoff, Managing Director and Global Head of Healthcare, General Atlantic. Structurally, there are capacity constraints across the industry.
• There is still a huge divide between buyers and sellers on price. That said, A-level assets will attract a lot of bidding and for those companies, prices will go up, Ian Wijaya, Head of North America Healthcare Services and Managing Director, Lazard, pointed out.
• Kelsey Maguire, Managing Director, Sandbox, noted that investors are taking a closer look at company’s fundamentals, including their path to profitability and the quality of their leadership team.

Innovations in Medicare Advantage

• Robert Fields, Executive Vice President and Chief Population health Officer, Mount Sinai Health System, suggested that equity must become more of a strategic focus in the MA universe.
• Adam Boehler, Founder and CEO, Rubicon Founders, Co-founder, Honest Medical Group, said that partnering with local primary care doctors and collecting more data points will help to increase performance and provide better care for beneficiaries.
• Blue Cross Blue Shield of Michigan is looking to partner with provider organizations that are aligned on incentives and create a good economic opportunity for such things as primary care, according to Todd Van Tol, Executive Vice President, Health Care Value, at the insurer.

Cell and Gene Therapies are Here. Now What

• Every drug will have its own unique adoption curve, noted Erin Satterwhite, President, Optum Frontier Therapies and Optum Specialty Distribution and Senior Vice President, Commercialization and Strategy, Optum Pharmacies. Questions will linger around the payback on the standard of care.
• There are elements of care that need to be standardized and critical questions answered — how many people need this therapy? Who is eligible, asked Surya Singh, MD, Chief Medical Officer, Emerging Therapy Solutions and Senior Advisor, Institute for Clinical and Economic Review.
• Dawn Barry, President and Co-Founder, Luna, said there is still an “epidemic of the undiagnosed” in rare disease. There’s also a loneliness factor that needs to be considered for patients on a CGT journey.
• Doug Danison, Head of Commercial Strategy and Operations, Bayer CGT, said that there must be greater collaboration across all stakeholders in the healthcare ecosystem to make cell and gene therapies a success.

The Fragmented Data Landscape

• A starting question organizations need to answer is: What do you want the data for, according to Carla Leibowitz, Vice President of Business Development, Flatiron Health. Often, companies build on data without knowing the problem they want to solve. The industry also needs to do a better job of cleaning out bad data in order to find the hidden gems that can lead to real improvements.
• There’s a data literacy problem in the industry. Most doctors don’t understand data science, Albert Chan, Vice President and Chief Digital Health Officer, Sutter Health, said, adding that organizations can’t continue to flood doctors with data that doesn’t make sense to their workflow.
• Amy Dirks Stevens, General Manager, Provider Performance and Value Innovation, Innovaccer, pointed out that the infrastructure is a problem because no single party owns the whole infrastructure. “Twenty years ago, we didn’t have vendors willing to curate the data but now we have more commercially developed solutions,” she added.

The Pharmacy Value Chain

• Ned McCoy, President and CEO of Civica, said one of the non-profit drug company’s goals is to create a resilient supply chain. Civicia does not rely on China for any raw resources or materials to produce drugs; everything is sourced from the US or Europe. The company announced earlier this year that it would manufacture and distribute affordable insulin, as well as break into the retail space with CivicaScript.
• Joe Cardosi, Founder and CEO, Free Market Health; and Sarah Marche, Senior Vice President, Pharmacy, Clinical Market Strategies, Highmark; are working together to help guide patients to specialty drugs that are tailored and best fit their clinical needs.

New Rules for the Workforce

• As long as nurses and other staff are viewed on the cost side of the ledger, incentives for creating a new paradigm for the workforce will be misaligned, said Rebecca Love, Chief Clinical Officer, IntelyCare. The industry does not let nurses practice the way that they want to.
• The industry must start thinking about its workforce as being more transient and build for that, said Rosemary Sheehan, Chief Human Resources Officer, Mass General Brigham. Amazon anticipates high turnover and has structured to deal with it.
• The time people spend on their core job is not the grind, noted Melissa Swift, US Transformation Leader, Mercer. It’s the stuff that’s added on that’s burning people out. The industry is asking too much of its workforce and adjustments need to be made.