Novel combinations attempt to remake the health system
The US health industry is in a period of unprecedented dealmaking. New business models are emerging from unexpected sources. These models, a mix of new entrants and traditional players, are coming together to offer new capabilities and models of care. Their arrival in the industry should prompt players new and old to reconsider their business models and their strategies or risk being left behind.
PwC’s Health Research Institute (HRI) has identified four new archetypes in the recent announcements of healthcare deals and partnerships: Vertical Integrators, Employer Activists, Technology Invaders and Health Retailers. Each can transform the New Health Economy in unique ways, but key challenges may limit their disruptive abilities.
Companies trying to reduce supply chain costs by owning more of it, and pass savings to patients
CVS Health and Aetna; UnitedHealth Group’s Optum and DaVita Medical Group; Cigna Corp. and Express Scripts Holding Company
Health integrations are especially tricky. Fifty-eight percent of executives involved in M&A transactions said integrations were more difficult than expected. Just 50 percent say the deals were financially successful—sobering data for some healthcare executives about to spend tens of billions to make acquisitions.
Gain insights from unparalleled access to critical data. Vertical Integrators will collect a wealth of data, and should invest in systems and staff to create customized customer experiences, reduce costs and improve outcomes.
— Jane Sarasohn-Kahn, a healthcare economist and founder of the group THINK-Health
— Eric Topol, founder and director of the Scripps Translational Science Institute
Employers seeking to limit the growth of their healthcare costs
JPMorgan Chase & Co., Berkshire Hathaway, Amazon; Health Transformation Alliance
Think big. To drive down healthcare costs, companies must rethink how they purchase and deliver care. Scale is one option, but some employers are focused on new innovations.
There’s no silver bullet for healthcare. Employer Activists may be large and well-capitalized, but their negotiating power remains relatively modest. Their employees are spread out across the country, diluting their leverage in negotiations with local providers and payers.
— Rob Andrews, CEO, Health Transformation Alliance
— Rebecca Onie, Co-founder of Health Leads
Technology companies seeking to grab a greater foothold in health
Google; Apple; Amazon; Uber; Lyft
Changing consumer behaviors create new opportunities. Technology Invaders can wield new devices, apps, robots, and data to meet consumer wants and needs, such as accessing their healthcare information on their phones.
Partnerships can lead the way. While Technology Invaders have the capability to disrupt, they likely will need partnerships with existing health companies to access industry expertise.
— Jeff Arnold, Chairman and CEO of Sharecare
— Josh Riff, CEO of Onduo
Retailers looking to gain market share by providing some types of healthcare directly
Walmart; CVS Health; Amazon; Albertsons Companies/Rite Aid
Broaden your view of the consumer. Retailers are uniquely positioned to understand the wide range of people’s needs that impact their overall health, such as access to food.
Beware of a changing environment. A common shadow looms over many pharmacies and retailers alike: Online retailers can meet key consumer needs without pricey retail locations.
Companies not involved in these deals should be prepared. Some players may find themselves out-competed or disintermediated. New capabilities and partnerships will help to ensure survival.
Workforces are likely to be a key differentiator for companies with capabilities that are similar to their competition. Advancements in technology will require the right people to make use of those technologies.
Invest in customer experience. Consumers are ready for healthcare to mirror other parts of their lives in terms of convenience, transparency, choice and affordability. Companies that invest in a deep data-driven understanding of their customers will win.
Focus on price. Employers, government and other players largely have focused on utilization over the past decade. Price is the next frontier.
The message is clear for players across the US health industry: Disrupt, or be disrupted. That was the theme of PwC’s 180° Health Forum held on May 8, 2018. At the Forum, thought leaders and executives from the health industry and beyond explored opportunities to disrupt the status quo as the New Health Economy evolves. The videos below provide a glimpse of some of the disruptive forces that are reshaping our industry.
