The convergence of powerful trends - new technologies, the demand for value, a growing health economy, and the government as an influencer - is changing the traditional US health care market. While this convergence is creating substantial challenges for health care's incumbent stakeholders, it is also creating opportunities for disruptive innovators in four major areas:
1. Everywhere Care: Shifting the spectrum of care from hospitals to alternative and lower-cost sites. Cost pressures, consumer preferences and technology create a business case for care anytime, anywhere. Value-based care strategies such as ACOs and bundling, coupled with consumer preferences for convenience and increased cost-sharing, are driving consumers to seek care at lower cost settings. For example, Retail Clinics, staffed by nurse practitioners and physician assistants, are gaining traction with consumers because of their convenient locations, expanded hours and lower costs of care. These clinics are expanding from primary care to chronic disease management organizations.
2. Wellness Care: Shifting disease management from reactive to preventive and proactive management. About half of US employers with 50 or more employees have a wellness program. Even as employers expand their programs; they will likely look for more effective methods using incentives and penalties to engage their employees and secure a return on their investment. For example: digital health, mobile health, and wearables will engage consumers and generate health information. Also, with consumer devices, non-traditional sources such as social media gathering increasing amounts of data to help identify new care pathways and high-risk individuals.
3. Personalized Care: Shifting offerings from mass generalization to mass customization and driven by individual preferences. Scientific advances can provide optimal value when targeted to unique consumers. Widespread adoption of "personalized care" will likely be made possible through offerings that integrate drugs and devices with low cost diagnostics, disease management programs, and clinical decision support. For example, personalizing care based on genetic information has the potential to generate new therapies that may radically improve outcomes. These personalization tools can identify which medications, at what dosage, work best for which patients.
4. Aging and End-of-Life Care: Shifting the focus from institution-based aging to community-supported aging by leveraging technology, personalization and decision support tools. A wealthy, aging population segment is likely willing to pay for these new services. Caregiver involvement may increase as the "sandwich generation" looks for better solutions for their parents. This will likely result in a need for new services and care models. One in every two Americans between 40 and 50 years of age takes care of a parent 65 years or older while raising a child or financially supporting another adult. For example, personalizing care based on an individuals' health information and personal information has the potential to generate new ways that outcomes can be achieved by fusing traditional physician services, outpatient services, home care, care management and hospice services for those with life-limiting diseases that could enhance the quality of one's life while extending the quantity (time).
These converging trends are already creating real challenges for healthcare's incumbent players to meet customer expectations and maintain their margin. The time to challenge these incumbents is now. To change the health care landscape, challenge the incumbents, and get traction - disruptive innovators should focus their strategic designs and business models on these converging trends. Let's get moving. Now.