Healthcare in 2016: consumer-driven

'We know health plans don't have the legs to reinvent the marketplace'
By Jessica Davis
05:44 AM
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Over the next five years technology has the "ability to change the marketplace," with three major trends: convergent technology redefining what's possible in healthcare, the invasion of consumer technology and the big question of whether the consumer will use it. No one wins unless the consumer wins.

During their 2016 Health Predictions Webinar this week, hosts Welltok CEO Jeff Margolis and Tom Main, founder of the Oliver Wyman Health Innovation Center, discussed the "birth of a new marketplace."

[See also: Revenue cycle management enters consumer age]

"We know health plans don't have the legs to reinvent the marketplace," Main said during the webinar. "We have these emerging new players, blind to geography and politics, but focused on consumer experience."

With the technology market sure to develop even further over the coming years, consumers will be rewarded for smart shopping, with transparency, crowd sourcing and a more targeted personalized marketplace.

[See also: Consumer adoption of digital health still huge market opportunity]

"We're not going to win as an industry by tearing the consumer apart, by thinking you can own the consumer in the world they live in," Margolis said, "but this is pretty far from what we could consider integration."

The idea is the consumer is the missing piece from the healthcare platform, he argued. Too often, clinical systems aren't focused on patients, but rather sick care, which doesn't include an accurate profile of the patient.

For health providers to succeed, care needs to shift to a consumer-type platform, able to piece together and understand the consumer, even built around the consumer themselves to "avoid undesirable consumer experiences."

Meanwhile, analytics and big data are redefining what's possible in healthcare.

"The idea here is how we make big data small for the consumer," Margolis said." The concept of how we can use big data for research, gathering and identifying subject, capitalizing the data down to a smaller level, it's important… to research solutions for a singular person."

"We have to be able to pull the data together. It's not going to happen in the clinical system of the EHR and EMR world; it would have already happened in the benefits system," he continued. "These systems aren't built for it."

As for the invasion of consumer technology, to engage the patient, companies are utilizing new technologies to merge health and wellness marketplace.

"The consumer technology players are getting great traction with mobile health, bringing a level of services even outside of their plans to help them live better," Main said.

"We see these players getting providers and making the consumer feel connected," he added.

Technology must be relevant to the personalized marketplace, Margolis said. Wearables are a major way to extend the patient experience; 'effective consumer experiences are digitized, humanized and multi-channel.'

The overwhelming idea is technology isn't enough to bring these changes into effect. Using a digital-only strategy will isolate those consumers who prefer physical means for connection.

"It's much more about problem-solving for the consumer," Main said. "Not about a complete switch to digital, but changing the consumer experience for the better."

[See also: Docs need to make consumer engagement a priority]

To be competitive in this market, the hosts agreed companies must be willing to provide better value, error-free healthcare, consumer rewards and better patient experience.

Main said, "It's a tall order, but we think in five years this will be in place."

"An engaged or activated patient will be compliant to a regimen put out by provider," Margolis said. These patients are held 'accountable for their overall health alliance, largely outside of the domain over the traditional provider world.'

"You have to have an intelligent hub of capability that allows a crossover from the consumer experiences," he added.