Healthcare Business Services (HCBS)

As the volume of healthcare demand is increasing and both severity and utilization will only increase; the market opportunity for healthcare business services in enormous.

Healthcare Business Services Problems to Solve

1. Technology: Interoperability
2. Labor Supply Demand Imbalance: Nurse, Doctors, and Technicians
3. Cost Distribution/Redistribution: Cost efficiency
4. Integration of Services:
5. Government Intervention & Regulation
6. Pay for Performance: Transparency: Outcomes Management
7. Aggregation/Disintermediation of Information
8. Prevention
9. Retail Medicine
10. Mobility Technology

 

Healthcare Business Services Landscape

Physician's revenues are down while volumes are up

Physician’s revenues are down while volumes are up; moreover physicians have to content with the following issues:

• 47m uninsured: underinsured population
• Regulations
• Rising costs and pricing conundrum (not unit of one pricing)
• Scalability
• Retail based competition from hi volume lower value add.
• Technology adoption

While many physicians have one or more EHR components in either the planning or implementation phase, over 90 percent of all physicians in the United States still lack a complete electronic health records (EHR) system. And now, with some $21 billion earmarked for healthcare IT spending through The American Recovery and Reinvestment Act of 2009, the magnitude of opportunity has multiplied.

Hospital Consolidation

Hospital Consolidation is driven by:

• Interoperability of technology and tools, integration costs
• Lack of consistent management
• Stickiness of patient (Patient Tourism)

Patient Trends

• Consumer Convenience: Patient preferences and Healthcare Consumerism
• No continuity of care consistent – one patient record
• Total costs increasing for the individual
• Access to clinical management
• Eligibility Issues

Macro Trends Driving Healthcare Business Services (HCBS)

#1: Technology Requirement for Efficiency.

• Clunky, no interoperability, client-server, no connection or communication, costs of old technology
• ICD10 (Diagnosis Code) – US last company to adopt – Y2k for coding. Adoption enables folks to bridge data gap with other countries.
• For Consumerism
• Paper and DMS (Document Management System)

#2: Costs Efficiency (Distribution, Management, etc.)

• Near-Term: Reimbursements
• Long-Term Cost Curve (Administration and Efficiency)

#3: Labor Skill Shortage

• Physicians
• Nurses

#4: Integration Platform

• From Hospital Perspective
• Integration of clinical and financial

#5: Government Intervention & Regulations

#6: Pay-for-Performance

• Moving to outpatient/ retail model.
• Physicians being paid by hospitals

#7: Aggregation and Disintermediation.

#8: Preventative medicine.

• Treat people not patience.
• Genetic testing and mapping.

#9: Cost/Quality Conflict

#10: Volume and Utilization of Services.