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Growth Opportunities for MedTech in the Transformation of the US Healthcare Provider Ecosystem
Growth Opportunities for MedTech in the Transformation of the US Healthcare Provider Ecosystem
Transformational Growth in the Care Delivery Landscape is Changing Health Systems into Systems of Health
14-Jun-2021
North America
Description
Healthcare providers are on the verge of reinventing their role in the care delivery process due to various external factors, such as the following:
• Unsustainable growth in healthcare spending driving continuous downward pressure and declining operating margins
• The emergence of alternative payment models that focus on patient outcome and reduce costs for payers
• Threats from non-traditional players transforming the care delivery model through innovative business models, delivering operational efficiency and applying advanced technologies for patient-centric care
• Empowered patient-consumers taking an active role in their health and demanding personalized care and effective treatment.
The COVID-19 pandemic has necessitated the adoption of novel care delivery models among providers, further accelerating the payers’ plans to reduce avoidable in-patient admissions, thereby saving costs.
The pandemic has exposed the vulnerabilities of the existing fee-for-service model which is highly reliant on case volumes, resulting in misalignment of incentives between payers and providers, where providers and health systems suffered huge losses due to drop in outpatient and elective surgery volumes even as payers reported significant profits. As a result, providers are ready to embrace alternative payment models (APMs) like bundled or capitated and global or population-based payments which minimize the focus on acute care by enabling the providers to manage conditions without affecting revenues. More than ever, providers are willing to explore hybrid models of care and benefit from the advances in virtual care. The change in reimbursement models that incentivize providers for generating savings is driving them to adopt new technologies that can help deliver efficient care across the continuum.
To achieve cost-synergies and scale up operations, providers are building alternative sites of care and integrated delivery networks (IDNs) that help them offer care in appropriate settings to align with the principles of value-based care and retain patients who would have otherwise switched to competitors. Increasingly, providers are looking to partner with MedTech companies that can support them in building new capabilities for the value-based care models. In order to build solutions that solve the needs of key stakeholders in the current landscape, MedTech companies need to demonstrate the value of their device in achieving the goals of the providers by supporting them with operational efficiency, improving the patient experience, owning the outcome, and easing reporting and health information exchange.
Providers are looking for quantifiable, data-driven metrics that create evidence on the efficacy and effectiveness of the therapy to prepare them for shared-risk models. Providers and health systems need to be prepared for the changing policies (including price transparency, anti-trust measures and provider regulation, and cost-containment through APMs) under the current federal administration in the United States, which might impact them.
Research Highlights
- Strategic imperatives for key stakeholders (providers, payers, and MedTech)
- Priority areas for health system CXOs and their emergent strategies for modernizing the care process
- The impact of payment reforms and policies in the service delivery landscape
- Growth drivers and restraints for the provider transformation
- Top growth opportunities due to the ensuing transformation
Author: Srinath Venkatasubramanian
RESEARCH: INFOGRAPHIC
This infographic presents a brief overview of the research, and highlights the key topics discussed in it.Click image to view it in full size
Table of Contents
Why Is It Increasingly Difficult to Grow?
The Strategic Imperative 8™
The Impact of the Top Three Strategic Imperatives on the US Healthcare Market
Growth Opportunities Fuel the Growth Pipeline Engine™
Executive Brief of the Report
Coverage Areas and Scope of Analysis
Top Themes and Factors Impacting the Healthcare Service Delivery Landscape
Costs, Consolidation, and Care Delivery Infrastructure—Dominance of Hospitals and Skewed Expenditure
Segmentation of the US Provider Landscape—Care Delivery Segments
Segmentation of the US Provider Landscape—Care Delivery Segments (continued)
US Healthcare Spending—Last Decade
US Healthcare Spending—Current Decade
Healthcare Expenditure by Type and Source of Funds
Majority of US Hospitals are System-affiliated Community Hospitals
Consolidation in the US Provider Landscape
Attractiveness of Alternative Sites of Care—Physician Practices and ASCs
Key Trends Impacting Providers
Healthcare Industry’s Transition to Quadruple Aim and What it means for Providers
Growth Drivers for the Provider Transformation
Growth Restraints for the Provider Transformation
External Challenges or Forces of Transformation for Providers
Internal Challenges or Forces of Transformation for Providers
Short-term and Long-term Issues Confronting the Provider Leadership
The COVID-19 Pandemic has Exposed the Constraints and Inefficiencies in the Current Healthcare Landscape
Key Focus areas of CXOs of Health Systems / Providers
Drivers Determining Novel Provider Strategies
Organizational Redesign Creating New Personas and Influencers in Health Systems
Health Systems Need to Shift from a Capital Intensive Low-margin Business Model to a Patient-centered High Value Model
Consumerism and Payer Priorities Impacting Care Volumes of Health Systems, Favoring Non-traditional Care Setting
Hospitals’ Impact on the Revenue Stream by Shift in Sites of Care
Care Delivery Platforms transforms Health Systems to Systems of Health through Integration and Rationalization
Emergent Strategies of Providers for Modernizing Care Process and Staying Relevant and Sustainable
Future of Hospital—Health System to Health Platform Where Hospitals are at the Core of Managing Health
Future of Hospital—Health System to Health Platform Where Hospitals are at the Core of Managing Health (continued)
The Next Growth Wave in the Care Delivery Landscape Relies on the Restructuring of Strategic Priorities by Providers
Health Systems Focusing on Investments, Reallocation of Resources, and Alternative Sites of Care, Post COVID-19
What Should MedTech Companies do to Build the Capabilities of Providers to Deliver Care in Alternative Sites?
Best Practice Implementations—Philips e-ICU
Best Practice Implementations—Medtronic Care Management Services
Policies from Capitol Hill Impacting the Care Delivery Landscape
Impact of Changing Policies on Providers and Opportunity for MedTech Firms
The Transition to APMs Brings New Opportunities for MedTech Companies to Work with Payers and Providers in Integrating Functionalities for Data Extraction, Evidence Generation, and Reporting
Rise of APMs
APM Adoption has been Positive Across Payer Categories
CMS Programs to Transform the Provider’s Role in the Care Delivery Process
Key Demonstration Programs Across Categories and MedTech Opportunity
Key Demonstration Programs Across Categories and MedTech Opportunity (continued)
Priority CMS and Pioneering MedTech Models
Change in Provider Priorities and MedTech Company Strategies
Transformation in Traditional Models of MedTech Engagement with Providers, Payers, and Patients is Driving Reformed Value Propositions
Providers Need to Transition from Legacy Siloed IT Infrastructure to New Connected Data Architecture to Benefit from Changing Financing Models Centered on Accountability
Altered Value Stream in MedTech will Transform the Two-sided Linear Links between Provider and OEM Companies into a Platform Mediated Business Structure
Altered Value Stream in MedTech will Transform the Two-sided Linear Links between Provider and OEM Companies into a Platform Mediated Business Structure (continued)
Solution Prioritization for Provider Needs
Adoption of New Models by Providers and Health Systems will Unlock New Growth Opportunities for MedTech Companies
Growth Opportunity 1: Enablement of Care Delivery beyond the High-acuity / Hospital Setting using Connected Care Solutions
Growth Opportunity 1: Enablement of Care Delivery beyond the High-acuity / Hospital Setting using Connected Care Solutions (continued)
Growth Opportunity 2: Capturing and Integrating Data Across Care Continuum to Improve Clinical Efficiency and Optimize Performance
Growth Opportunity 2: Capturing and Integrating Data Across Care Continuum to Improve Clinical Efficiency and Optimize Performance (continued)
Growth Opportunity 3: Managed Services Help Control Costs and Optimize Efficiency for Providers, Yielding New Revenue Streams for MedTech
Growth Opportunity 3: Managed Services Help Control Costs and Optimize Efficiency for Providers, Yielding New Revenue Streams for MedTech (continued)
Growth Opportunity 4: Network of Asset-light Models Expands Market Access for Providers by Improving Margins
Growth Opportunity 4: Network of Asset-light Models Expands Market Access for Providers by Improving Margins (continued)
Growth Opportunity 5: New Payment Models Centered Around Managing the Disease Condition
Growth Opportunity 5: New Payment Models Centered Around Managing the Disease Condition (continued)
Growth Opportunity 6: Virtual hospital / HaH to Increase Capacity for Hospitals and Deliver Appropriate Care to Patients
Growth Opportunity 6: Virtual hospital / HaH to Increase Capacity for Hospitals and Deliver Appropriate Care to Patients (continued)
List of Exhibits
List of Exhibits (continued)
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Research Highlights
- Strategic imperatives for key stakeholders (providers, payers, and MedTech)
- Priority areas for health system CXOs and their emergent strategies for modernizing the care process
- The impact of payment reforms and policies in the service delivery landscape
- Growth drivers and restraints for the provider transformation
- Top growth opportunities due to the ensuing transformation
Author: Srinath Venkatasubramanian
| No Index | No |
|---|---|
| Podcast | No |
| Author | Srinath Venkatasubramanian |
| Industries | Healthcare |
| WIP Number | K5B8-01-00-00-00 |
| Is Prebook | No |
| GPS Codes | 9564-B1,9600-B1,9612-B1,9566-B1,9A47-B1,9A4B-B1,9614-B1 |