The Oliver Wyman Health Innovation Center (OWHIC) Leaders Alliance is a selective group of senior leaders from across the healthcare landscape. Convened by OWHIC to help advance health transformation, the Leaders Alliance is comprised of individuals who are passionate about accelerating market progress and committed to breaking down industry barriers to drive real change. Collectively, the group possesses the experience and market position to move beyond discussion and take concrete steps to push the industry forward. Recently, several members shared their thoughts on what they think are the most pressing issues in healthcare today – challenges that require a multi-stakeholder approach:
Founding Managing Director, Health Catalyst Capital Management
One of the more challenging issues that we must address is how do we integrate transformations occurring within the various channels care delivery. For example, in spaces with rising tides, like personalized medicine, there are no real established incumbents; as a result, there appears to be more collaboration. But in established, mature spaces, innovators are trying to truly disrupt the market, and it results in heated tensions between players. So the challenge is how do we facilitate transformation across the whole spectrum? How do we create shared incentives and perspectives, so that incumbents and innovators are working side-by-side to provide the best care possible, while curbing healthcare spending?
CEO, Motive Medical Intelligence
There are a plethora of concrete, tactical challenges facing the industry today; but existing a level above that is the need for improved innovation diffusion. Currently, we lack the ability to translate transformation from one space into the next, and so we end up with isolated revolutions, rather than industry-wide evolution. Dispersing innovation from one player to the next, from one specialty to the next, and from one population to the next is crucial to connecting the historically insulated pieces that comprise our industry. Our goal should be to create an industry where there are mechanisms in place for innovation and advancements to ripple through the entire field. You can't ignore the power of continuous improvement, and we should strive for that to be our new norm: always advancing by finding the next application or next connection point.
CEO, Omada Health
In a world where innovation is both proliferating rapidly and proving to be quite effective, the industry does have structural roadblocks for advancements that live outside traditional CPT codes and the world of fee-for-service. This is particularly evident for digital innovations. While there are commercialization and billing pathways for other types of innovation (e.g. devices, drugs, or procedures) to be widely diffused in the market, there is no analogous path for digital innovations. This results in innovators spending an inordinate amount of time working on structural roadblocks rather than on advancing their innovations. These are challenges that we work with our partners and customers to address each and every day. We hope that in some part we're helping pave the way and to define some of these pathways for digital innovation.
Rushika Fernandopulle, MD, MPP
CEO, Iora Health
Scaling innovation remains the biggest challenge to healthcare transformation. There are plenty of examples of people building effective, consumer-centric solutions; but it starts and stops with a particular clinic, city/region, product, or technology. With new partnerships and a committed focus on cooperation between innovators and incumbents, we could scale innovation to provide real value to consumer. There is a real fear of changing the industry, but what I see is that the healthcare industry is headed straight for an iceberg. So shifting left or right is irrelevant; we need to make a move.
The healthcare industry is headed straight for an iceberg. So shifting left or right is irrelevant; we need to make a move.
CEO, Hill Physicians Medical Group
The number one issue requiring a multi-stakeholder solution is the affordability – or lack thereof – of healthcare. Even though there is general consensus around the notion that there is a lot of waste in healthcare, and there is ample opportunity to reduce costs by doing things smarter, we still have a healthcare system that costs way too much. As you project forward, this leads to an unsustainable burden for the country, which leads to even higher taxes and a significant cost to employers, who are increasingly facing tough competition in global industries. The challenge for all stakeholders now is how do we take a more innovative approach to dealing with the affordability approach to healthcare?
General Partner, Canaan Partners
At the center of our industry and driving significant current transformation efforts is the consumer. Yet there is still much work to be done in unlocking consumer behavior change. As we head towards a marketplace that relies on consumers to make responsible, healthy choices, and invest heavily in their health and wellness, we need to better understand and predict consumers' backgrounds, personalities, life events, and intrinsic and extrinsic motivations. Currently, much of the relevant data is siloed within different stakeholders. We need to collaborate and create a more open data marketplace, where we can combine consumer data with behavior models and psychological motivation learnings to help guide consumers through their health journeys in the full context of their lives. There have been inroads towards this goal, but we have a long way to go before we can say the industry has a good handle on positively influencing consumer behavior to create long-term healthy populations.
Harry Leider, MD
CMO/Group Vice President, Walgreens
In the healthcare community, we need to be more open to forming new partnerships and new ways of business. By striding out of the traditional ways of the healthcare industry, we can bring the value chain together in different ways to orient around the consumer. With the demand for consumer-centric products and services rising, the existing players in the field and those continually joining in need to be willing to put aside traditional industry barriers and mindsets and come together effectively. Some have struggled to embrace the forging of new working relationships, but this will be the key to unlocking the next phase of healthcare.
Senior Vice President of Commercial Markets, Medica
An obvious, but incredibly complex challenge is that of creating healthy communities. Insurers and healthcare providers throughout the country struggle to engage people effectively across the health continuum – from encouraging kids to eat healthy, to supporting individuals as they quit smoking, to helping the elderly stay active. It’s a challenge that no one stakeholder can address on their own. There are individual success stories where specific at-risk populations have been identified and targeted solutions have been deployed on a local basis. But, our collective challenge is to determine how we can create scale and translate what works for a specific group into a solution that can serve the broader communities within which we all live.
An exceptional consumer experience has been proven to dramatically change healthcare utilization for the better. Harnessing data to deliver that exceptional consumer experience is a common aspiration, but no single stakeholder can achieve that aim alone. Right now, most data sharing is related to healthcare patient-focused data. Information is often siloed within large healthcare organizations and some plan administrators resist sharing even basic claims data with other consumer healthcare services. It would be even more significant if we could start sharing a broader set of consumer data that takes a more holistic view of the drivers of healthcare utilization. That would include data currently in the healthcare system, but also information and insights about consumer behavior, gleaned from their shopping habits, peer groups, and other psycho-social and environmental factors that, if understood, can be used to improve care decisions and access to care. Consumers have shown they are willing to share this information if they trust it will be used to improve their access to the right care. That is the next frontier to tackle.
CEO, Livongo Health
One of the top issues facing the healthcare industry today is the need to refine how we scale innovation quickly and effectively throughout the market. The number of successful innovators is growing, but their reach is limited by size and resources, and there is an abundance of innovation that has not yet reached scale. We need incumbents to embrace that change is happening; and rather than tip-toing around the change, leap in to the multi-stakeholder partnerships that will ultimately lead to better, safer, less expensive care. Some companies are starting to do this, but as an industry, we need to help smaller innovators get traction and break into the broader market. If there are solutions that are proven, they should be embraced by the market and the existing players.