Healthcare Convergence
This is a transformative period for health care industry,
with this industry committed to address issues ranging
from inconsistent quality, escalating costs and other
problems eluding right solutions.
Not long ago,
employers were at the center of health benefits
payments and decisions, posing several challenges for
the health care system. But, with the dawn of consumercentric vision – with consumer now at the heart of
everything – health care is getting transformed for the
better.
The shift in focus has only brought all the stakeholders
closer - an attempt to improve individuals’ well-being.
Now, the participants of the health care system
converge as in a way to serve consumers in the best
possible way, redefining industry boundaries in the
process. The effective convergence of participants is
expected to breed progressive outcome on health
systems.
Where health meets retail
Today, the promise of a bright retail future shines
through the healthcare landscape. The move taking
healthcare closer to retail is expected to create a
responsive and transparent health care to consumers.
More than anything, customers would now play the
king’s role to perfection by understanding the cost and
consequences of care that they receive and making sure
that impeccable care is delivered in the end.
While this vision of health care system providing highquality care to consumers has taken off the ground,
employers, insurers and governments exhibit their
unwavering commitment to make this vision a reality by
offering financial incentives for consumers to take good
care of themselves.
The system makes it easy for consumers to shop for
services and products as part of their plan pertaining to
anticipated health care needs. In this move towards
retail, health care market will unveil product
manufacturers and providers competing for different
segments through different formats, channels, and
business models, and agents coming to the aid of
consumers by designing health care programs that suit
consumers down to the ground.
True signs of this heath care retail convergence come to
light through:
New health care formats that are gaining traction
by the day
Shift towards health care consumerism triggered
by non-tradition health care players promoting
new offerings
Providers making quality and cost more
transparent to help consumers make informed
choices
Source: Oliverwyman
Convergence in health care triggering the shift
Consumer – the change agent
Healthcare industry is going through dramatic changes –
‘Convergence’ has emerged as the catchphrase
condensing the changes gripping the healthcare
industry.
The convergence has resulted in the disintegration of
traditional lines separating healthcare and health
insurance - employer-sponsored benefits and retailbased healthcare - physical and virtual. The concept of
convergence deals with the re-definition of industry
boundaries. With the convergence, health system
participants including providers, employers, payers and
the government are pushed to shed traditional roles in
favor of jobs that ought to be done to meet the exacting
needs of consumers and patients.
As convergence in healthcare has come to stay, payer
and provider organizations come together to work in
new combinations – with providers focused to tackle
financial risk and insurers turning their attention towards
care delivery. New integrated marketplaces seem to be
the need of the hour for creating the bridge between
insurance/traditional care providers and personalized
health/wellness offerings.
As of now, healthcare industry is catering to empowered
consumers. With consumers becoming more engaged in
managing their health, they turn out to be the change
agent transforming the health care system. Providers
and payers recognize the significance of looking beyond
convergence, to meet the needs of empowered
customers.
The empowered customer has given cause for health
system participants to assess their roles in terms of their
relationships with one another and unearth ways that
need to be adopted by health care to meet and
establish connection with resources at community level
for promoting high-value, coordinated experience
sought by consumers.
Source: Oliverwyman
What’s pushing convergence?
Though the health system is yet to achieve its objective
of empowering health care participants to rally around
patient needs, there are signs that point towards
growing convergence of health care system.
There is growing demand for more affordable,
prevention-focused and streamlined healthcare
experiences
The need for an ideal alternative for the system
that is difficult to navigate
Private and public sectors getting better aligned
to pursue improved health and reduce costs
The dynamic consumers and employees
demanding efficient care and higher quality
Improved technology entwined with ability to get
adjusted to risk differences allowing participants
to tap into increased ability – for sharing risk and
aligning financial incentives
Data giving way for increased optimization of
care processes and gauging care variations and
best practices
Roadmap to 2025
Source: Oliverwyman
Source: Oliverwyman
What does the future hold for health care system?
Though convergence is expected to enhance consumer
experience, it also unveils risks for incumbents. For
healthcare organizations the switch to value-based
models from the outdated-fee-for-service models is
going to be a long and arduous process.
Presently, alterations endured by healthcare landscape
are expected to change the dynamics pertaining to
industries connected to it. In short, challenges and
rewards await providers, insurers, intermediaries,
product makers and new entrants. More than anything,
convergence will pave way for a holistic, seamless and an
affordable health care experience.
Source: Oliverwyman