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Healthcare 2019, continued from page 8 Uber, as companies that have successfully created a ‘value line’ of products or services. “Those companies have optimized value, lowered cost, and most importantly have still figured out how to turn a profit,” said Walker. “Southwest was a disrupter in the industry,” he noted of the upstart Texas company that turned the airline industry upside down. While healthcare continues to be on a slow journey to greater price transparency, consumerism and efficiency, Walker said there has been significant movement over the last few years. “The interplay between regular industries and healthcare is greater than it’s ever been, and that’s also driving lower cost and greater efficiency,” he stated. “We know so much more now than we did about healthcare cost. We’re engaging the consumer in more efficient ways to deliver healthcare.”

Employer-Sponsored Healthcare

Underscoring an earlier point, Dashiff said transformation often happens in the private marketplace where there is more flexibility and a direct value proposition. An example is the worksite clinics that employers have historically used to improve productivity and reduce absenteeism. “What’s happened over the span of a couple of decades is you have employers, particularly self-insured employers, who

are probably the most in control of their destiny as it relates to improving outcomes and bending the cost curve. They are probably the most motivated party participating in the healthcare delivery system to pursue significant change,” said Dashiff. He added their position allows them to look at the unique intersection of the patient, provider, and ultimate employer payor coming together in a way that can use the onsite or shared-site clinics as a hub to serve an entire population health management strategy when wrapped with the appropriate analytics capabilities and tech-enabled solutions for engagement and virtual care outside the walls of the clinic. While worksite clinics have been around for decades, Dashiff said what has changed is the ability and desire of self-insured employers to be able to bring the various component parts of a population health strategy under one umbrella, coupled with the technology to stratify risk and identify employees and family members who might benefit from specific interventions. The beginning of last year saw Amazon, Berkshire Hathaway and JPMorgan Chase announce their plans to form an independent healthcare company for their employees, and a number of other large employers have begun exploring population health management projects, as well. In addition, Dashiff continued, “The more sophisticated players in employer-

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sponsored healthcare are doing more holistic things like narrow network management in connection with their approach. I believe this is an area where you’re going to see employer-sponsored healthcare evolve rapidly over the next several years and emerge as one of the more disruptive things that has happened to healthcare service delivery in a very long time. Not surprisingly, it will be another area of disruption that has been around a long time but simply had its model of care evolve.” He added, “As this all plays out, it won’t be at all surprising if you see similar models that address the commercial population, address the Medicare population, the Medicaid population. That’s not happening overnight, but the self-insured employer marketplace is happening now, and it’s pretty exciting.”

The Upside of Upheaval

“There continues to be a lot of areas in healthcare that have taken their licks over the years but are ubiquitous,” said Dashiff. Diagnostic imaging is an example where reimbursements took a pretty significant hit for several years. “That being said, imaging as a diagnostic modality is not going away. In fact, it’s a critical path area for effective and efficient care,” he pointed out. Dashiff added there isn’t much left to be taken away at this point so those reimbursement headwinds that

battered the sector have faded. He continued, “What you have left is a universe where the really good management teams figured out how to survive and come out on the other side. They figured out interesting strategies and are now at a point where they can grow with the market from a trend standpoint … and if they have the right strategy, they can grow market share.” That lean, mean model has become interesting to private equity firms looking for value. Dashiff said transactions are once again happening in areas like diagnostics and infusion that have weathered the storm. While change comes slowly … and sometimes painfully … in healthcare, Dashiff and Walker both pointed to very real signs of transformation and a growing willingness by industry stakeholders to innovate and rethink the business model to create a more efficient, more intuitive delivery system with a greater emphasis on wellness, early intervention and smarter disease management. “I think it’s a very exciting time in the industry both as a professional and as a patient,” said Walker. “The industry has just needed this efficiency for so long, and the innovation that’s taking place using best practices from other industries is creating new success stories across the healthcare continuum.”

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