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Follow the money healthcare business models - seattle startup week

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Follow the money healthcare business models - seattle startup week

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Healthcare business models are particularly challenging to distinguish between customers, buyers, and the users. Many claim we are moving away from our business as usual “fee for service” to value based reimbursement. What does this mean for digital health, biotech and device entrepreneurs and what is the timing for this change? Who pays for any solutions in healthcare? Where can you be successful?

This session will start with a discussion of healthcare customers: insurance companies, hospitals, doctors, patients, and consumers. We will focus on the unique challenges that each present. What defines winning for each player? And what does each player need to do to win.

We will propose various approaches to help your business models succeed by drawing on our own healthcare startup and corporate experiences

Healthcare business models are particularly challenging to distinguish between customers, buyers, and the users. Many claim we are moving away from our business as usual “fee for service” to value based reimbursement. What does this mean for digital health, biotech and device entrepreneurs and what is the timing for this change? Who pays for any solutions in healthcare? Where can you be successful?

This session will start with a discussion of healthcare customers: insurance companies, hospitals, doctors, patients, and consumers. We will focus on the unique challenges that each present. What defines winning for each player? And what does each player need to do to win.

We will propose various approaches to help your business models succeed by drawing on our own healthcare startup and corporate experiences

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Follow the money healthcare business models - seattle startup week

  1. 1. Follow the Money in Healthcare: Business Models 1 Geoffrey Baker Managing Director Michael Uradnik CEO www.cascadebh.comwww.venadvisory.com
  2. 2. 2 • Follow the money • Healthcare Value Chain – Who, What, Where, and How? • Opportunities – Changes & Shifts in healthcare • Finding the Right Business Models • Where to Play and Not Play - Entrepreneurial opportunities • Healthcare Business Model Case Study • Discussion Session Introduction 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health 2
  3. 3. 33 Just Follow the Money 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  4. 4. Healthcare Value Chain 4 Source: The World Financial Review (9-2012), “The Business of Healthcare Innovation: Convergence in the Marketplace.” 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  5. 5. Disruption & Change Lacking Open Standards Data Integration, Interoperability, Connectivity Aging Population Substandard Healthcare Value, Safety & Waste Need for Patient Centered Care Unaffordable, Uncoordinated, Inaccessible Care 5 A’s Government Intervention & Compliance Need for Transparency Precision Medicine Drivers of ChangeDrivers of Change 52015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  6. 6. Paradigm Shift 6 Source: #1 HLTH 807 Sources: Frost & Sullivan, June 2015
  7. 7. 7 Crowded Digital Health Marketplace 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  8. 8. page 8 Where Are You In Your Business Model Journey? Source: Bill Aulet, MIT Entrpreneurship Center, “Disciplined Entrepreneurship: 24 Steps to a Successful Startup” 2013 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  9. 9. 9 • Profit Model: How you make money. • Network: How you connect with others to create value. • Structure: The organization and alignment of talent, resource and assets. • Process: Developing and implementing unique or superior methods. • Product Performance: the development of distinguishing features and functionality. • Product System: the creation of complementary products and services. • Service: supporting and amplifying the value of your offerings. • Channel: The way in which your offerings is brought to customers. • Brand: The representation of your offerings and business. • Customer Engagement: Fostering compelling interactions. Why is your Business Model Innovative? Source: Perkin [2014]; Kelley, L. et al. 2013. Profit Model Network Structure Process Product Performance Product System Service Channel Brand Customer Engagement C O N F I G U R A T I O N O F F E R I N G E X P E R I E N C E 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  10. 10. Finding the Right Business Models in Healthcare Source: Ash Maurya (Running Lean) 2012 adaptation of Business Model Generation (2009) Canvanizer.com Leanstack.com Start with Lean Business Canvas Model
  11. 11. Orbits 11 (1) Center for Medicare and Medicaid Services, Office of the Actuary, April 2010. (2) CPT code 99490 - chronic condition management $42.60 (3) Steve Blank “The Startup Owner’s Manual” $635 BN (1) Chronic Care Conditions $17BN (2) CPT 99490 Served Available Market Target Market Total Addressable Market (TAM) (100% market share) (3) 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  12. 12. 12 What Value Does Your Business Model Create for Customers? 12 Metrics Improved Solution Value Growth Efficiency LeversValue levers Customers New Markets New & optimized products & services Channels Consumption & Pricing models Lower Cost Process Improvement Capability Maturity Velocity Quality Outcomes General Industry Healthcare • Triple Aim • Better Experience • Better Access • Less Disparity • Better Outcomes • Lower Cost • Reduced waste • Patient Safety • Care Coordination • Payment for value + Customers New Markets New & optimized products & services Channels Consumption & Pricing models Process Improvement Lower Cost Capability Maturity Velocity 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  13. 13. 13 What is your Business Model Evidence? #’s are Illustrative Only 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  14. 14. 14 Live Case Study – MVP lean validation interview with customer 14 2015, Seattle Start-up Week. Venture Advisory Services, Cascade Behavioral Health
  15. 15. PROBLEM 1. Caseworkers must manage hundreds of patients, but can only reach 10% on any day. There’s not enough resources. 2. Crisis helpline nurses have no automated intake to expedite calls or triage. 3. Patient satisfaction and patient outcomes survey results are delayed and expensive to collect. Mental Health Virtual Intelligent Assistant SOLUTION 1. Supports care health risk assessments, coordination, self-care between visits, treatment compliance. Notifies nurses and caregivers of progress results interactions. 2. Outreach prompts patient adherence to advice, medications and modifies behaviors. 3. Reduce anxiety and information burden on patient to comprehend complex information with multiple choices. Support patient decision- making for treatments. UNIQUE VALUE PROPOSITION 1. Regularly prompt patients to self-report status and progress on therapy sessions. Therapists have far more information about patients between visits. 2. VIA guides patients in conversation through difficult choices for treatments. 3. VIA interpretation, explanation and alert routing of wearable sensor results. 4. VIA natural conversation call with a patient regarding their satisfaction with recent service experience. CUSTOMER SEGMENTS 1. Health Coaching, Behavioral coaching 2. Clinics/Hospitals 3. Call Centers, Nurse Helpline Intake COMPETITION Virtual Care Assistants (Nuance – Nina, VirtOz, CDI, Gamgee/22 Otters, Get Abby, Next IT – Alme, IBM Watson, Great Call, Welltok/IBM). Horizontals. Mental Health (Ginger IO, Lifegraph, empower interactive, breakthrough, Intellicare, Big White Wall, Talkspace, Optimism) Patient Satisfaction (Press Gainey) REVENUE STREAMS Transaction based, Cognition- as-a-Service (API); i.e., $0.004 per request, Query volume pricing, mo. subscription cost for licensing technology Therapy digital visits at $40/20 min session CHANNELS (Licensing Technology) Medicaid MCOs (Molina, Centene, United Behavorial Health, Lantern Health), Telemedicine HIT (MD Live/Breakthrough, Carena, Teladoc, GE- Intel CareInnovations), HIT Companies (EMRs, CDI), Urgent Care (QAlliance), Wearables (biometric, Samsung, ANT, apple), Care Coordination Outreach (Emmi Solutions, + 100 more) MARKET SIZE $3N Market (2020) (Nuance ~1BN in HC), 30% CAGR TIME TO MARKET 11X Mos, High velocity
  16. 16. Take Aways...What did we learn? 10/28/2015 16

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