Diese Präsentation wurde erfolgreich gemeldet.
Wir verwenden Ihre LinkedIn Profilangaben und Informationen zu Ihren Aktivitäten, um Anzeigen zu personalisieren und Ihnen relevantere Inhalte anzuzeigen. Sie können Ihre Anzeigeneinstellungen jederzeit ändern.

Virtical Integration in Healthcare

Internal Sharing about different integration in healthcare

  • Als Erste(r) kommentieren

  • Gehören Sie zu den Ersten, denen das gefällt!

Virtical Integration in Healthcare

  1. 1. Virtical IntegrationVirtical Integration in Healthcarein Healthcare By 2019-09-02 Jazz Yao-Tsung Wang 1
  2. 2. My first impression ...My first impression ... Reviewing my idea for DevCon 2018 after I joined for 6 months ... Vertival Integration of Data Pipeline from Provider to Payer for providing Value to Consumer DevCon 2018 Ideation by Jazz Yao-Tsung Wang @ 2018-07-14 2
  3. 3. Business Model: B-to-B-to-C ( CHC - Payer - Patient ) Deliverable: Web Services for each Payer that help Patient to identify their best package for each payer. Value proposition for Payer: Customer Relationship Management (inspired by Telecom fare diagnosis service in Taiwan). 3
  4. 4. Vertical Integration in "Change Healthcare"?Vertical Integration in "Change Healthcare"? -- Source: https://www.google.com/search?q="vertical integration"+site%3Achangehealthcare.com 4
  5. 5. But ...But ... Learned from the perspective of Cardiologist -- Source: "Vertical vs Horizontal Integration in Cardiac Surgery", Arie Blitz, MD, 2015 Vertical vsVertical vs Horizontal Integration in Cardiac SurgeryHorizontal Integration in Cardiac Surgery A presentation from the 2015 The New Orleans Conference covering the topic of integration in healthcare and how it a ects those in the cardiac surgery specialty. https://www.youtube.com/watch?v=S40xaVjmetM 5
  6. 6. DefinitionsDefinitions 6
  7. 7. What is "Horizontal integration"?What is "Horizontal integration"? -- Source: Horizontal integration Horizontal integration is the process of a company increasing production of goods or services at the same part of the supply chain. A company may do this via internal expansion, acquisition or merger.[1][2][3] The process can lead to monopoly if a company captures the vast majority of the market for that product or service.[3] Horizontal integration contrasts with vertical integration, where companies integrate multiple stages of production of a small number of production units. Horizontal alliance Aspects of horizontal integration Media terms Examples See also References Horizontal integration is related to horizontal alliance (also known as horizontal cooperation). However, in the case of a horizontal alliance, the partnering companies set up a contract, but remain independent. For example, Raue & Wieland (2015) describe the example of legally independent logistics service providers who cooperate.[4] Such an alliance relates to competition. A diagram illustrating horizontal integration and contrasting it with vertical integration. Contents Horizontal alliance Aspects of horizontal integration https://en.wikipedia.org/wiki/Horizontal_integration 7
  8. 8. Horizontal integrationHorizontal integration Increase production of goods or services at the same part of the supply chain via: internal expansion acquisition merger 8
  9. 9. What is "Vertical Integration"?What is "Vertical Integration"? -- Source: Vertical integration In microeconomics and management, vertical integration is an arrangement in which the supply chain of a company is owned by that company. Usually each member of the supply chain produces a different product or (market-specific) service, and the products combine to satisfy a common need. It is contrasted with horizontal integration, wherein a company produces several items which are related to one another. Vertical integration has also described management styles that bring large portions of the supply chain not only under a common ownership, but also into one corporation (as in the 1920s when the Ford River Rouge Complex began making much of its own steel rather than buying it from suppliers). Vertical integration and expansion is desired because it secures the supplies needed by the firm to produce its product and the market needed to sell the product. Vertical integration and expansion can become undesirable when its actions become anti-competitive and impede free competition in an open marketplace. Vertical integration is one method of avoiding the hold-up problem. A monopoly produced through vertical integration is called a vertical monopoly. Vertical expansion Three types of vertical integration Problems and benefits Internal gains Internal losses Benefits to society Losses to society Selected examples Birdseye Alibaba Steel and oil Telecommunications and computing A diagram illustrating horizontal integration and contrasting it with vertical integration. Contents https://en.wikipedia.org/wiki/Vertical_integration 9
  10. 10. Vertical IntegrationVertical Integration Bring large portions of the supply chain not only under a common ownership, but also into one corporation Three types of Vertical Integration: (A) backwards (upstream), (B) forwards (downstream), (C) balanced (both upstream and downstream) 10
  11. 11. Goal of Vertical Integration in HealthcareGoal of Vertical Integration in Healthcare Create superiorCreate superior ValueValue in the healthcare marketplacein the healthcare marketplace - improving patient care quality- improving patient care quality - bending the cost curve- bending the cost curve Remember the de nition of Healthcare Value in "Value-based Healthcare" sharing? Healthcare Value ↑ =  Cost of Care  ↓ Quality of Care  ↑ 11
  12. 12. Vertical Integration in Healthcare ProviderVertical Integration in Healthcare Provider OutpatientInpatient Hospital ED Hospitalist Specialist Nurses Inpatient Nurse Practitioner Primary Care Cardiologist Interventionalist Cardiac Surgeon Outpatient Emergency department (ED) -- Source: "Vertical vs Horizontal Integration in Cardiac Surgery", Arie Blitz, MD, 2015 https://www.youtube.com/watch?v=S40xaVjmetM 12
  13. 13. Vertical Integration: 80’s Fad or Health Care’s Future?Vertical Integration: 80’s Fad or Health Care’s Future? July 1, 1997 -- Source: "Vertical Integration: 80’s Fad or Health Care’s Future?", 1997-07-01 https://www.strategy-business.com/article/18205?gko=a00f6 13
  14. 14. Cases for Vertical Integration between Payors and ProvidersCases for Vertical Integration between Payors and Providers owning physicians gives a health plan greater in uence over practice patterns and reduces the use of medical resources owning hospitals allows an insurer to control medical facility capacity and generate lower unit costs combining insurance, physician and hospital components under one entity yields reductions in administrative costs -- Source: "Vertical Integration: 80’s Fad or Health Care’s Future?", 1997-07-01 https://www.strategy-business.com/article/18205?gko=a00f6 14
  15. 15. Vertical Integration throughtoutVertical Integration throughtout 1980's1980's ...... Kaiser expand its owned hospitals and contracted exclusively with the Permanente Group Aetna built sta model clinics across the country CIGNA also built sta model clinics and acquired the Lovelace integrated health system FHP owned health plans, physician clinics and hospitals Prudential invested in the "group model" and owned/managed clinic assets Humana owned health plans and hospitals Henry Ford Hospital System, Sentara and Geisinger started up their own 's -- Source: "Vertical Integration: 80’s Fad or Health Care’s Future?", 1997-07-01 H.M.O. H.M.O. https://www.strategy-business.com/article/18205?gko=a00f6 15
  16. 16. Horizontal Consolidation inHorizontal Consolidation in 1990's1990's Kaiser is renting hospital capacity rather than owning it, and has started to contract with non- Permanente physicians to supplement its core networks. Aetna sold its physician practice management company to MedPartners. CIGNA divested its southern California clinics to MedPartners. FHP sold its hospitals and created a separate subsidiary for its group practice, ostensibly as a rst step toward spinning it o . -- Source: "Vertical Integration: 80’s Fad or Health Care’s Future?", 1997-07-01 https://www.strategy-business.com/article/18205?gko=a00f6 16
  17. 17. Why refocus on vertical intergration again?Why refocus on vertical intergration again? Affordable Care Act (ACA)Affordable Care Act (ACA) March 23,March 23, 20102010 -- Source: https://en.wikipedia.org/wiki/Patient_Protection_and_A ordable_Care_Act 17
  18. 18. ACAACA encourages integrationencourages integration Payment Reform Pay-for-performance (P4P) Bundled payments Episodes of Care Coverage of uninsured Health Care Delivery Medical Homes being formed Accountable Care Organizations (ACOs) Reengineering of care -- Source: "Vertical vs Horizontal Integration in Cardiac Surgery", Arie Blitz, MD, 2015 https://www.youtube.com/watch?v=S40xaVjmetM 18
  19. 19. The Way Forward for Integrated CareThe Way Forward for Integrated Care 31 March,31 March, 20142014 -- Source: "The Way Forward for Integrated Care", 2014-03-31 https://ldi.upenn.edu/way-forward-integrated-care 19
  20. 20. Hospital-Physician IntegrationHospital-Physician Integration -- Source: "The Way Forward for Integrated Care", 2014-03-31 The percentage of physicians employed by hospitals has increased from 11% in 2000 to nearly 15% in 2008. It has led to nancial losses approaching $200,000 per year per physician, double the losses incurred during the early period of integration in the 1990s. https://ldi.upenn.edu/way-forward-integrated-care 20
  21. 21. Physician - Hospital - Health Plan IntegrationPhysician - Hospital - Health Plan Integration -- Source: "The Way Forward for Integrated Care", 2014-03-31 Another form of vertical integration is between providers and health insurance plans. There are several well-known examples of these systems, including Kaiser Health Plan and other major integrated systems (e.g., Mayo Clinic, Cleveland Clinic). The success of these integrated systems can be attributed to a number of features, in particular a notably physician-driven system, uni ed clinical and administrative cultures, a long history with su cient time to develop this culture, and strong economic interdependence among their three arms (the physicians, the hospital, and the health plan). https://ldi.upenn.edu/way-forward-integrated-care 21
  22. 22. "Virtual Integration" ?"Virtual Integration" ? -- Source: "The Way Forward for Integrated Care", 2014-03-31 There is also a movement towards "virtual integration" which allows a physician to remain independent but exploit some of the advantages of group practice, including centralized administration, risk spreading, and leverage with health plans. https://ldi.upenn.edu/way-forward-integrated-care 22
  23. 23. Vertical Integration in Healthcare Provider (PROs & CONs)Vertical Integration in Healthcare Provider (PROs & CONs) -- Source: "Vertical vs Horizontal Integration in Cardiac Surgery", Arie Blitz, MD, 2015 https://www.youtube.com/watch?v=S40xaVjmetM 23
  24. 24. Horizontal Integration in Healthcare Provider (PROs & CONs)Horizontal Integration in Healthcare Provider (PROs & CONs) -- Source: "Vertical vs Horizontal Integration in Cardiac Surgery", Arie Blitz, MD, 2015 https://www.youtube.com/watch?v=S40xaVjmetM 24
  25. 25. Economic Barriers to IntegrationEconomic Barriers to Integration -- Source: "Vertical vs Horizontal Integration in Cardiac Surgery", Arie Blitz, MD, 2015 Fee-for-service (FFS) https://www.youtube.com/watch?v=S40xaVjmetM 25
  26. 26. Vertical Integration in HealthcareVertical Integration in Healthcare Doesn’t Boost Care QualityDoesn’t Boost Care Quality February 14,February 14, 20192019 -- Source: "Vertical Integration in Healthcare Doesn’t Boost Care Quality", 2019-02-14 A new study from Rice University’s Baker Institute for Public Policy shows vertical integration in healthcare has little to no impact on care quality. https://revcycleintelligence.com/news/vertical-integration-in-healthcare-doesnt-boost-care-quality 26
  27. 27. How about the role ofHow about the role of "Platform""Platform" in Vertical Integration?in Vertical Integration? 27
  28. 28. DiscussionDiscussion The position ofThe position of Change HealthcareChange Healthcare in Vertical Integration?in Vertical Integration? 28
  29. 29. Let's take a look atLet's take a look at RolesRoles inin Digital Marketing (AdTech)Digital Marketing (AdTech) -- Source: "Data Pipeline Matters -- take tracking pixel as an example", Jazz Yao-Tsung Wang, 2018 https://www.slideshare.net/jazzwang/data-pipeline-matters 29
  30. 30. Revisit the position of Change HealthcareRevisit the position of Change Healthcare Mapping roles in "Healthcare IT" and "Digital Marketing (AdTech)" ... Digital Marketing (AdTech) ⟷ Healthcare IT Audience: Website Visitor ⟷ Consumer: Patient Demand side: Budget Source ⟷ Payer: Insurer Platform: Advertising Network ⟷ Financial Data: Cleaning House Clinic Data: CommonWell Supply side: Publisher (Website) ⟷ Provider: Hospital, Clinic, Dental, Lab Can we reproduce the Disruptive innovation in AdTech like Facebook? 30
  31. 31. Q & AQ & A Today's sharing is majorly talking about different types of "Supply Chain"different types of "Supply Chain" in healthcare!! 31

×