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SCALEit	
  Inspire	
  Århus,	
  	
  
16.	
  August	
  2013	
  
_________________________________	
  
	
  	
  
Keynote	
  indlæg	
  
	
  
	
  
Hans	
  Erik	
  Henriksen	
  
Business	
  Development	
  Manager	
  
CompuGroup	
  Medical	
  Danmark	
  A/S	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  1	
  
Agenda	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  2	
  
•  IntroducLon	
  to	
  CompuGroup	
  Medical	
  
•  USA	
  market	
  experience	
  
•  The	
  USA	
  healthcare	
  market	
  opportunity	
  
•  What	
  does	
  it	
  take	
  to	
  make	
  it	
  in	
  the	
  U.S.	
  ?	
  
•  What	
  did	
  I	
  learn	
  ?	
  
•  What	
  would	
  I	
  focus	
  on	
  if	
  I	
  started	
  building	
  a	
  company	
  ?	
  
	
  
	
  
"   Best	
  provider	
  of	
  IT	
  soluDons	
  for	
  higher	
  quality	
  	
  
and	
  efficiency	
  in	
  the	
  healthcare	
  system	
  
"   Worldwide	
  market	
  leader	
  in	
  MIT	
  
(Medical	
  InformaDon	
  Technology)	
  
"   High	
  profitability	
  and	
  30%	
  annual	
  growth	
  
CompuGroup	
  Medical:	
  >385,000	
  customers	
  in	
  34	
  countries	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  3	
  
Goals	
  
	
  2011 	
  Prel.	
  Results	
  2012	
  
Customers 	
  ca.	
  385,000 	
  	
  
Revenue 	
  €	
  397	
  M 	
  €	
  451	
  M	
  
EBITDA 	
  €	
  73	
  M 	
  €	
  105	
  M	
  
Employees 	
  ca.	
  3,600 	
  	
  
Key	
  figures	
  
n	
  =	
  19	
  countries	
  with	
  own	
  locaLons	
  
n	
  =	
  addiLonal	
  15	
  countries	
  with	
  customers	
  
Strategy	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  4	
  
InternaDonal	
  corporate	
  
structure	
  with	
  strong	
  regional	
  
presence	
  and	
  unique	
  coverage	
  
of	
  healthcare	
  providers.	
  	
  
Coverage	
  
Therapist	
  
Rehab	
  
Center	
  
Insurance	
  Hospital	
  
Pharmacy	
  
Nursing	
  
Service	
  
Intelligent	
  connecDvity	
  of	
  all	
  
parDcipants	
  on	
  the	
  basis	
  of	
  
structured	
  medical	
  
informaDon.	
  
ConnecLvity	
  
So[ware	
  Assisted	
  Medicine	
  
(SAM)	
  for	
  more	
  efficiency,	
  	
  
for	
  greater	
  effecDveness	
  and	
  	
  
for	
  best	
  quality.	
  
Decision	
  Support	
  
	
  
CGM	
  	
  LIFE	
  eSERVICES	
  based	
  on	
  
vita-­‐X	
  technology.	
  
PaLent	
  
The	
  products	
  of	
  CompuGroup	
  Medical	
  help	
  to	
  increase	
  the	
  performance	
  of	
  healthcare	
  
systems	
  by	
  approximately	
  15%	
  to	
  20%.	
  	
  
USA	
  market	
  experience	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  5	
  
B-­‐Data	
   IBM	
   Cetrea	
  IBM	
  
•  CEO 2008 - 2012
•  Clinical Logistics
•  2008: 7 employees
– 2012: 38 empl.
•  80% of the Danish market
•  International customers
•  2001 - 2008
•  Healthcare Exec.,
•  North East Europe
•  Nordic
•  Denmark
•  ACURE due diligence
and Executive
•  1996-2001
•  Director, Sales and
delivery
•  Project Executive
•  1983 - 1996
•  Healthcare Market
Oppt. Manager
•  IBM Consulting Group
•  Systems Engineer
•  Avaleo: Chairman of the Board
IBM	
  US	
  
project	
  
IBM	
  WW	
  
HC	
  strategy	
  
EHR	
  project	
  based	
  
on	
  Danish	
  assets	
  
Cetrea	
  US	
  
entry	
  2010-­‐2012	
  
The	
  signing	
  of	
  the	
  PaLent	
  ProtecLon	
  and	
  Affordable	
  Care	
  Act	
  (PPACA)	
  of	
  2010	
  will	
  
drive	
  significant	
  change	
  for	
  the	
  United	
  States	
  healthcare	
  delivery	
  model	
  
Availability	
  of	
  affordable,	
  
value	
  based	
  care	
  for	
  the	
  
majority	
  of	
  Americans	
  	
  
While	
  reducing	
  costs	
  
Access	
   Affordability	
  
Key	
  highlights	
  
•  Establishes	
  health	
  insurance	
  exchanges	
  (new	
  markets	
  	
  that	
  provide	
  
economies	
  of	
  scale,	
  product	
  choice,	
  and	
  risk	
  pooling	
  of	
  large	
  firms	
  for	
  
individuals	
  and	
  small	
  businesses)	
  
•  Expands	
  coverage	
  through	
  the	
  Medicaid	
  program	
  
•  Provides	
  premium	
  subsidies	
  for	
  persons	
  living	
  below	
  400%	
  of	
  Federal	
  
Poverty	
  Guidelines	
  
•  Assures	
  guaranteed	
  coverage	
  and	
  also	
  prohibits	
  health	
  status	
  premium	
  
adjustments	
  
•  Requires	
  most	
  Americans	
  to	
  have	
  health	
  insurance	
  and	
  creates	
  individual	
  
and	
  employer	
  penalDes	
  for	
  people	
  without	
  coverage	
  
•  Will	
  be	
  funded	
  through	
  Medicare	
  and	
  Medicaid	
  spending	
  reducLons,	
  
addiDonal	
  Federal	
  tax	
  revenue	
  and	
  penalDes	
  
Affordability	
  will	
  require	
  major	
  changes	
  in	
  US	
  
care	
  delivery	
  
Increase	
  Health	
  Care	
  Value	
  
Improve	
  Quality	
  
Reduce	
  Costs	
  and	
  Spending	
  
Accountable	
  Care	
  
OrganizaLons	
  
Bundled	
  Payments	
  for	
  
Services	
  
Medical	
  Home	
  
Pay	
  for	
  Performance	
  
(Health	
  exchanges)	
  
Electronic	
  Quality	
  ReporDng	
  
Electronic	
  Health	
  Records	
  
Electronic	
  Sharing	
  and	
  Exchange	
  of	
  Health	
  InformaDon	
  
Goals	
  
IniDaDves	
  
Health	
  IT	
  
Obama	
  administraLon	
  subsidiaries	
  through	
  EHR	
  
Meaningful	
  Use	
  cerLficaLon	
  is	
  a	
  key	
  driver	
  
•  2011-2014: EMR’s and EMR implementation
•  2014-2016: E-health
•  2015- :
•  Patient Medical Home
•  Wellfare Technology
What	
  does	
  it	
  take	
  to	
  make	
  it	
  in	
  the	
  USA	
  ?	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  10	
  
•  The	
  right	
  product	
  
•  Truly	
  innovaDve	
  and	
  unique	
  
•  With	
  the	
  right	
  organizaDon	
  
•  Sales	
  organizaDon	
  in	
  the	
  US	
  is	
  not	
  enough	
  
•  NavigaDng	
  business	
  partners	
  and	
  compeDtors	
  
•  Why	
  will	
  a	
  business	
  partner	
  sell	
  your	
  product	
  ?	
  
•  How	
  will	
  compeDtors	
  react	
  ?	
  ”Me	
  too”	
  ?	
  
•  Patent	
  protecDon	
  strategy	
  
•  Product	
  cerDficaDons	
  
What	
  did	
  I	
  learn	
  ?	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  11	
  
•  Investment	
  is	
  not	
  an	
  issue	
  if	
  you	
  have	
  the	
  right	
  product	
  
•  A	
  Danish	
  background	
  is	
  a	
  big	
  advantage	
  
•  Denmark	
  reputaDon	
  
•  Danish	
  Trade	
  Council	
  support	
  and	
  Silicon	
  Valley	
  InnovaDon	
  Center	
  
•  PenetraDng	
  the	
  US	
  market	
  takes	
  Dme	
  
•  The	
  right	
  sales	
  organizaDon	
  is	
  crucial	
  
What	
  would	
  I	
  focus	
  on	
  if	
  I	
  started	
  building	
  a	
  
company	
  ?	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  12	
  
•  The	
  right	
  team,	
  organizaDon	
  and	
  board	
  
•  Mission,	
  Vision	
  and	
  Strategy	
  
•  Products	
  
•  Markets	
  
•  Company	
  
•  Focus	
  on	
  short	
  Dme	
  objecDves	
  
•  Product	
  referenceability	
  
•  DomesDc	
  market	
  
•  InternaDonal	
  markets	
  
•  Start	
  out	
  in	
  Denmark	
  ?	
  
•  Strong	
  domesDc	
  market	
  for	
  advanced	
  healthcare-­‐IT	
  
•  Seed	
  funding	
  
•  EU	
  tender	
  rules	
  
•  Start	
  out	
  in	
  the	
  U.S.	
  ?	
  
•  Investments	
  
•  Early	
  technology	
  adopters	
  
•  Market	
  and	
  culture	
  experience	
  
Agenda	
  
19/08/13	
   SCALEIt	
  Inspire	
  Århus,	
  16.	
  August	
  2013	
  13	
  
•  IntroducLon	
  to	
  CompuGroup	
  Medical	
  
•  USA	
  market	
  experience	
  
•  The	
  USA	
  healthcare	
  market	
  opportunity	
  
•  What	
  does	
  it	
  take	
  to	
  make	
  it	
  in	
  the	
  U.S.	
  ?	
  
•  What	
  did	
  I	
  learn	
  ?	
  
•  What	
  would	
  I	
  focus	
  on	
  if	
  I	
  started	
  building	
  a	
  company	
  ?	
  
	
  
	
  

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The US Health market opportunity

  • 1.   SCALEit  Inspire  Århus,     16.  August  2013   _________________________________       Keynote  indlæg       Hans  Erik  Henriksen   Business  Development  Manager   CompuGroup  Medical  Danmark  A/S   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  1  
  • 2. Agenda   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  2   •  IntroducLon  to  CompuGroup  Medical   •  USA  market  experience   •  The  USA  healthcare  market  opportunity   •  What  does  it  take  to  make  it  in  the  U.S.  ?   •  What  did  I  learn  ?   •  What  would  I  focus  on  if  I  started  building  a  company  ?      
  • 3. "   Best  provider  of  IT  soluDons  for  higher  quality     and  efficiency  in  the  healthcare  system   "   Worldwide  market  leader  in  MIT   (Medical  InformaDon  Technology)   "   High  profitability  and  30%  annual  growth   CompuGroup  Medical:  >385,000  customers  in  34  countries   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  3   Goals    2011  Prel.  Results  2012   Customers  ca.  385,000     Revenue  €  397  M  €  451  M   EBITDA  €  73  M  €  105  M   Employees  ca.  3,600     Key  figures   n  =  19  countries  with  own  locaLons   n  =  addiLonal  15  countries  with  customers  
  • 4. Strategy   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  4   InternaDonal  corporate   structure  with  strong  regional   presence  and  unique  coverage   of  healthcare  providers.     Coverage   Therapist   Rehab   Center   Insurance  Hospital   Pharmacy   Nursing   Service   Intelligent  connecDvity  of  all   parDcipants  on  the  basis  of   structured  medical   informaDon.   ConnecLvity   So[ware  Assisted  Medicine   (SAM)  for  more  efficiency,     for  greater  effecDveness  and     for  best  quality.   Decision  Support     CGM    LIFE  eSERVICES  based  on   vita-­‐X  technology.   PaLent   The  products  of  CompuGroup  Medical  help  to  increase  the  performance  of  healthcare   systems  by  approximately  15%  to  20%.    
  • 5. USA  market  experience   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  5   B-­‐Data   IBM   Cetrea  IBM   •  CEO 2008 - 2012 •  Clinical Logistics •  2008: 7 employees – 2012: 38 empl. •  80% of the Danish market •  International customers •  2001 - 2008 •  Healthcare Exec., •  North East Europe •  Nordic •  Denmark •  ACURE due diligence and Executive •  1996-2001 •  Director, Sales and delivery •  Project Executive •  1983 - 1996 •  Healthcare Market Oppt. Manager •  IBM Consulting Group •  Systems Engineer •  Avaleo: Chairman of the Board IBM  US   project   IBM  WW   HC  strategy   EHR  project  based   on  Danish  assets   Cetrea  US   entry  2010-­‐2012  
  • 6. The  signing  of  the  PaLent  ProtecLon  and  Affordable  Care  Act  (PPACA)  of  2010  will   drive  significant  change  for  the  United  States  healthcare  delivery  model   Availability  of  affordable,   value  based  care  for  the   majority  of  Americans     While  reducing  costs   Access   Affordability  
  • 7. Key  highlights   •  Establishes  health  insurance  exchanges  (new  markets    that  provide   economies  of  scale,  product  choice,  and  risk  pooling  of  large  firms  for   individuals  and  small  businesses)   •  Expands  coverage  through  the  Medicaid  program   •  Provides  premium  subsidies  for  persons  living  below  400%  of  Federal   Poverty  Guidelines   •  Assures  guaranteed  coverage  and  also  prohibits  health  status  premium   adjustments   •  Requires  most  Americans  to  have  health  insurance  and  creates  individual   and  employer  penalDes  for  people  without  coverage   •  Will  be  funded  through  Medicare  and  Medicaid  spending  reducLons,   addiDonal  Federal  tax  revenue  and  penalDes  
  • 8. Affordability  will  require  major  changes  in  US   care  delivery   Increase  Health  Care  Value   Improve  Quality   Reduce  Costs  and  Spending   Accountable  Care   OrganizaLons   Bundled  Payments  for   Services   Medical  Home   Pay  for  Performance   (Health  exchanges)   Electronic  Quality  ReporDng   Electronic  Health  Records   Electronic  Sharing  and  Exchange  of  Health  InformaDon   Goals   IniDaDves   Health  IT  
  • 9. Obama  administraLon  subsidiaries  through  EHR   Meaningful  Use  cerLficaLon  is  a  key  driver   •  2011-2014: EMR’s and EMR implementation •  2014-2016: E-health •  2015- : •  Patient Medical Home •  Wellfare Technology
  • 10. What  does  it  take  to  make  it  in  the  USA  ?   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  10   •  The  right  product   •  Truly  innovaDve  and  unique   •  With  the  right  organizaDon   •  Sales  organizaDon  in  the  US  is  not  enough   •  NavigaDng  business  partners  and  compeDtors   •  Why  will  a  business  partner  sell  your  product  ?   •  How  will  compeDtors  react  ?  ”Me  too”  ?   •  Patent  protecDon  strategy   •  Product  cerDficaDons  
  • 11. What  did  I  learn  ?   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  11   •  Investment  is  not  an  issue  if  you  have  the  right  product   •  A  Danish  background  is  a  big  advantage   •  Denmark  reputaDon   •  Danish  Trade  Council  support  and  Silicon  Valley  InnovaDon  Center   •  PenetraDng  the  US  market  takes  Dme   •  The  right  sales  organizaDon  is  crucial  
  • 12. What  would  I  focus  on  if  I  started  building  a   company  ?   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  12   •  The  right  team,  organizaDon  and  board   •  Mission,  Vision  and  Strategy   •  Products   •  Markets   •  Company   •  Focus  on  short  Dme  objecDves   •  Product  referenceability   •  DomesDc  market   •  InternaDonal  markets   •  Start  out  in  Denmark  ?   •  Strong  domesDc  market  for  advanced  healthcare-­‐IT   •  Seed  funding   •  EU  tender  rules   •  Start  out  in  the  U.S.  ?   •  Investments   •  Early  technology  adopters   •  Market  and  culture  experience  
  • 13. Agenda   19/08/13   SCALEIt  Inspire  Århus,  16.  August  2013  13   •  IntroducLon  to  CompuGroup  Medical   •  USA  market  experience   •  The  USA  healthcare  market  opportunity   •  What  does  it  take  to  make  it  in  the  U.S.  ?   •  What  did  I  learn  ?   •  What  would  I  focus  on  if  I  started  building  a  company  ?