November 13, 2019
By Oak HC/FT
Recently, Oak HC/FT’s Healthcare team completed our annual pilgrimage to HLTH, an industry event that has quickly become our favorite (and busiest) for the year.
We spent the week catching up with old friends and meeting new ones. Like last year, the conference was packed with phenomenal content delivered by leaders representing health systems, payers, pharma, employers, and the government (…plus a stellar performance by Flo Rida, who arguably topped the inimitable Wyclef Jean from 2018!). And we continue to be blown away by the companies that are pushing the envelope in Healthcare and making a meaningful impact.
The conference also gave our team a chance to take stock of the Healthcare industry as a whole and start to think about where it’s headed next. We thought we’d share a few of our thoughts about the major trends we see across the core constituents in the ecosystem.
Over the past decade, the number of enrollees in Medicare Advantage (MA) plans has doubled to 22 million, representing over a third of eligible lives. This has made MA a fertile environment for innovation, as risk-bearing plans (particularly new entrants like Devoted Health) find ways to deliver savings and improve quality versus traditional fee-for-service Medicare. We believe these trends will surely continue, especially as CMS allows health plans to be more creative in designing benefit plans and incentives.
Meanwhile, we think the next frontier of innovation will be in the world of Managed Medicaid. Thirty-nine states deliver at least some portion of Medicaid services through managed care organizations (MCO) and nearly three-quarters of eligible lives are covered by such plans. Increasingly, MCOs are focusing on quality and outcomes, broadening the services they offer and necessitating novel approaches to delivering care.
For the commercially insured population, the focus will remain on improving the customer experience by driving high NPS, expanding services and trying to create captive members. It will be fascinating to observe if health plans are finally able to drive brand loyalty by enhancing the member journey.
Telehealth services are shifting from what was once a novel offering just finding its footing to one that is becoming a “table stakes” benefit for employees. Across both primary and specialty care, employers are leaning on virtual care models to extend delivery beyond the clinic as acceptance by patients increases.
Just as telehealth went from obscurity to ubiquity, we are interested in employer investment behind underappreciated segments like women’s health and mental health. The most innovative employers are making inroads, but the real test in 2020 will be if broad adoption follows. The key will be for vendors in these markets — including Maven and Emilio Health — to demonstrate to employers that their investment will drive an ROI on their overall health spend.
As pharmaceutical companies face public pressure on drug pricing, they will have even greater incentives to find cheaper ways to develop new products. This means improving the ways they identify new therapeutics and execute clinical trials. As a result, we expect significant investment by pharma to do all they can to enhance speed and efficiency and companies like Sema4 help support these efforts.
The pharma landscape is also undergoing a massive shift in the way drugs are distributed. Amazon’s push into the market feels like an impending tidal wave. CVS and UPS have announced plans to deliver prescriptions via drone. WithMe Health — a modern replacement for traditional PBMs — reimagines the entire pharmacy supply chain. And instead of waiting for a doctor’s diagnosis, consumers can increasingly request specific drugs (usually focused on sexual health) with little more than a click of a button. The days of dropping off and picking up a prescription at a local pharmacy are undoubtedly waning.
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Stay tuned for part two of this post, where we share our views on where Healthcare is headed for providers, consumers, and government regulation.