Event Horizon for the Healthscape: Part II

This article is the second in a series. To catch up, read Part I first.

By now, 72% of employers offer at least 1 consumer-driven healthcare policy, pushed heavily by human resources directors with promises of lower premiums. Why? Because Millennials aren’t the chronically ill who are devouring the nearly $600 billion in Medicare payments. These deductibles are high because it’s assumed the under-35 demographic doesn’t need utilization of care. This paradigm shift has only expanded with the launch of healthcare exchanges.

The result?

Healthcare shopping based on up-front price transparency and convenience for an increasingly overworked population. Even though 50% of Medicare payments will be tied to quality or value by 2018, traditional hospitals and clinics haven’t turned their compasses to accommodate a new market, a gaping hole now being served by retail health under the banners of CVS, Walgreens, Wal-Mart, and others.

When the single largest population only visits a physician twice a year, why go to your local health network when you can pop into a CVS clinic, be seen by a licensed nurse practitioner within half an hour, and walk ten feet to the pharmacy for any needed prescriptions? You can even use the retail clinic’s app to travel the continuum of care, from discharge instructions to refill reminders.

Traditional health networks, which have been dependent on intra-network referrals and guaranteed fee-for-service payments, operate on a 1% to 3% margin. As the U.S. Healthscape approaches our Event Horizon into true fee-for-value reimbursement, it’s imperative that these same networks recognize and pivot to a consumer-based model that provides world-class chronic care to an aging Baby Boomer generation while also offering the consumerization and its incentives to the health population who’s reading this blog on a smartphone right now.

We may not know exactly how the Healthscape will look beyond its Event Horizon, but with the right on-board navigation system, we could be looking at the dawn of a new era—more streamlined, more patient-friendly, more convenient, more personal.

More beautiful.

Sources:

  • Beth Seidenberg, KPCB General Partner
  • Lynne Chou, KPCB Partner
  • CMS National Health Expenditure Projections 2013-2023, National Business Group Survey Aug. 2014

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