A client with cutting-edge technology for point-of-care clinical decision support for providers was pursuing opportunities to expand into the adjacent payer and pharmaceutical markets.
Expansion into new markets meant a whole new set of direct and indirect competitors. Health Business Group provided an in-depth perspective on the market and competitive environment for health care analytics across the relevant markets and helped the client understand how the market would evolve over time.
We segmented the analytics market by major customer type, estimated the size and growth of each segment, and identified the leading players in each segment. We did extensive analysis of the top 15 to 20 competitors in each major segment. This work included a detailed outline of service offerings, customer segments served, key customers, value proposition, size and growth, alliances, M&A activities, sources of data, pricing structure and levels, reputation, and strategic intent. A fact base was constructed through a combination of primary and secondary research, including company and customer interviews, industry conferences, market research, SEC filings, and analyst reports.
With a shared, in-depth understanding of the current and evolving health care analytics marketplace and the key players, we worked with management to develop a set of strategic and tactical implications, including business development, product development, pricing, positioning, and bundling.
The client highly valued our work product and collaborative process. Over the following year, the client was successful in expanding into new markets and was ultimately acquired by a national health plan.
A leading provider of physician clinical decision support tools asked Health Business Group to assist in developing a business case for a platform for professional mobile medical apps. The mobile app market had undergone rapid growth and transformation over the past several years and all indications were that this space would continue to be highly dynamic.
We structured our work to focus on three areas:
- Competitive environment to understand how the overall app market was evolving, how the medical apps segment fit into the overall market, and how competitors were approaching the space.
- Customer demand to understand current mobile hardware and apps usage by customers, considerations for pricing models, and expectations for future spending
- Internal capabilities to assess the client’s ability in addressing the mobile app market (e.g., app development, curation, hosting, marketing, support), to identify gaps and to develop strategies to fill those gaps
We built a fact base by conducting extensive primary and secondary research including interviews with established and emerging players, electronic surveys of customers, and review of market research and analyst reports. With the fact base in place we collaborated with the client team to develop and evaluate strategic options and made introductions to several potential business development partners and acquisition targets.
A leading integrated practice management and electronic health records company asked Health Business Group to research best practices and benchmarks for lead generation fees paid to channel partners for referring new business. The client's compensation structure and levels needed to be refreshed due to the company’s evolving product portfolio and changes in market conditions.
We estimated fair market value based on market norms for compensation rates and structures by researching the fees received by third parties for comparable lead generation services. This comprised market interviews with referrers, compensation experts and comparable companies, plus secondary research to identify published benchmarks. In addition, we compared market norms to the cost of lead generation by the company’s internal marketing team.
As a follow-on project we extended the analysis to two newly acquired business units.
The Forum for Collaborative HIV Research is an independent public-private partnership, which facilitates and enhances HIV research by framing difficult issues and helping to establish research strategies. Its members include governmental agencies such as NIH and FDA, private industry including big pharma and biotech, academic researchers from leading institutions, providers, foundations and the advocacy community. The Forum is the only organization that regularly brings together such a wide spectrum of participants for open, collaborative discussion in a neutral setting.
The Forum has been instrumental in moving the field forward. It has led the way in defining research programs for therapeutic vaccines, metabolic abnormalities, salvage therapy, and prevention.
With its initial 5-year funding mandate coming up for renewal, the Forum needed a business plan to serve as the basis for its funding request and to organize its programs for the future. David Williams led the effort to objectively document the Forum’s value to its varied constituencies, demonstrate the Forum’s uniqueness, develop a five-year financial plan, and lay out a compelling argument for continued funding in an environment of tightening budgets. Health Business Group activities included interviewing Executive Committee members, analyzing the results of past projects, benchmarking other HIV-related organizations and public private partnerships, financial planning, and business plan writing.
Since completing the business plan, Health Business Group has continued in an advisory role to help the Forum implement its plan and recruit new members. The Forum has grown and prospered, and has become an integral part of the University of California Berkeley’s School of Public Health.
A statewide electronic health care collaborative was nearing the end of its pilot funding from a large payer. The collaborative needed support in developing a broader funding plan in order to achieve its full statewide objectives. The collaborative brought together the state’s main health care stakeholders to overcome the barriers to electronic health record (EHR) adoption. The initial pilots were considered widely successful and provided lessons learned that would inform the planning for statewide rollout. The goal was to reach 90 percent EHR adoption by physicians in six or seven years, up from the 15 to 20 present EHR penetration estimated at the outset of the work.
Over 145 regional health care information organizations had developed over the prior several years. Many had failed, most commonly due to the lack of a compelling, sustainable business model.
Health Business Group developed a capital funding plan to enable statewide roll out of EHRs in physician offices as well as a health information exchange to connect electronic health data together across providers. The plan identified the resources required and alternative funding formulas based upon the pilot experience, projections, and other analogous benchmarks. Various options were developed and evaluated across several criteria including simplicity, equity, and alignment of incentives shared by all stakeholders.
As a result of our success in uniting the key constituencies around a statewide rollout plan, the state legislature approved a multi-year initiative to provide tens of millions of dollars in funding for statewide EHR rollout.
Around the same time, the federal government launched its Meaningful Use initiative to support EHR rollout. The client was well positioned and obtained substantial federal funding to expand its work. The client developed a strong reputation that it leveraged with the creation of a for-profit professional services group, which was developed with assistance from a Health Business Group team.
A major retail pharmacy chain asked Health Business Group to undertake a review of its medication information offerings. The client had assigned ownership for the project to the online group, but we encouraged the company to view the opportunity more broadly than simply a website content strategy.
We conducted data gathering and analysis in three areas:
- Consumer demand, to determine how important medication information is to consumers and to zero in on key areas of interest
- Competitive differentiation, to learn what competitors were doing and what the client could do that others could not
- Client business drivers, to assess how the client could leverage medication information to drive business results
We spent time behind the counter in a variety of retail stores, observing the work of the pharmacists and other staff and developing an understanding of their needs. We developed mockups of potential medication information offerings and participated in focus groups with several segments of consumers to identify those that were most compelling.
Working with a client team we developed a framework to categorize different types of medication information and to assess them on criteria such as their dependency on in-store pharmacists, customer segments addressed, level of differentiation, and ease of implementation.
We developed an overall strategy and a rollout plan for the client’s entire retail network.
Health Business Group has assisted many clients in developing their growth strategies, often tapping into new products and services in existing customer segments and assisting clients in expanding into new customer segments. An outsourced health care services client was interested in expanding into a new market segment by providing medical cost containment solutions and asked Health Business Group to evaluate the market and perform due diligence on a potential acquisition.
There are different approaches to medical cost containment, many of which rely upon claims analysis. From a clinical perspective, this can be used for intelligent benefit plan design and risk stratification for disease management and wellness initiatives, screening for medical necessity/appropriateness, and other uses. From a financial perspective, this analysis can be used for claims re-pricing, claims arbitration/negotiation, and fraud and abuse identification.
In our assessment, we found that the market was slowly evolving from best-of-breed to one-stop-shop as a way to simplify the supply chain and minimize integration points of failure. The rate of evolution was constrained by the ability of the vendors to offer broad, fully-featured solutions.
We evaluated the needs of the self-funded employer market and how they were being met by TPAs and service/technology providers. We conducted primary and secondary research, which included speaking with TPAs, employers, brokers, and peers of the client. We further segmented the target customer markets, determining the size, degree of outsourcing, level of satisfaction, and the target company’s competitive positioning in each segment.
Ultimately, we determined that the target was well-positioned for future growth and would be a complement to our client’s strategy. The acquisition was subsequently completed.
A leading hospitalist company was seeking additional growth and evaluating long-term strategic alternatives to maintain a differentiated offering in the marketplace.
The overall hospitalist market is large and growing, due to increasing acceptance from community physicians, demand from hospitals for new programs and expansion of existing programs, and a growing realization that insourced solutions have drawbacks.
To determine our client’s current market positioning and growth opportunities, we spoke with current and past customers as well as potential customers. Through this process we gained a thorough understanding of customer needs, level of satisfaction, performance metrics, and operational considerations. This formed the basis of a market model of size and growth of the hospitalist industry. We further segmented this analysis to represent market potential by geography, size, and hospital type/ownership. In addition, we analyzed the competitive landscape and evaluated our client’s market positioning and differentiation.
We made specific recommendations in many areas across the business. Within sales and marketing, we helped the client refine and improve its value proposition to target hospitals and to incorporate our hospital segmentation database into sales planning efforts and marketing materials. In product development, we recommended that the client evolve its existing product offerings to address emerging issues (e.g., public reporting of quality and patient satisfaction, IT optimization). From a human resources perspective, we analyzed the labor supply and trends and made specific suggestions on how to bolster physician recruiting and retention. Lastly, we identified and profiled several acquisition targets.
Advanced Practice Strategies (APS) is a medical risk management company, which partners with leading professional liability carriers such as the Harvard Risk Management Foundation/CRICO to develop demonstrative evidence for use at malpractice trials and to provide online continuing medical education (CME) to health care providers to improve patient safety and risk management.
Health Business Group’s relationship with APS began in 2005. Initially we provided business development support and strategic advisory services to help the company negotiate or renegotiate agreements with content and distribution partners. As we helped the company gain traction we realized that the commercial potential of APS could be maximized by going beyond the bounds of a traditional consulting relationship.
In 2007, the Health Business Group team secured a round of growth financing for APS. Dennis Ferrill left our consulting practice to become CEO of APS, and David Williams became chairman of the board of directors while remaining at Health Business Group full time.
The company entered an era of growth and prosperity characterized by national expansion and development of strategic partnerships with leading hospitals, liability carriers and universities. In 2012 Ascension Health Ventures made a substantial investment in APS to support continued growth and product development.
A leading medical technology company asked Health Business Group to evaluate whether the company should expand its presence in the market for remote patient monitoring (RPM) for chronic illness. RPM is a promising technology that has the potential to address fundamental issues in health care, especially the rising demand for chronic care coupled with caregiver shortages and financial constraints. However, the potential for RPM has not been realized; reimbursement is just beginning to emerge and few RPM companies have prospered.
Opinion within the client’s senior management was sharply divided. Some thought the company should move boldly into the market through major acquisitions while others thought the sector should be avoided entirely.
Health Business Group and the client chartered a joint project team to conduct research and make recommendations. We researched the strength and nature of customer demand, which we compiled through interviews and secondary sources. We identified and profiled a set of vendors and competitors, and conducted in-person evaluation sessions with the joint team.
Relying on our experience in disease management we developed a quantitative economic value creation model to demonstrate the potential return on investment from RPM for a variety of chronic conditions, including diabetes and heart failure. Finally, we established a set of strategic options and evaluated them according to objective criteria.
In the end the joint team adopted a robust set of strategic recommendations that unified top management’s thinking and set the company on a defensible strategic course.