Category: Case Studies

Channel partner compensation for electronic health record company

published date
December 1st, 2017 by

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.

Business plan for HIV research consortium

published date
December 1st, 2017 by

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.

Sustainability plan for statewide e-health collaborative

published date
December 1st, 2017 by

A statewide electronic healthcare 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 healthcare 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 healthcare 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

Medication information strategy for major pharmacy chain

published date
December 1st, 2017 by

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.

Medical cost containment acquisition for strategic buyer

published date
December 1st, 2017 by

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 healthcare 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.