I started out
2009 saying political change, economic volatility and competitive rivalry will
challenge every stakeholder—customers, employees, business leadership, and
investors. As the year closes out, the health care industry remains preoccupied
with health reform – what’s the outcome going to look like, who are the big
winner and losers, and what can be done now to prepare for a reformed
marketplace.
Going into 2010,
my advice is to start early evaluating and planning for new opportunities, and
focus on designing strategies to protect core lines of business against threats
that lie on the horizon. The following provides a few background resources to
help guide strategies around health reform, Medicare and strategic trends.
HEALTH CARE REFORM
The
country’s health care system will see sweeping change in 2010: over $750 billion in new
expenditures and possibly 30 million uninsured individuals set to receive
health coverage. The impact will be huge, affecting every citizen, every
provider and every health plan: insurance exchanges, Medicaid expansion,
Medicare payment adjustments, individual and employer mandates, increased
taxes, and far-reaching overhaul of traditional risk management rules.
Now is the time
to for health care entities to prepare. Don’t wait. Business assumptions and
operating models need to adapt, quickly. Winners will anticipate change and
react quickly in a reformed health care marketplace.
One place to
start is evaluating the House and Senate health care reform proposals that will
guide Conference Committee negotiations prior to sending legislation to the
President. A comprehensive review is Kaiser Family Foundation’s Side-by-Side
Comparison.
For a more
specific look at health care reform’s affect on Medicare plans, Gorman Health
Group’s Executive Briefing provides an analysis on reform’s Impact on Medicare
Advantage and Part D.
MEDICARE
For consumers, the
Medicare landscape is a complex jumble of product and delivery options. Finding
the balance between financial and medical choice makes Medicare confusing, if
not intimidating for many seniors. After receiving their copy of “Medicare
& You” and searching medicare.gov, seniors start receiving dozens and dozens of heath plan
solicitations.
From Medicare Advantage to
Prescription Drug Plans to Medigap, making an informed choice about what plan
best meets a senior’s needs is a very personal decision. This recent article in the Wall Street Journal titled Medicare Maze looks at resources available to seniors as well as helpful
shopping hints.
The flip side is the
challenge faced by health plans: educate seniors, communicate value, abide by
massive regulatory requirements, and break out of the sea of sameness that characterizes the Medicare competitive
landscape. For Medicare
plan sponsors competing for the 3 million seniors turning 65-years old, and those
seniors seeking to switch from their current plan, one skill becomes more important
than ever–lead generation. Execution must be based on data, laser-focused, and
grounded in the core principles of direct response marketing. This article, 4 Steps To
Generating Quality Medicare Leads discusses the essential ingredients
of high-performance lead generation.
STRATEGIC TRENDS
Health care reform is front-and-center
on every health care company’s strategic radar screen. But, waiting in the
wings are many other important trends such as medical home, cloud computing
platforms, socialnomics, accountable care organizations, comparative
effectiveness indicators, and customer transparency.
In light of the massive change that
lies ahead, a robust strategic planning process is key to sustainability. Amidst
marketplace transmogrification business leaders must be prepared to identify
and capture opportunity, and have the capacity to absorb change, manage through
obstacles and build on their company’s advantages.
Strategic planning calls for
analytical thinking and objective decision-making that continuously works to improve
corporate vision and strengthen brand. Management needs answers to tough,
introspective questions. A sample of how this process can be structured at the
most senior levels in an organization is outlined in Strategic Assessment.
Monitoring mega-trends
to plan your strategic future can’t get postponed either. What are the hot
consumer trends? Who’s Wall Street tracking…and why? How are innovators
positioning themselves?
This coming year
promises to be as challenging as any other that the health care industry has
seen. Monitoring, analyzing and interpreting trends enables smart executives to
predict market change, clarify strategic vision and capture new opportunity. It
puts today’s decisions in tomorrow’s context.
One resource, Trendwatching.com, provides research to help
companies shape their corporate vision. To both inspire innovation and refine customer
sensitivity, their year-end
review indentifies 10 Crucial Consumer Trends For
2010.