Will Your Organization Be Left Behind as Consumer Healthcare Transforms?

It’s no surprise that the pandemic has changed the way consumers interact with healthcare. We see it in the proliferation of virtual care across the care continuum, from acute to chronic, episodic and now primary and preventive care. We see it in the embrace of new digital devices and programs designed to monitor chronic conditions at home. And we see it in the uptake of digital pharmacy services that promise ever-faster delivery times and simple, easier, prescription transfers. These shifting consumer need states are forcing companies to action.

Those that will win with consumers in the post-pandemic age are the ones that will accelerate innovation as they reimagine their business models – integrating and re-configuring assets around emergent consumer use cases.

Here are three healthcare business design imperatives for making markets and capturing post-pandemic value through big, bold and transformative moves:

1) Trade the value chain for value exchange

The old news? Payers, providers, pharmaceuticals and MedTech companies once controlled discrete pieces of the value chain. Today, they are operating as collaborators and competitors alongside one another – with non-healthcare entrants (financial services and technology companies) also looking for a piece of the pie.

The new news? “Who does what” doesn’t matter to consumers, instead they value the promise of an integrated approach to health. Whether you build, buy or partner, leaning into the discomfort of superseding the value chain can lead to transformative, new offers. Teladoc Health is a great example of a company that bet big on the idea that virtual primary care is here to stay. It built the Primary360 platform as an entryway to take advantage of its unique portfolio of assets from acute and episodic care (Teladoc Health) to chronic care (Livongo), behavioral health (BetterHelp), and more.

Alternatively, a company that took the partnership route is Cigna. They joined forces with Oscar Health to create an integrated, easily navigable approach to health plans for small businesses. By bringing together Cigna’s provider network and Oscar’s technology platform, they’ve created a relevant solution for the small business population that meets their needs.

2) Meet consumers in the messy middle

If transcending historical value chains is one way to play, another is to exploit the current outages in the value chain and become the middleware that bridges a care gap. Emerging care gaps could include areas like post-acute care, kidney care, pre-and post-Cancer treatment, and health conditions at the intersection of health and wellness (e.g. sleep, behavioral health).

Take recently acquired startup PatientPing, which focuses on the post-acute care space. Through its technology platform, the company can coordinate care by “pinging” healthcare providers when their patients are treated at other facilities. For instance, a provider could be notified in real-time when a patient is transferred from a nursing home to another outpatient setting. Now, with its acquisition by Appriss Health, close to 1 million healthcare professionals across all 50 states can be connected across care settings.

“Those that will win with consumers in the post-pandemic age are the ones that will accelerate innovation as they reimagine their business models.”

In another direction, Alula Health is a startup tackling the “messy middle” of the physical, emotional and financial changes involved with a cancer diagnosis and treatment process. Alula’s platform focuses on patients and their caregivers. They provide organizational tools such as spreadsheets and calendars to ease treatment coordination and a curated list of cancer-specific shopping items (e.g. post-surgery bras and robes with extra room for prostheses or drain management, “Travel to Treatment” bundles with pill organizers, sickness bags, sanitizing wipes, and face masks).

A final example is Talkspace, a platform aimed to make behavioral therapy more accessible. In a world where the dominant method of therapy was administered through expensive 1:1 sessions, Talkspace broke the prevailing mode of thinking and dispensed therapy through bite-sized, text-based interactions – a new modality for meeting the needs of those struggling with mental health challenges discreetly and without confining therapy to a set date/time. In doing so, they normalized therapy for a whole new, addressable market and have since expanded to partner with employers to offer its service as part of workplace benefits.

3) If it doesn’t have their name written on it, it’s not for them

The third hack for making markets through transformation is to address the unmet needs of unique consumer populations. Traditional provider-driven healthcare focuses on triage to identify a treatment path for every patient. But flipping this approach on its head allows for a deeper level of focus, prioritizing time, resources and expenses to solve the needs of one population group more effectively than a general solution.

Segment-specific opportunities are everywhere and can include:

1. Those with a stigmatized condition
2. An underserved population with unique needs
3. An overly generalized population.

A good example of the first opportunity is Ro, self-styled as “the patient company”. Ro started by providing telemedicine and prescriptions for erectile dysfunction via its Roman brand, but gradually expanded to include other medical challenges like smoking cessation (via zero) and weight management (via Plenity). With the technology infrastructure, brand architecture and consumer base established, the company can pursue additional disease states with room for growth.

An example of the second segment-specific opportunity is Included Health, newly acquired by telemedicine provider Grand Rounds / Doctor on Demand. Included Health focuses on the needs of the LGBTQ+ community, who have all too often faced challenges finding culturally competent and affirming providers. The company works with employers to provide benefits to individuals that help them connect to physical care providers, mental care providers, community support and gender-affirming care.

The third-dimension type of play is to identify an overly generalized population – and the field of women’s health is a great example. While some companies have developed “female” healthcare brands, women have different needs by life stage. The spectrum of startups in today’s women’s health space demonstrates different focus areas such as reproductive/sexual health, pregnancy and postpartum, as well as menopause. Within each focus area, individual companies target specific challenges. For example within the category of reproductive/ sexual health, some companies focus on areas such as fertility (Modern Fertility, recently acquired by Ro), cycle tracking (Glow), birth control (Nurx) and more.