Gesundheitswirtschaft und Pharmaindustrie

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Gesundheitswirtschaft und Pharmaindustrie Insights

  • Responding to Ebola

    Responding to Ebola

    A breakfast discussion as part of Oliver Wyman’s participation in the World Economic Forum, Davos, Switzerland, Wednesday, January 21, 2015

    Epidemics are inherently transnational, and the resources to fight disease are dispersed across continents and constituents. They cannot be marshalled by any one general or an interest group. The risk is global. If Ebola has taught us one l...

  • Operationalizing Wellness

    Operationalizing Wellness

    In a previous paper (available here) we discussed the importance of psychosocial wellness and its enormous impact on healthcare costs and outcomes. Patient Activation, a key metric that looks at how patients feel about their health and how involved they are, predicts h...

  • Getting Ready for Price Transparency

    Getting Ready for Price Transparency

    Transparent pricing is quickly becoming a reality for healthcare providers. Employers are using services like Castlight Health to guide employees to low-cost care. Consumers on high-deductible plans are actively shopping for bargains, and government and private initiatives are providing them with the data to find them. Healthcare providers, especially hospitals, are in danger of losing volum...

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    Value-Based Care: A Guide For Medical Device Companies

    By 2025 value-based care delivery will account for 70 percent of total healthcare spend, and various forms of capitation and bundled payments will be ubiquitous. Patients will be treated differently, industry players will be reimbursed differently, and a whole new set of risks and opportunities will emerge. Medical device companies that want to compete successfully in this new marketplace ne...

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    The Patient-to-Consumer Revolution

    In the much anticipated follow-up to The Volume-to-Value Revolution, Tom Main and Adrian Slywotzky describe how seemingly unrelated phenomena—high-tech health entrepreneurs, personal fitness devices, retail clinics in big-box stores, “smart care” teams, and IBM Watson—are creating a new health market where demand trumps supply. The expanded cast of health companies enables unprecedent...

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    Measuring Wellness

    Health leaders have come to understand that they urgently need to transform today’s reactive, repair-oriented health and social care system into a proactive system focused on prevention. But how can we measure success? This paper, written in partnership with the UK’s National Association of Primary Care, and developed also with Public Health England, describes the rationale for measuring not...

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    International Summit of Cooperatives 2014

    Oliver Wyman is proud to return to Québec City for our participation in the second-of-its-kind International Summit of Cooperatives 2014, of which we are platinum sponsors.
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    Crushing Demand Presents Opportunity to Rewire Member Experience

    Crushing volume and call surges have overwhelmed both health-plan exchanges and customer-service channels of major payers. With 5+ million new members signed up by March 31, call volume was 10x more than pre-ACA levels. Many callers who were first-time members had a range of questions; existing members with policies that didn’t meet federal standards were confused about choosing a new policy...

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    Risk Adjustment Arrives for Commercial Health Insurance

    Health & Human Services’ new risk adjustment program for small-group and individual health insurers will partly protect carriers from some of the cost of adverse selection. But our actuarial analysis shows that the program also creates new risks. It tends to overpay for high-risk patients and underpay for low-risk. The cost to an insurer with even five percent fewer high-risk members tha...

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    Are Consumers Ready for Retail Healthcare?

    One key to reducing the cost of healthcare is to move as many services as possible out of the doctor’s office and the emergency room and into high-quality but lower-cost venues and channels of care, including clinics in drug stores, grocery stores, and other retail establishments and online. But do consumers actually want care in new settings? This survey asked more than 2,000 consumers abou...

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    ACO Update: Accountable Care Organizations Now Serve 17% of Americans

    More than two-thirds of the U.S. population now live in localities served by accountable care organizations (ACOs) and more than 40 percent live in areas served by two or more. The figures come from a new analysis by the consulting firm Oliver Wyman, based on the Department of Health and Human Services’ announcement of the latest class of ACOs approved to participate in Medicare’s ACO progra...

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    STAR Crossed: Why Docs Trump Health Plans in CMS STAR scores

    How much impact can a health plan have on whether members perceive it as high quality? What metrics best predict the performance of healthcare delivery systems? Oliver Wyman answers these questions by analyzing the latest round of CMS Medicare Advantage Star Rating scores. What we learned—that providers have a disproportionate impact on how payers are perceived, that seven CMS metrics are ke...