11 things we learned from HBI 2018
Many hundreds of you attended our conference HBI 2018 – Going for Growth at the QEII Centre in the heart of London last week. Here are eleven things we learned from the two-day event.
Domiciliary homecare has not been cracked
Potentially a huge market, no one has managed to come up with a model which consistently delivers high quality care and makes money. A Latin American CEO was venting on the problems he faced retaining staff and ensuring quality only to be told by the bosses of Ambea, the big Swedish group, and Esperi, a big Finnish care group, that this was precisely why they had both quit the sector.
Managing health is the new battleground
Monitoring health and building prevention programmes that deliver is the future. Note that this was how GSK and Unilever defined their programmes which cover in total over a quarter of a million employees. Who manages healthcare and controls patient pathways in exchange for per capita payments is the market of the future.
Diagnosis by artificial intelligence is growing faster than you think
For images and almost all primary care AI will be or is better than humans now or in the next three years. bablyon claims that 40% of all “consultations” with AI lead the patient to take no future action.
Telehealth and ehealth changes how patients consume doctors
Face to face sessions are not being substituted for by face to face video calls but by a bewildering array of new approaches from chat to email to video conferencing. Different patients will want different things in different circumstances. Digital changes consumption patterns. Doctrin claims that its software enables Capio’s primary care doctors to see twice as many patients in a day.
Internationalisation is the new norm
For many groups operating in more than one country is normal. That is particularly true of operators based in small or mid-sized countries. And it is particularly true in emerging markets where outpatient speciality groups focused on a specific treatment are now rarely not international – look at labs, oncology, IVF or ophthalmology.
The general hospital model is making way for new models
The focus is increasingly on outpatient, at the expense of the general hospital model which is increasingly seeing its component parts broken up and moved into specialist clinics. That applies increasingly to elderly care, rehab and psych.
Genetic testing for all is rapidly approaching
Full genome sequencing for under €1,000 is here, and beginning to raise more questions than it answers – such as who will pay for this testing, who will provide counselling for the 10% of the population with genetic defects (there are fewer than 3,000 genetic doctors in Europe at present), and how will this vast amount of data be stored?
The biggest investment opportunities in healthcare are in Emerging Markets
Put a group of investors and operators together in a room to talk about European investment opportunities, and lots of them will be straining their ears to hear what’s going on next door in the Emerging Market discussion because they think that’s where the real money is to be made.
Healthcare won’t become consumer-centric on its own terms
The move to creating customer-friendly patient experiences, through simpler offerings, affordable pricing and better outcomes, will not come from the industry itself. Rather, disruptors including the big tech giants, new telehealth and insurance players and even retailers will enter the sector and impose their DNA to do to healthcare what Amazon did to online retailing and Uber to transportation. Migros, the largest supermarket chain in Switzerland is already the largest primary care network. babylon is selling its offering in China through wechat, not healthcare providers.
Individual PMI is dead
The classic model of health insurance is on its last legs. The anticipated massive uptake in emerging markets and East Europe is not happening as more health-aware patients save their money and pay out-of-pocket. Simpler subscription models are emerging and big corporates are disintermediating the health insurance industry. And in many emerging markets another threat looms.
State social insurance in emerging markets supports private healthcare
Many developing markets (Gabon, Indonesia, India, Vietnam) are introducing statutory social health insurance as a way to fund universal coverage. While state health insurance widens access, it also competes with PMI. However, having a single state payor in these parts of the world will also support private healthcare development – since many patients are still unable to afford to pay for services. It will take time and sometimes as in Vietnam the roll out will not be so clever but gradually state payors are emerging as a new revenue stream for for-profit operators.
