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Payors and Providers : A new relationship: Presentation, Richard di Benedetto, Aetna International

The relationship between payors and providers is changing rapidly. In the USA, Aetna has already moved to a partnership model in which large providers are paid on a per capita basis, rather than by activity. Meanwhile, new apps are creating a much more direct relationship between insurers and patients. These enable remote diagnosis and enables the payor to steer patients to the most suitable provider. Di Benedetto looks at these changes and at how Aetna plans to roll them out worldwide.
August 22, 2017

Fullerton continues expansion into Aussie primary care

Singapore-based Fullerton Health, which provides a range of healthcare services to corporates, has bought 48 facilities from Australia’s second biggest hospital chain Healthscope for S$59.4m (US$43.6) – becoming the third largest primary care business in the country.
August 22, 2017

Lessons on Healthcare from Falck: Presentation, Jan Steenhard, Falck

Falck is the quiet giant of healthcare running ambulance services, clinics, primary care, rehab and subscription services across 3 continents and 40 countries with over €1.5bn in health care revenue. Here, Jan unpackages some of its surprising business models, such as subscription healthcare sold to 1m individuals in Latam and 300,000 in the Nordic. How does it incentivise entrepreneurs who sell their businesses to Falck. What has Falck learnt from its international expansion and where does it see opportunities?
August 22, 2017

Building an international hospital group in Asia – Dr Azad Moopen, Aster DM

Over 30 years Dr Moopen has built Aster DM from scratch into one of the largest groups in the GCC and India, moving into hospitals, pharmacies, diagnostics and outpatient. He talks about the challenges and lessons of the last five years as the group has expanded internationally and reflects on future business models and markets ahead of the group's listing on the Mumbai stock exchange.
August 22, 2017

Academic Medical Centers Involvement in Foreign Markets: An American Perspective on a Multi-Billion Dollar Business: Presentation, Juan Carlos Negrette, University of Utah

Mayo, Johns Hopkins, Cleveland, UPMC and Texas Medical Centers have built huge revenue streams from patient referrals and affiliation programmes. Juan Carlos, formerly managing director at Johns Hopkins International, presents recent research including his estimates of revenue flows by group and dissects the business models, successful and unsuccessful, that they have deployed. What are the lessons for other players?
August 22, 2017

Quality through specialization: Presentation, Daniel Ohman, GHP Speciality Care

The DRG system with payment per activity is a significant hurdle to improvements. In a unique customer collaboration with focus on outcomes, GHP has been able to deliver significant cost savings, quality improvements and innovations through the entire care pathway. GHP is a Nordic clinic chain which is now also manages hospitals in the GCC. Here Daniel looks at new contracts where GHP is paid by Sweden’s largest insurer on a per capita basis for orthopaedic and spine patients.
August 22, 2017

Lessons from the Future: New York State’s Medicaid Reforms: Presentation, John Howard, KPMG

Around 80-90% of payments to Medicaid providers in New York State will be based on quality outcomes by 2020. Much the new system, perhaps the most advanced of its kind in the world, are already up and running. Here John looks in detail at the implication for providers, whether they are delivering elective acute care or chronic disease management programmes. How is the new system affecting consumers and the behaviour of referring doctors? How is New York using big data to analyse outcomes?
August 22, 2017

Helping to inform your choice of hospital: Presentation, Matt James, PHIN

From April 2017, the UK’s Private Healthcare Information Network (PHIN) will go live with a mammoth website representing nearly 2 million datapoints covering the output of 14,000 consultant doctors with private practice at over 500 hospitals. Patients will be able to search for hospitals or doctors by procedure and make immediate comparisons on essential quality measures. Adopting NHS measures will facilitate direct and fair comparison of standards between the public and private sectors. That will make the UK one of very few countries where such comparison is possible.
August 22, 2017
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