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The global market for Population Health Management 2016

The emergence of and opportunities in, population health management.

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  • This is the first ever report explaining global PHM solutions with commentary on the lessons learnt and an outline of the emerging demand by region, globally. Complete with examples of leading and emerging suppliers.

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  • Crisis alert! Health services worldwide are facing unprecedented levels of pressure

    Report cover

    This is the first ever report explaining global PHM solutions with commentary on the lessons learnt and an outline of the emerging demand by region, globally. Complete with examples of leading and emerging suppliers.

    Context:  The global demand for acceptable levels of healthcare is already huge and growing at a significant rate. Unfortunately, the costs of provision are growing even more rapidly.

    The need for solutions to the escalation in healthcare costs is being experienced within both the government and the corporate sectors in all countries worldwide. A dizzying array of preventive, educational and management tools have been deployed, including:

    • Absence management
    • Condition management programs
    • Data management/Analytics/Systems
    • Employee Assistance Programs 
    • Health Risk Assessments
    • Occupational Health services
    • Pharmaceutical compliance programs
    • Remote monitoring
    • Telehealth
    • Holistic Wellness programs
    These tools and approaches are being adopted in various ways on a global basis, but:
    • ROI calculations per approach or overall are inconclusive or simply absent, meaning that there is general scepticism as to the value of these tools. 
    • Buyers are generally uneducated in this emerging PHM area and are often overcome by the ever widening range of ideas.
    • Adaptation of tools, sales techniques and data privacy set ups to different cultures and locations is hard, under anticipated and under developed.

    Unclear success-based compensation models, global recession based pricing pressures and the consequent perception of low margins are
    deterring suppliers from entry or from global expansion. In our report we:

    i. Describe and segment the different solutions available, with commentary on their purpose, payback and the lessons learned
    ii. Provide an outline of the various buyers’ needs and the demand for these solutions by region globally
    iii. Identify examples of leading and emerging suppliers of these solutions, with commentary on success stories and the barriers to be overcome

     

  • List of Contents

     
    Foreword
    5
     
    Disclaimer
    5

    1.0

    Introduction and Definition of Population Health Management
    7
    1.1
    Editorial Introduction
    8
    1.2
    Defining Population Health Management
    9

    2.0

    Crisis? What Crisis?
    11
    2.1
    Drivers of health costs
    12
    2.2
    The US story
    15
    2.3
    Chronic disease - the global picture
    18
    2.3.1
    Latin America
    18
    2.3.2
    Europe
    19
    2.3.3
    Russia
    19
    2.3.4
    Gulf Cooperation Council
    20
    2.3.5
    Africa
    20
    2.3.6
    India
    21
    2.3.7
    China
    22
    2.3.8
    South East Asia
    22
    2.3.9
    Australia
    23
    2.4
    Economic impact overall and by region
    24
    2.5
    Economic impact on employers
    28
    2.6
    Conclusions to date
    32

    3.0

    History of Population Health Management
    37
     
    A mostly ‘invented in the US’ story, which is at least 30 years old
    38

    4.0

    Solution Tool Box - What Exists and Pros & Cons
    49
    4.1
    Categorization of services
    50
    4.2
    Data collection and analysis tools
    51
    4.2.1
    Health Risk Assessment
    51
    4.2.2
    Physical Screening
    52
    4.2.3
    Healthcare Information Technology Systems, Data Management, Data Analytics Software
    54
    4.2.4
    Wearables and Biosensors (E-Health)
    59
    4.3
    Prevention/Education
    64
    4.3.1
    Occupational Health Programs
    64
    4.3.2
    Employee Assistance Programs
    65
    4.3.3
    Wellness Programs, Behavioral Change and Risk Factor Management
    67
    4.3.4
    Absence Management Programs
    72
    4.4
    Managed Intervention
    74
    4.4.1
    Pre-authorization/Pre-certification/Utilization Review
    74
    4.4.2
    Case Management
    75
    4.4.3
    Condition Management
    76
    4.4.4
    Telehealth/’M’health for cost reduction/better care
    78
    4.4.5
    Pharmacy Benefit Management/Drug Adherence
    80
    4.5
    Delivery Mechanisms
    83
    4.6
    Conclusions
    89

    5.0

    Summary of the Debate - Key Lessons
    91
    5.1
    Introduction
    92
    5.2
    Conclusion: Does PHM work? YES, but only if done right
    92
    5.3
    What does “doing it right” mean?
    94
    5.4
    Lessons
    96

    6.0

    Key Consumers - Who, Why and Where?
    107
    6.1
    Introduction
    108
    6.2
    Overview of buyers
    108
    6.2.1
    Corporates (private and state-owned)
    110
    6.2.2
    Governments
    114
    6.2.3
    Health and Life Insurers/Re-insurers
    116
    6.2.4
    Hospitals, Health Maintenance Organizations, Accountable Care Organizations and Medical Practitioners
    118
    6.2.5
    Individuals
    119
    6.2.6
    Consolidators and Advisors
    119
    6.2.7
    Healthcare Intergovernmental Organizations, Non-Governmental Organizations and Foundations
    119
    6.3
    Future trends
    122

    7.0

    Catalysts - Who is Pushing Wellness?
    123
    7.1
    Overview of Suppliers
    124
    7.2
    Category 1): Health service companies
    125
    7.3
    Category 2): Employee Benefit Consultants
    126
    7.3.1
    AON Hewitt
    126
    7.3.2
    Buck Consultants
    128
    7.3.3
    Mercer
    130
    7.3.4
    Towers Watson
    132
    7.3.5
    Willis
    134
    7.4
    Category 2): Assistance companies
    136
    7.4.1
    International SOS
    136
    7.5
    Category 3): Pharmaceutical companies
    138
    7.5.1
    Pfizer
    138
    7.5.2
    Sanofi
    140
    7.6
    Category 3): Enablers
    142
    7.6.1
    Sodexo
    142
    7.6.2
    Walgreens
    144
    7.6.3
    Apple - HealthKit
    146
    7.6.4
    Google
    147
    7.6.5
    Philips HealthTech
    149
    7.6.6
    Siemens
    151
    7.7
    Conclusions
    153

    8.0

    Market Opportunity - Today and To Come
    155
    8.1
    McGrigor Group PHM market definition/segmentation
    156
    8.2
    Workplace wellness market size 2015, globally and by region
    157
    8.2.1
    Global
    157
    8.2.2
    Regions
    160
    8.3
    PHM sub segments, size, globally and regionally
    162
    8.3.1
    IT supplier- based approaches
    162
    8.3.2
    Retail
    163
    8.3.3
    Summary so far
    164
    8.4
    Growth trends to date
    164
    8.5
    Predicted growth
    165
    8.6
    Assessing potential opportunities by segment and region
    166

    9.0

    Executive Summary
    173
    9.1
    The elevator pitch
    174
    9.2
    Expanded summary
    176
    9.2.1
    A definition of PHM
    176
    9.2.2
    Crisis, what crisis?
    176
    9.2.3
    Evolution of PHM programs
    177
    9.2.4
    Solutions Tool Box – what exists and pros & cons
    177
    9.2.5
    Key lessons from PHM so far
    177
    9.2.6
    Key Consumers – who, why, where
    178
    9.2.7
    Catalysts
    178
    9.2.8
    Market Opportunity – today and tomorrow
    178

    10.0

    Next Steps
    181
    10.1
    Preview of Reports 2 & 3
    182
    10.2
    Companies profiled in Report 2
    183

    11.0

    Appendix
    185
    11.1
    McGrigor Group: what can it do?
    186
    11.2
    Acknowledgements
    186
    11.3
    Key contacts in McGrigor Publishing
    187
    11.4
    Abbreviations
    187
    11.5
    List of tables and figures
    191
  •  List of Tables & Figures

    Figure 01: Growth of the world population from 1950 to 2050
    Figure 02: Pace of aging by country 1950 to 2050
    Figure 03: Medical spend per year by age
    Figure 04: Number of deaths from disease worldwide, by cause
    Figure 05: Cost increase as a function of risk factor
    Figure 06: Health expenditure for OECD countries
    Figure 07: OECD obesity rates (measured obesity not self-reported obesity)
    Figure 08: Age-adjusted prevalence of obesity and diagnosed diabetes among US adults - 1994
    Figure 09: Age-adjusted prevalence of obesity and diagnosed diabetes among US adults - 2010
    Figure 10: Global cost of five most common NCDs
    Figure 11: Global impact of NCDs on lost output 2010 to 2030
    Figure 12: NCD cost impact by region, 2013 - 2025
    Figure 13: Health conditions by annual productivity cost per person
    Figure 14: Annual productivity and medical costs for the average-size employer (10k employees)
    Figure 15: Impact of health risks on medical expenses
    Figure 16: Impact of health risks on absence from work and productivity
    Figure 17: Calculating ROI: critical steps to success
    Figure 18: What is the evidence base for workplace wellness programs’ savings?
    Figure 19: Anti ‘workplace health promotion programs’ headlines
    Figure 20: Healthy employees yield wealthy employers
    Figure 21: Current state vs. future state drivers of PHM
    Figure 22: The IHI Triple Aims
    Figure 23: Percentage of primary care physicians in the US and ROW using electronic medical records in 2009
    Figure 24: The evolution of medical management
    Figure 25: Stages required to achieve analytics progress, with examples case studies
    Figure 26: Expected growth in healthcare data, 2012-2020 (petabytes)
    Figure 27: Venture funding for companies using predictive analytics (2011-Q3 2014)
    Figure 28: Examples of wearables and biosensors
    Figure 29: Example of apps and their outputs
    Figure 30: Worldwide wearable electronic fitness devices shipments forecast (millions of units), 2013 - 2016
    Figure 31: Examples of provider oriented tools
    Figure 32: The key elements of wellness programs by region
    Figure 33 : Use of incentives vs. penalties in corporate wellness programs, 2013/14
    Figure 34: PruHealth outcomes using Vitality
    Figure 35: Components of overall drug cost trend, 2006-2013
    Figure 36: PHM toolkit
    Figure 37: Summary of 4 resourcing methods for multi-stakeholder collaborations
    Figure 38: HealthNEXT’s benchmark approach
    Figure 39: HealthNEXT’s multi-year plan approach
    Figure 40: Multi-year plan based on input
    Figure 41: McGrigor’s overall ranking for PHM tools
    Figure 42: Truven Analytics Benchmark Data of the best vs. most employers
    Figure 43: Key drivers of establishing a culture of health and their impact
    Figure 44: Summary of the 'Employer Health Asset Management Roadmap'
    Figure 45: Employers use of strategic planning for employee health
    Figure 46: Employers with wellness champion networks report better outcomes
    Figure 47: The relationship between the value of the financial incentive and the participation rate in an HRA
    Figure 48: The integrated health and safety model
    Figure 49: UK measurements of national wellbeing
    Figure 50: Core metrics for employee health management
    Figure 51: The seven main PHM customer types
    Figure 52: Healthy living offers multiple business opportunities in all sectors
    Figure 53: The relative importance of motives behind wellness programs by region
    Figure 54: Top 10 health promotion components by region
    Figure 55: Fastest growing wellness program elements by region
    Figure 56: Discovery Health’s ability to contain key drivers of medical inflation
    Figure 57: Prevention vs. Intervention - the imminent changes to conventional healthcare
    Figure 58: Purchasing value in healthcare (via RxCollaborative)
    Figure 59: Philips Healthcare highlights 2014
    Figure 60: Ultimate market size segmentation
    Figure 61: Global market size of wellness industry clusters in 2013
    Figure 62: Global survey indicating proportion of employers offering health promotion to
    their employees by region, 2014
    Figure 63: Wellness penetration by region, using multiple sources
    Figure 64: McGrigor Group’s ‘top-down’ analysis of workplace wellness market by region, 2015
    Figure 65: Markets and Markets PHM software and services market size
    Figure 66: HRAs, education and coaching sold only online to global MNCs
    Figure 67: PHM market size by sub segment - indicative size, 2015
    Figure 68: Wellness program and incentive spending, 2010 -2015
    Figure 69: Future growth of the global workplace wellness market
    Figure 70: 2025 Potential workplace PHM spend by region
    Figure 71: Aspects of McGrigor Group’s methodology for evaluating type/timing of opportunities by region
    Figure 72: NCD cost distribution by countries for 2013-2025E
    Figure 73: Global Heat Map: privacy and data protection by country
    Figure 74: PHM: Progress of programs to date, and key customers of PHM services in key global regions
    Figure 75: Estimated regional workplace PHM market size in 2015
    Figure 76: Future growth of the global wellness market in US$bn
  • This Report will be useful for:
    • Population Health Management suppliers looking at how and where they should focus
    • Customer-distributor hybrids and other ‘enablers’ of PHM, such as Employee Benefit Consultants, Foundations, Pharmaceutical Companies, etc
    • Governments struggling to contain the costs of healthcare
    • Health and Life Insurers and re-insurers undergoing transformation from ‘payers to partners’
    • Hospitals and other provider groups
    • Corporate HR benefits managers looking to create a worthwhile health strategy
    • Healthcare management consultants
    • Investors in Population Health Management

     

     

     

     

     

     

     

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