New Regulations Mean Opportunities for Health Care Entrepreneurs
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Entrepreneurs scouting prospects in the post–health care reform world should find plenty of opportunities, panelists told a crowd at a panel discussion, “Health Care Entrepreneurs in a Changing Environment,” held during the University of Miami’s Global Business Forum, Jan. 12–14, 2011.
One field that is ripe with possibilities is information technology, where advances continue to present new ways to contain costs and improve patient care. “The problem with our health care system is that 20 percent [of people] generate 80 percent of the costs,” said Michael Mindlin, a health care investment analyst at Stelliam Investment Management. “As Americans we are conditioned to believe that more care is better care. What health care reform brought to light is that we should be focusing more on pay for quality. If you have a solution, such as information technology, that can put more information in the hands of doctors [and contain costs], then you will have a successful business.”
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Panelists (L-R) Kevin Hutchinson, Entrepreneurial
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One development that should open the door to greater opportunities is a new set of federal standards that will allow the secure exchange of health information over the Internet, with protocols similar to online banking, said Kevin Hutchinson, an entrepreneurial health care executive who is helping to craft the standards. The new rules will allow patients will be able to share test results and medical histories more easily and securely across care providers. In addition, vendors will be forced to share data across their systems, Hutchinson said. Entrepreneurs should be looking at new ways to ensure interoperability among these systems.
Social media might offer another avenue for sharing information, said Hutchinson, suggesting a system in which patients control their health records and could invite their physicians to join their social network to share information. Mindlin, however, cautioned that such a scenario would have no future without a financial incentive for doctors to participate.
In addition, panelists said, as information-gathering systems improve, providers will be able to use the collected data to spot trends in patient care.
“The uses of data for good — to drive utility and improvement and patient satisfaction and coordination and care management — are huge opportunities that are undefined right now,” Hutchinson said.
David McLean, CEO of NovoLogix, a pharmaceutical benefit management company, considers data-driven care the future of the pharmaceutical industry as well.
“If you go back and look at the last 100 years of pharmacy, the first 50 years [were] focused on manufacturing drugs, the next 50 years [were] focused on the distribution of drugs. The focus for the profession for the next 50 years has to be on how we use information to improve patient care and drive more value,” he said.
McLean gave the example of a company he recently helped start that has developed what he calls a therapeutic records system. The company began with the premise that patients with multiple conditions and medications consume an “inordinate” amount of medical care, between regular doctor’s visits, ER and hospital stays. The system helps health plans track the delivery of the very high-cost drugs patients receive and better coordinate care. With the shortage of primary care physicians, these kinds of tracking systems can help fill gaps. “This company is building a model where the technology can support clinicians in better managing patients, demonstrating those results and … demonstrating value,” he explained.
While many of the opportunities for health care entrepreneurs will be in information technology, there are other areas to keep an eye on. In 2014, some Americans will begin buying health insurance through health exchanges, and as that time approaches, insurance companies will be fighting to keep customers, according to Anthony Masso, former president and CEO of Consortium Health Plans. He cited one company that has already begun sending coupons for healthy foods and activities to its customers as a way to foster loyalty.
“How do you get the consumers to play a role and give the consumers new information so that he or she can recognize they are getting some benefit from their insurance carrier?” Anthony asked. “Opportunities exist all over the place.”
— By Marika Lynch
