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Consumer-Centered Business Models

A sharp focus on consumer needs is shaping business models for health care payers and providers in both developed and emerging-market countries.

With so much inefficiency in the health care sector, significant shifts in market leadership among payers and providers are likely to occur. Some payers and providers will grow their market share, while others may fall prey to takeovers and acquisitions. However, to thrive and grow, organizations must be able to provide greater value to consumers. Consumer demands are driving growth in both emerging and developed markets.

In emerging-market countries with rapidly growing middle classes, demand for health care services will continue to fuel growth in the years ahead. As more people become insured, countries such as Brazil and India represent prime areas of growth for established health care payers and providers. Older business models for these emerging markets may no longer be effective. Accountable care organizations are leading the way, combining hospital and outpatient services, and moving quickly to provide services where demand is highest.

In developed markets, digitalization is improving the consumer experience and patient outcomes. The proliferation of smartphones, tablets, and portable computers encourages consumers to use web-based tools to communicate with health care professionals and track health progress online. Leading payers and providers are using the web strategically to both improve patient health and reduce costs.

Making Big Data Work for Payers

Karalee Close, BCG’s global leader of digital, big data, and advanced analytics in health care, talks about making big data work for payers.

Karalee Close

Will Health Care Embrace Digital or Will We Die Waiting?

Using a mobile app to check glucose levels, sending selfies to facilitate diagnoses, and receiving text reminders to take pills. Is this the future of health care? Karalee Close believes it should be, considering that medical mistakes are the fourth leading cause of death in the U.S. She argues that a closer marriage of technology, big data, and health care can improve today’s system.

Health Care Payers & Providers
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