I’m in the digital health space (CEO of Omada Health).
Agree completely on the IT & product integration barriers highlighted in the article. This (& more) make health care a nuanced place to build a business.
There are simply more stakeholders to manage:
- Employers (Google, etc; those w/ >500 emps usually carry financial health care risk)
- Plans (United, etc; both carry risk and administer employer plans)
- Providers (Sutter, etc; deliver care, can carry some risk, contract with plans, and sometimes contract directly w/ employers)
- Benefits Consultants (Mercer, etc; guide employers, more)
- Societies (AMA, etc; build guidelines, unify provider voices, more)
- Patients (you; remain frustrated w/ system complexity)
- Consolidators (McKesson (Rx logistics & channel), Express-scripts (pharmacy benefit manager); add leverage and efficiency)
- Regulators (HHS (HIPAA), FTC, FDA, etc; define ground rules for all these players)
- Suppliers (Pharma, device, digital health; sell value into this space)
This # of important stakeholders makes it difficult to “trace a dollar” and figure how who is your buyer. It's important to understand the basics of the financial, contractual, and regulatory relationships between all of these.
But it’s also very, very fascinating. And once you suffer through some of the learning curves can get quite fun. There are enormous financial and impact opportunities to be had. The wall can be a little high.
I'm always still learning, but if you need help on your idea and how it'd fit in, email me at sean@omadahealth.com.
This is a GREAT post. It is a giant puzzle, not for the faint of heart but very fun. Provider motivations vary widely based broadly on their economics and interests. There's 316 distinct U.S. markets alone! Cheers, Sherri (CEO@Medigram)
Wow. Fascinating to see so many stakeholders involved. While I'm not in the health care space, I'm going up against an industry who's fairly closed off (residential real estate) and am wondering if you have any ideas/advice on what are the key things for breaking through industries that are very tight/complex? What's key for managing all these stakeholders?
Agree completely on the IT & product integration barriers highlighted in the article. This (& more) make health care a nuanced place to build a business.
There are simply more stakeholders to manage:
This # of important stakeholders makes it difficult to “trace a dollar” and figure how who is your buyer. It's important to understand the basics of the financial, contractual, and regulatory relationships between all of these.But it’s also very, very fascinating. And once you suffer through some of the learning curves can get quite fun. There are enormous financial and impact opportunities to be had. The wall can be a little high.
I'm always still learning, but if you need help on your idea and how it'd fit in, email me at sean@omadahealth.com.