Alaffia Health’s Post

Even Walmart cannot crack America’s dysfunctional healthcare market https://lnkd.in/dP66Av-X And people think healthcare is anyone's/everyone's cup of tea! #Healthcare is based on 3 A's #Accessibility #Affordability & #Acceptability Dare I add 2 more A's #Accountability #Adaptability Most of the recent so called health tech innovations are simply tech innovations with some relevance to healthcare. A true health tech disruption must come from people who understand it, i.e. healthcare workers from primary to super speciality level Feel free to add anything that I might have missed.

Nice summary of the top trends in Payer, Provider and Health Tech industry (from JPM24) - moving from pure play payer/ providers to payvider structure, increased focus on ambulatory care, usage of digital technologies in specialty and chronic care, meaningful GenAI, focus on profitability and adaptability to regulatory changes. #healthcare #healthcareai #healthtrends #healthcareinnovation #payer #provider #jpm2024

This year has been challenging for retail companies expanding into healthcare delivery. Some major players are pulling back, but the potential for retail healthcare shouldn't be dismissed. Key Developments: - Walmart Health closed all 51 health centers and ended its virtual care services in April. - Walgreens is shutting down numerous VillageMD clinics and reassessing its approach. - CVS Health announced significant layoffs and is undergoing a strategic review. Implications for Health Systems: - These challenges reflect how difficult it is to navigate healthcare's complex landscape, validating health system leaders' caution. - Despite these setbacks, Scott Christensen, Senior VP at Kaufman Hall, warns traditional providers not to assume retail disruptors will continue to fail. Retailers' Strengths and Opportunities: - Retail giants like Walmart and Walgreens have immense capital and consumer loyalty. - While they’ve faced struggles in primary care and delivery, they still have opportunities, especially when combined with insurance strategies. - Walmart’s history shows adaptability, like its pivot to Supercenters in the late 1980s, which helped it dominate the grocery market. Conclusion: Retail healthcare may face hurdles, but their potential impact is significant. Traditional health systems must remain vigilant and not underestimate these players. https://lnkd.in/gYvJGzbc

Still trying to make sense of Walmart pulling back from healthcare delivery? 3 quick thoughts: 🏥 Healthcare delivery is hard, even for companies where it's a primary focus. Navigating reimbursement and competition is extremely challenging. 💸 The patient may be a customer, but they are never the payer. 📊 No matter a company's stature, cooperation and reimbursement from health plans—both nationally and locally—are still critical for building profitable businesses. For a deeper dive, check out our full analysis here: https://lnkd.in/eXTeugKD

In his recent article, Scott Christensen explores the closures of Walmart Health and VillageMD, prompting reflection for traditional providers. Success often hinges on integrating insurance, as seen with CVS and Aetna. Diverse revenue models, like Amazon’s One Medical, also show promise. Walmart’s adaptability demonstrates resilience in the face of setbacks. As the healthcare landscape evolves, focusing on consumer needs for convenience and transparency is essential. Adaptability is key to thriving in today’s healthcare environment. #HealthcareInnovation #RetailHealth #ConsumerCentricCare https://lnkd.in/dkT4vs2K

So many factors need to go into primary care to be "profitable" like providing the right care, at the right place and at the right time - i.e. VBC. In order to do that, Walmart would need the right contracts with the right reimbursement and also deliver the right quality. Scaling retail healthcare is not easy especially when you're relying on a FFS model. Yikes. Let's see how long One Medical will last. 🤔

Payers and providers need to drastically improve their “consumer driven” initiatives. Disruptors rely on the complacency of large well-established organizations and status quo.  The complexity of the healthcare ecosystem offers no safe harbor. Consumer obsessed disruptors own the consumer, are well funded, well established and those with significant scale always find a business process to improve.  Amazon and "Amazon-similars," are actively pursuing ways to disintermediate health plans by leveraging its vast resources and technological expertise. With initiatives like Amazon Pharmacy and Amazon Care, the tech giant aims to provide consumers with direct access to healthcare services and products. By offering transparent pricing, convenient delivery options, and personalized health recommendations, Amazon seeks to empower individuals to take control of their healthcare needs. Additionally, Amazon's acquisition of PillPack and partnerships with healthcare providers signal its commitment to disrupting the traditional healthcare model. Through these efforts, Amazon is positioned to challenge the dominance of health plans by providing a seamless and customer-centric healthcare experience. As the company continues to expand its presence in the healthcare space, it has the potential to reshape the industry landscape and drive innovation in how healthcare services are delivered and accessed. Complacency says, “they tried and failed in health before.” These disruptors also failed at their core businesses too, until they didn’t.  https://lnkd.in/g4ZqAEMK

From the article Alwin shared, "By 2026, according to a 2023 analysis from IDC, 55% of worldwide private health insurance companies and 75% of U.S. health systems will evolve into payviders." This highlights how competitive the healthcare industry is becoming, with a growing need to prioritize tech integration and strong leadership skills. #HealthcarePayers #HealthcareInnovation #LeadershipSkills

US healthcare spending to reach $7.3 Trillion by 2032, from $4.8 Trillion today. In 2000, total US healtchare spending was a meager $1.4 Trillion. In 2023, we spent $1.5 trillion for hospital care alone. Put differently, our 2023 hospital spend eclipsed the entirity of US health expindtures in 2000. Warning: You can't unsee the following comparison: 2023 hospital expenditures vs 2023 Revenue of Global Conglomorates Walmart's 2023 Revenue: $611B (2023 hosp spending 2X Walmart) Amazon's 2023 Revenue: $575B (2023 hosp spending 2.6X Amazon) Apple's 2023 Total Revenue: $383B (2023 hosp spending 4X Apple) United Health 2023 Revenue: $371B (2023 hosp spending 4X United) Target's 2023 Revenue: $109B (2023 hosp spending 15X Target) Starbucks 2023 Revenue: $35B (2023 hosp spending 42X Starbucks) https://lnkd.in/diBACe46

It's a serious blow to those hoping for a shake-up in #healthcare. Walmart's recent decision to close all its clinics nationwide is a stark reminder of the challenges facing new entrants in the US healthcare market. While Walmart's low-cost approach had the potential to disrupt the traditional provider landscape, #reimbursement issues ultimately proved insurmountable. This episode underscores the urgent need to re-evaluate the current payer-provider model. Isn't it time we explore alternative models that prioritize affordability and accessibility, ensuring innovative healthcare providers have a sustainable path to success? Please leave comments below, and let's discuss! https://lnkd.in/gHmB-6wC