Clinical & Business Model Round of 32 Results: Standing With the Devil We Know
No surprises here, as all four top-seeded trends overpowered their rivals to continue on to Round 2. The overall theme in this region was a back-to-basics, circling the wagons atmosphere that signaled that 2023 will not be the year to take chances, but to batten down the hatches and stick with known variables, even those with notable flaws.
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Here’s how the four matchups in this region unfolded:
Clinical & Business Model Trends
Medicare Advantage Squeaks Past Omnichannel Healthcare
“Seeding malpractice!” erupted one Committee Member to open this matchup, which pits two of last year’s Top Four contestants against each other.
Further making the case for Omnichannel Healthcare (8), this member added, “Success isn’t brick and mortar OR virtual; it’s got to be both going forward.”
Another Committee Member agreed, pointing out that Medicare Advantage (1) had a rough season last year and is likely to continue struggling under the weight of litigation and increased scrutiny.
A third member launched a powerful defense of Medicare Advantage, saying that virtual healthcare has fallen off after Covid just as quickly as it rose up during Covid and furthermore, providers are starting to charge for services like e-mails and chart messages, discouraging virtual care. A provider Committee Member concurred, adding that for all its troubles, Medicare Advantage is continuing to grow, pushing Medicare Advantage in for the win at 3-2.
Vertical Integration Knocks Out Retail Healthcare
“Everyone’s becoming a payvider,” said one Committee Member.
Another added, “The large retailers are innovative in their approach, but I think the wider impact in 2023 is Vertical Integration.”
There was a lot of curiosity around Retail Healthcare (7) and what kind of trend it will be in future championship tournaments – led by big players like Walmart, Walgreens, Amazon and CVS Health – but there was strong consensus that for 2023, the stronger trend is Vertical Integration (2) with an easy win at 5-0.
Total Cost of Care Annihilates Membership Models
“This is going to be a really bad game; not sure I will even watch it,” said the first Committee Member to weigh in.
“Membership Models (6) may have had some stronger seasons in the past, but they are just not tournament material in 2023.” By a landslide, Total Cost of Care (3) quickly annihilated Memberships Models with a 5-0 win.
Primary Care Transformation Trounces Specialty Care Transformation
One Committee Member voted for Specialty Care Transformation (5) based on the opinion that because specialty practices are already so much more streamlined, they are more prepared for transformation than the broad, wide open spaces of Primary Care. “Create the models in specialty care, and then you build them upstream to primary care.”
This opinion was met with an immediate rebuttal: “You can’t get anywhere without first involving the primary care doctors.”
Primary care is typically operated as a loss leader, said another Committee Member, and serves as the gatekeepers to specialty care, so the transformation has to begin with primary care.
The rest of the committee voted hard for Primary Care Transformation (4), resulting in a trouncing of Specialty Care Transformation in a 4-1 win.
Which trends do you think will shape the industry in 2023?