PRESCRIPTION FOR ROI:
INNOVATION IN HEALTH CARE
DELIVER ON ROI -- PDMA, CINCINNATI
Meredith Baratz
October 2012
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Never leave well enough alone –
Raymond Loewy, Designer
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
3
Who We Are
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Helping people live healthier lives. Our Mission
Our Values
Integrity Compassion Relationships Innovation Performance
Making health care work better for everyone. Our Purpose
UnitedHealth Group’s Business Model
OUR HEALTH BENEFITS BUSINESS: UNITEDHEALTHCARE OUR HEALTH SERVICES BUSINESS: OPTUM
Helping People Live Healthier Lives
UnitedHealthcare Community & State
UnitedHealthcare Employer & Individual
UnitedHealthcare Medicare & Retirement
Making the Health Care System Work Better
for Everyone
OptumInsight
OptumHealth
OptumRx
A dedicated and independent business providing services to: 6,000 hospital facilities, nearly 250,000 health care professionals, 58 million consumers
39,000 employees
• Health care information technology
• Consumer engagement and support
• Integrated care delivery
• Pharmacy
• Health financial services
• Serving 39 million Americans at every stage of life
• Innovation-driven growth
• Well positioned to evolve and grow through health care reform
• 63,000 employees across Unitedhealthcare and corporate
FOUNDATIONAL
COMPETENCIES
Domain knowledge around care management and care resources Actionable health care information and intelligence Advanced, enabling technology
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Strategic Guideposts for Improving Health
Help people achieve the best possible health
Provide people with transparent performance data
to help them use the system
Help the system perform at its highest potential
The Health Care Landscape
A Market in Transition
Care Providers
Payers
Consumers
Fiscal challenges driving need for innovative cost-effective solutions
executed at scale and delivered locally.
Increasing role of government driving greater regulatory requirements
and changes in market structure.
Consumer as purchaser with increased financial responsibility drives
product innovation and retail strategies.
Aging, declining health status and coverage expansion creating need for
clinical effectiveness and assistance to navigate the system.
Reimbursement pressures driving greater pay for performance and
clinical integration.
Primary care capacity and structural changes in medical practice giving
rise to alternative strategies for care delivery.
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
UnitedHealth Personal Rewards
7
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Keys to Innovation Success
• Integrated Innovation Capabilities
Strategy and Structure
• Process Discipline
• Focus on the Front End
Harnessing Analytics
• Rapid Prototyping
• Culture
Acceptance of Risk
• Open Innovation
• Measurement
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Our United Culture Values
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
UnitedHealth Group
Innovation Council
Business Segment
Innovation Labs
Center for Health
Reform and Modernization
UnitedHealth Group
IT R&D
Structure: Integrated Innovation Capabilities
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Better information. Better decisions. Better health.
Ideas: • Customers • Innovation
Advisory Group
• Trend studies • Market
research • Competitive
analyses • Operational/
cost analyses
Filter: • Translate
need to approach
• Market research
• Rigorous prioritization process
Incubate: • Pilot design
and build (StageGate)
• Customer engagement
Pilot: • Integration
with other UHG businesses or external partners
• 4 - 5 incubations become 2 - 3 pilots/yr
Launch: • Disposition • Integrate,
revise, launch or kill
• Key learnings
OR
Redirect/ dissect
Assess: Rapid-cycle development or exit
Process: A Focused Discipline of Innovation
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Concept
Development
phase1
Exploration • Empathize with the customer and identify unmet needs
Understanding Unarticulated Needs
• Spot trends and patterns that could change the rules of the game
Harnessing Discontinuities
• Question deeply held dogmas inside the company and industry about what drives success
Challenging Convention
• Thinking of UHG as a portfolio of skills and assets rather than a provider of products and services
Leveraging Competencies and Assets
Systematizing the “Front End”
12 Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Identifying Opportunities
Multiple sources for business opportunities
Internal sourcing: External sourcing:
•Frequent communication with
business leaders, corporate
development
• Insight-driven research widely
distributed
•Rich data and analytics
•Formal cross-organizational
intercompany advisory group
• Involvement in industry and trade
groups
• Interaction with customers (including
government entities)
•Relationships in academia and
research institutions
•Soliciting ideas from healthcare
entrepreneurs
•Linkage to Fortune 500 and
technology firms
•Active alternative
investment portfolio
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
• A new way to understand and solve
problems
Common to CPG – Revolutionary in health
• Developing competency for:
Empathy
Contextual understanding
Seeing beyond the survey
• Creates rich insights that spur creativity
• Inspires solutions with meaningful
impact
My Health Sherpa
Harnessing Unarticulated Needs: Design Thinking in Health Care
14 Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Designing Experiments: Getting Going vs Getting Perfect
Cultural shift introduces rapid, iterative prototyping
Experimentation:
– Unlocks insights about customer behavior and desirability
– Low-cost, low-fidelity learning opportunities
– Informs solution development while reducing risk
Building out the competencies:
– Frame the right questions to ask
– Construct the learning prototype
– Rapid resourcing
– Quick, easy access to customers
Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Harnessing Analytics and Discontinuity:
Type 2 Diabetes Epidemic: The Human Toll
2020
One of the fastest-growing diseases in the U.S.
40% 52%
Estimated
prevalence (adults)
2010
27 million
67 million
Diabetes
Prediabetes
39 million
96 million
Annual US
Spending $194 Billion $500 Billion
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
The Type 2 Diabetes Epidemic: The Financial Toll
$4,400
Person without diabetes
Person with Diagnosed
Diabetes
$11,700 Person with
Complications Related
to Diabetes
$20,700
Rising costs for the health care system
• Annual U.S. health care spending on diabetes and
prediabetes will rise from $194 billion in 2010 to an
estimated $500 billion by 2020 – or about $3.35 trillion
over the next decade.
Rising costs for the individual
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Type 2 diabetes
Prediabetes Obesity Overweight
The Type 2 Diabetes Continuum
CDC-endorsed
weight loss
and exercise
protocol
In-store
pharmacist
consultation
on medication
management
Diabetes Control Program
The Diabetes Prevention and Control Alliance
An Alternative Model of Care Delivery
Pre-diabetics who lose 5-7% of
their weight reduce conversion
to full-blown diabetes by 58%
Glucose, blood pressure, and cholesterol control may reduce diabetes complications 12% to 50%
Diabetes Prevention Program
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
20
A Platform for Growth
• Diabetes Health Plan
• Natural History of Disease
• Diabetes Prevention and Control
Alliance
• Diabetes Prevention Program – Virtual
• JOIN for Me
Type 2 diabetes Prediabete Obesity Overweight
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Core pillar of cultural values Constant and consistent reinforcement
Innovation Day Learning sessions – Expo – Award dinner
Virtual setting for remote employees
CEO Challenge
Golden ticket to Innovation Council
Prepare/Launch Challenges Collaboration sessions
Ignite! Toolkit
Consulting for business unit leaders
Space to Innovate
Culture: Alignment
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Local recognition and awards
Enterprise-level recognition
• Innovation Council presentations
• Innovation Day Award ceremony
Career opportunities
• Innovation Lab leadership
• Innovation Champions
• Executive-in-Residence
• Executive Leadership positions
Culture: Compensation/Careers
Local recognition
More consistency across teams
Enterprise-level recognition
• Simplify
Career opportunities
• Adapt Human Capital approaches for participation
Current State Evolution
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Nine Key Attributes of UHG’s Reputation
Industry Rank
Innovation 1
People Management 1
Use of Corporate Assets 1
Social Responsibility 1
Quality of Management 1
Financial Soundness 1
Long-Term Investment 1
Quality of Products/ Services 1
Global Competitiveness 2
2011 Recipient of the Product Development
and Management Association’s Outstanding
Corporate Innovator (OCI) Award, the Only
Innovation Award Which Recognizes
Sustained, Quantifiable Business Results
from New Products and Services, and First
in Our Industry to Receive This Award
Received the U.S. Chamber’s 2011 Corporate
Citizenship Best Business Neighbor Award for
“Deploying Vast Resources and Technological
Expertise to Combat America’s Diabetes
Epidemic”
UnitedHealth Group: Recognized for Leadership, Innovation and Social Stewardship
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
The Objective:
To modernize the U.S. health system, developing new, financially responsible ways to make quality care more accessible and affordable for all Americans.
Goals:
• Outgrow our competitors
• Create the best experience for patients and caregivers
• Enable measurable increases in the quality of care
• Help the system work better with the resources it has
Units of Measure:
Membership
in New
Products
Revenue from
New Services More Value
in Care
Delivery
Employee
Engagement
Index
Public Recognition/
Goodwill
ROI: Assessing Impact Across Dimensions
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Innovation: In the Service of Practical Solutions
• We must be thoughtful
advocates of the always
changing health care
environment
• We value change
• Must be proficient at adapting
• Must be engaged in constant
change, yet embody a positive
dynamic
• It must change progressively
We Must Adapt
Health Care Environment Advocates of Change
• Encourage and invest in new
ideas
• We must be continually curious
Challenge the Status Quo
Our fundamental role is to Make Health Care Work for Everyone
We are not afraid to fail in honest efforts to focus on practical and purposeful
innovation that builds value and benefits the entire health care system – so it
truly works for everyone.
© 2012 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited.
Telehealth for the Navajo Nation
26