prescription for roi: innovation in health care by meredith baratz of unitedhealth group

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.


Never leave well enough alone –

Raymond Loewy, Designer


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Who We Are

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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


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.


UnitedHealth Personal Rewards

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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


Our United Culture Values


UnitedHealth Group

Innovation Council

Business Segment

Innovation Labs

Center for Health

Reform and Modernization

UnitedHealth Group

IT R&D

Structure: Integrated Innovation Capabilities


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


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.


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


• 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.


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.


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


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


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


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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


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

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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


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


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


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.


Telehealth for the Navajo Nation

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prescription for roi: innovation in health care by meredith baratz of unitedhealth group

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