New Entrants Grabbing Slice of Changing Healthcare Market

Christopher Cheney, for HealthLeaders Media , May 14, 2014

The new entrant study's lead author, Trine Tsouderos, a director at PwC's Health Research Institute, says a consumer survey served as "the heart of our report." The survey asked consumers whether they would be comfortable receiving medical services outside of a traditional setting or with new "virtual technology" options such as smartphone apps and telemedicine. The medical services in the survey ranged from a routine electrocardiogram to dialysis.

A significant finding of the survey is that 45% of respondents said they were likely to choose the new options for outpatient care and services historically obtained in physician offices. "People were very open to doing these in new ways," said the study's lead author, Trine Tsouderos, a director at PwC's Health Research Institute, during the webcast.

New dialysis options drew the most tepid consumer response, with 26% of respondents embracing options such as home dialysis.

Tsouderos says the consumer survey also gauged "the money at stake" for traditional healthcare organizations. She said $42 billion is a "conservative number," noting 2011 data indicates new entrants had the potential to vie for more than $64 billion in medical services.

New entrants, new payment models

Lack of experience in the healthcare industry—particularly with complex payment systems—is the largest obstacle for nontraditional players trying to establish niches in the market, Connolly says. Some new entrants are building their business models without public and commercial healthcare payers in the mix, she says. Other new entrants are establishing partnerships with traditional players.

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