Healthcare at a Turning Point : A Roadmap for Change

If the furious debate around the state of healthcare in the US has led to any consensus, it’s that the system should be delivering better quality for less cost than it does. The truth is that our healthcare system is a sprawling mix of competing interests in which those of the patient are valued least. Too much discussion has devolved to simplistic scapegoating, and too few comprehensive, constructive solutions have been offered. It’s time for a fresh vision.

In straightforward language, Healthcare at a Turning Point: A Roadmap for Change outlines a new market-based business model that aligns industry financing mechanisms with the goals of prevention, improved quality, and reduced costs. Drawing on more than 25 years of cross-industry consulting experience, the authors:

• Articulate a market-based vision of the industry
• Examine past efforts to reduce costs, their failures and their unanticipated consequences
• Spotlight perverse incentives that distort the way the healthcare system operates and make it less than it could be
• Present concrete recommendations for change within the healthcare delivery, insurance, pharmaceutical, device and diagnostics sectors
• Explain the changes that employers, consumers and policy makers can make to create a more customer-responsive system that delivers more value

For all the uncertainty in the current environment, there is also a rare opportunity to fundamentally redefine who wins in this market. Healthcare at a Turning Point provides guidance to executives ready for that contest as well as a roadmap for change.

Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc., is an internationally recognized consultant and author with more than twenty-five years of experience in the field of strategy development and execution, business model design, and market analysis. Her clients have included Fortune 500 companies such as Johnson & Johnson, Eli Lilly, Pfizer, Westinghouse, AstraZeneca, Merck, Abbott Laboratories, major healthcare institutions, payers, and government agencies. The focus of her consulting addresses the challenges of maintaining competitive advantage in highly dynamic and regulated markets.

Dr. Numerof has been a consistent advocate for the importance of strategic differentiation, organizational alignment of structure, competencies and metrics to ensure effective implementation, and anticipating, rather than reacting to industry trends. She’s been a pioneer in the area of economic and clinical value, anticipating the impact of changing global payer attitudes on the fundamental business model of the healthcare industry. Her work across the entire healthcare spectrum gives her a unique perspective on the challenges and needs of manufacturers, physicians, payers, and healthcare delivery institutions.

Under her leadership, NAI has developed proprietary approaches that provide precise insight and practical solutions to some of the industry’s most complex business challenges. Taking a systemic approach, Dr. Numerof has addressed such diverse issues as comparative effectiveness research, accountable care, bundled pricing, consumer engagement, operationalizing compliance and transparency, portfolio management and the identification of growth platforms that provide sustainable differentiation through economic and clinical value, and effective commercialization based on value propositions that matter to key constituencies.

Dr. Numerof is widely published in business journals and has authored five books. She serves as an advisor to members of Congress on healthcare reform and comparative effectiveness research. She was a senior advisor with the Center for Health Transformation, a regular contributor to the Manhattan Institute, and wrote the Heritage Foundation’s policy paper, "Why Accountable Care Organizations Won’t Deliver Better Healthcare—and Market Innovation Will." She led a tri-partisan, cross-industry work group on payment reform and developed recommendations for new payment models that incent better health outcomes at lower cost. In addition, Dr. Numerof provides guidance to policy organizations and agencies on the relationship between innovation and regulation, working to support innovation and ensure responsive regulatory oversight.

Dr. Numerof graduated magna cum laude from the Honors College, Syracuse University and received her MSS and PhD from Bryn Mawr College.

Cofounder and Managing Partner of Numerof & Associates, Inc., has served as an internal and external consultant to Fortune 50 corporations, major pharmaceutical and medical device companies, healthcare delivery institutions, the financial services industry, and government agencies for over twenty-five years. He has worked extensively in the areas of strategic planning and implementation, product strategy and portfolio development, market analysis, consumer engagement, and operational improvement.

Abrams is well known for his expertise in the design and implementation of strategies for building competitive differentiation, defining sustainable value, identifying market influence mechanisms, and translating white space analysis into the creation of innovative solutions to meet unmet needs. His ability to identify market opportunities and to effectively improve organizational performance has been an invaluable resource to client companies on a global basis across industries.

Abrams has structured and managed innovative programs to evaluate care delivery and payment models, thereby defining the internal change processes necessary to translate business opportunities into effective market position, operations, product portfolio management, and new product design consistent with changing regulatory requirements. He has provided solutions to healthcare delivery systems to improve the management of care transitions, thereby reducing unnecessary hospitalizations, and reduced length of stay by identifying and managing factors causing extended stays, changing admissions and patient care management processes, and managing across the continuum of care while maintaining or improving clinical outcomes and reducing costs.

He is experienced in the design and execution of econometric modeling and analysis and decision support systems for a variety of science-driven industries and applications. He has designed technology solutions to meet a wide range of needs, including strategic account planning and management, thought leader interface, and key opinion leader management. His ability to manage the process of technology integration to support business objectives across multiple business environments ensures return on investment (ROI).

Abrams has written extensively on economic and clinical value creation and the need for integrated, systemic solutions to the challenges facing the global healthcare industry. His articles have appeared in more than a dozen leading business journals, and he coauthored the book Solving the Healthcare Crisis. As an adjunct faculty member of Washington University in St. Louis and LaSalle College School of Business Administration in Philadelphia, Abrams has taught MBA courses in strategic management, product planning and evaluation, quantitative decision making, and market analysis.

Michael Abrams completed his doctoral work in Business Policy at St. Louis University. He received his MA from George Washington University in Washington, DC.