Consultant Perspective on the
Health Care Sector
Future of Healthcare – Trends in 2015
January 8, 2015
Xerox Proprietary and Confidential
Xerox Healthcare
Overview
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Who We Are
With sales of $22 billion, we are a global
leader in IT services, business process
outsourcing and document management
Employees: 140,000 worldwide
History: Founded in 1906 as The
Haloid Company; named Xerox in
1958 and Xerox Corporation in 1961;
acquired Affiliated Computer Services
in 2010
Headquarters: Norwalk, CT
Chairman and CEO: Ursula M.
Burns
Ursula M. Burns, Chairman and CEO
“We operate our businesses in ways
through which economies grow,
societies benefit and the environment
is protected. Some call it the triple
bottom line. We call it the best thing for
our business success.”
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FORTUNE magazine's annual
ranking of the World’s Most Admired
Companies places Xerox at the No. 4
position in the computer industry.
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Healthcare is the largest Vertical
Market within Xerox
• Healthcare is Xerox’s fastest growing market
• We understand Healthcare
• Strategic vendor relationships
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Key Healthcare Metrics
19,500+
900+
22+
Hospitals served
Million healthcare claims
processed per year
Thousand employees
dedicated to healthcare
36
100
$2.5B+
Million people served by
government health services
Percent of the top 10 BCBS
organizations are clients
Healthcare services revenue
19
2/3
37
Of the top 20 US Managed
Healthcare plans are clients
Of U.S. insured patients are
touched by our services
U.S. states supported by
government health solutions
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Xerox Touches All Aspects of Healthcare
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$2.5B+ Healthcare Services Revenue
Providers
• Management and
Technology Consulting
• Infrastructure and
Platform Services
• EHR & HIE Integration
• Analytics & Data
Management
• Care and Quality
Management Software
and Comparative Data
• Enterprise Print Services
• Adoption and End User
Training
Payors / Employers
Pharma / Life
Sciences
• Transaction processing
• Analytics
• State HIEs
• Customer Care
• Customer Care
• Communication &
Marketing Services
• Document Supply Chain
Management
• Eligibility/Health Insurance
Fraud and Abuse
• Cost Avoidance and
Recovery
• Finance and Accounting
• Care Management
• Health Insurance Exchange
• Enterprise Print Services
• Enterprise Marketing
Services
• Human Resources
• Transaction BPO
• IT Outsourcing
• IT Outsourcing
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Government
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• Health Analytics &
Reporting
• Health Information
• Medicaid Fiscal Agent and
MMIS
• Pharmacy Benefits
Management
Recognition / Points of Pride
Gartner ranks Xerox the market-share leader for
IT Services in the Healthcare Provider market
in North America, based on revenue for 2013
and 2012
Everest Research Group’s Leader and Star
Performer for Contact Center Outsourcing
(CCO) Service Provider Landscape with
PEAK Matrix Assessment
TM
- July 2014
- Gartner, Market Share: IT Services
April 2014
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Winner’s Circle of the HfS Research
Healthcare Payer BPO Blueprint
Gartner Magic Quadrant Leader for Finance
and Accounting BPO, Worldwide
- July 2013
- May 2014
KLAS Research, recognizes Midas+ as the
highest-rated Quality Management software
platform
Gartner Magic Quadrant Leader for Customer
Management Contact Center BPO,
Worldwide
- October 2014
- December 2013
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Healthcare Provider Landscape
Industry Dynamics and Xerox Point of View
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Current Healthcare Landscape
Government legal and regulatory initiatives and mandates are creating
political, economic, and cultural pressure on existing healthcare
systems to transform the way they do business:
Market Drivers
• ARRA/HITECH
Market Impacts
• Decreased inpatient
volumes
• PPACA
• ICD-10
• HIPAA
• IHI Triple Aim
• Quality initiatives
• Reporting requirements
• Audits
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• Consumerism
• Patient engagement focus
• Reduced reimbursement
and lower margins
• Fee-for-Service to Value
based reimbursement
• Increasing resource
shortage
• Price transparency
• Privacy/Security –e-PHI
• Industry consolidation
• Moving outside of the “4
walls”
• High deductible insurance
• Competition for patients
• Insurance and Benefits
Exchanges (HIX/HBX)
• Increase in Technology
spend
• Risk shifting
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Keys to a Successful Provider Transformation
Industry moving from episodic delivery of care to a Population
Health focus and fee for service to Value Based reimbursement
To thrive, organizations must:
1. Governance/Leadership to drive the most appropriate value based model
2. Engage patients proactively in managing their health and utilization
3. Develop and strengthen the relationship with care providers
4. Focus on clinical as well as business process change
5. Significantly expand the use and purpose of information technology:
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Focus on internal and external clinical system integration, adoption and enablement
Capture & codify data and actively use information to improve care, quality and
efficiency
Share structured, patient-specific information and coordinate care between affiliated
providers and across care settings
Use data analytics and business intelligence to stratify patients, assess risk, improve
care, enhance efficiencies and evaluate contracts
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Health Care Sector Market Trends
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Xerox Proprietary and Confidential
Health Care Sector Market Trends for 2015
- Health IT legislation with new Congress including FDA authority, ICD-10, health
data breaches and Meaningful Use
- Legislation to incent arrangements with non acute care services providers (i.e.,
telemedicine, LTC, Assisted Living, hospice )
- Accelerating transition from Fee for Service to Value Based Healthcare contracts
and delivery models including Population Health Management
- Increasing utilization of analytics to support the new healthcare paradigm
- Focus on process and technology improvements especially in the Revenue Cycle
and Coordination of Care (interoperability) areas
- Continued industry consolidations through mergers, acquisitions and affiliations
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Traditional mergers and acquisitions – large Health Systems
Affiliations – mid to small community and rural facilities
Physician practice affiliation and employment with health systems
Vendor consolidation will continue
- MU S2 and ICD-10 compliance
- Increasing requirements on privacy/security
- New technology tools and application to promote care outside of the acute care
setting (i.e., remote sensing solutions, Kiosks, mHealth applications)
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Health Care Sector Market Trends for 2015 (cont.)
- Workforce issues will have greater impact
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IT, Care Providers and Senior Leadership areas
Numbers
New skill sets required
–
Technologies and new delivery models
–
Flood of newly insured
Current staff retention
Legislation on care providers extenders
- Risk Shifting will continue
•
Providers/Payors/Consumers
- Increasing competition for patients
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Consumerism
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Transparency continues to grow
Patient engagement and population health management must become focus for providers
Will take more responsibility for their health and healthcare in 2015
Increasing utilization of mHealth and telehealth applications
Increasingly demand Proof of Quality
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