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Acute

Event
Future
Treatment
Plus
Monitoring
Trends in
Healthcare:
Chronic
Disease

Impact on Group Practices

Ogan Gurel, MD MPhil


Aesis Research Group, LLC
gurel@aesisgroup.com

Leader’s Board
San Diego, CA
January 23rd , 2006
Outline

 Change
 The Future of Healthcare
 Imperatives for Group Practices
Competitive forces cause
change
• Entry of hospitals

• Relaxation of CON

• Aging of the population

•Emphasis of baby-boomers
on convenience and
• Growing influence of device seamlessness
companies
• Consumer-directed health
• Relative physician/surgeon plans
shortages
• Growing influence of
• Physician work-life balance Federal government
issues
• Emphasis on quality
measures

• BBA II?

• Emerging technologies

• Convergence of
diagnosis and treatment
Source: Porter, Michael, On Competition, 1995
Change can be
incremental or disruptive

Source: Christensen, Clayton et al, Seeing What’s Next, 2004


Outline

 Change
 The Future of Healthcare
 Imperatives for Group Practices
The hospital as center of
care

Acute
Event

Chronic
Disease
Care is now decentralized
and fragmented
Acute
Event

Diagnosis Monitoring

Treatment
Plus

Chronic
Disease
The future will demand more
integration and coordination

Acute
Event

Sub-
Diagnosis
Diagnosis

Treatment
Plus
Chronic
Disease
Buyer driven forces

• Aging of the population

•Emphasis of baby-boomers
on convenience and
seamlessness

• Consumer-directed health
plans

• Growing influence of
Federal government

• Emphasis on quality
measures

• BBA II?

Source: Porter, Michael, On Competition, 1995


Growth of Over-65 Age Group
Accelerates After 2010
Forecasted Percent Change The Baby Boomers
US, 2004-2014 US, 2004-2014
Millions

Total 10.7% 45-64


86

65-UP 22.4%
76

66

45-64 19.7%
56 65 +

46
18-44 6.3%

36 Year
2004 2006 2008 2010 2012 2014

00-17 3.0%
Source: Sg2 Analysis, 2004
Supplier-driven forces

• Growing influence of device


companies

• Relative physician/surgeon
shortages

• Physician work-life balance


issues
Potential entrants
• Entry of hospitals

• Relaxation of CON

Source: Porter, Michael, On Competition, 1995


Substitutes

• Emerging technologies

• Convergence of
diagnosis and treatment
Source: Porter, Michael, On Competition, 1995
Key disruptive technologies
Carotid stenting
CVLess invasive intervention
Non-invasive angiography
Targeted therapies
CancerMIS advances
& GeneralVirtual colonoscopy
SurgeryHIFU
Image-guided surgery
Carotid stenting
Image-guided surery
Neuro/OrthoRobotic surgery
MIS advances (hip,knee,spine)
Outline

 Change
 The Future of Healthcare
 Imperatives for Group Practices
Imperatives for Group Practices
In order to meet the changes in the future group practices must …

 Provide coordinated, seamless care


 Address increasingly complex conditions and must address more than just the medical / surgical problem
 Consider alliances to help address these challenges
 Measure quality
 “Ride the IT wave” or be rendered irrelevant
 Increasingly consider the integration of imaging (and diagnosis) to their operations
 Be increasingly aware that the federal government (Medicare, etc.) are not just “bystanders” in the process.
Regulation and compliance are critical
 Keep costs down – reimbursements will not be increasing and may very well decrease (though without
compromising quality)
 Keep physicians happy … which is not always about money
 Be flexible enough to accommodate technology changes.
Æsis Research Group
Ogan Gurel, MD MPhil
Providing forward-looking information, intelligence and
research services to healthcare investment decision-makers
Facilitating hospital-clinician relationships to help implement
and move forward strategic, operational and facilities initiatives

11 S. LaSalle Street, 5th Floor, Chicago, IL 60603


T (312) 423-2764 | F (773) 409-5897 | M (312) 543-9019

gurel@aesisgroup.com

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