The Dilemma of Hub vs. Point Health Solutions
Wandering around the US Healthcare Conference in San Diego this week, looking at the sea of vendor booths, I was struck by the dilemma facing many employers today. A similar dilemma faces the solution-providers themselves when strategizing on the best path for their business. On the one hand there are many incredibly innovative health solutions really moving the needle on specific aspects of employee health and wellbeing. And on the other hand, there is expansion in services and consolidation of providers to combat the fragmented and frankly overwhelming assortment of offerings facing not only the employer, but the individual employee as well.
At opposite ends of the spectrum are the phenomenal Sword Health (in the MSK category that also includes Hinge and Vori) and the newly minted Personify Health which is a recent merger of Virgin Pulse and HealthComp.
Sword Health (and its direct competitors) have revolutionized musculoskeletal care with a compelling ROI that is an easy-sell. They have turned the traditional paradigm of a referral to a physical therapist’s office on its head. Rather than waiting weeks for the first appointment, taking time away from work to drive there and back once or twice a week, and the hit-or-miss prospect of self-directed exercises at home in between, it’s a real-time virtual experience. Special sensors track if you are doing your exercises correctly and your dedicated physical therapist, accessible 24/7, is monitoring your progress daily. Research data supports the efficacy of this mode of treatment: quicker recovery rates, avoidance of surgery and lasting improvement. Sword has recently expanded its services to women’s pelvic care and global access to validated exercises and education to fight pain.
Virgin Pulse, one of the largest and truly global wellbeing platforms, already had a large ecosystem of individual point solutions. This enabled employers to leverage a single vendor partnership to provide a range of leading-edge solutions in categories such as MSK, mental health, nutrition, chronic condition management, physical activity and family services. It simplified contracting and reduced the blizzard of possibilities down to a more manageable number. In becoming Personify Health they have added health plan administration and comprehensive health navigation providing a truly one-stop-shop for employers. It remains to be seen if the execution of the vision to tackle increasing healthcare costs and complexity stands up to reality in practice.
In debating the pros and cons of consolidation versus specialization, I fear we are losing sight of what actually generates health in the first place. Conspicuously absent from the vendor parade at the conference were many of the solution-providers I am most excited about these days. I call them the functional medicine crowd – they look at the root-cause of the condition and reverse it through addressing what we refer to as lifestyle. Often dismissed as a nice-to-have and more relevant for the generally healthy, what you eat and drink, how often you move, the quality of your sleep, your relationships and the environment you live in, does more for your health than any medication or surgery. Solutions like Parsley Health, Well Theory, MyMee, Ciba, andHealth, Day Two and Digbi are on the right path to truly reduce healthcare costs through disease reversal, rather than management. They look at chronic underlying infections, the health of your microbiome, toxicities due to mold and chemicals in the work or home environment, as well as nutrient deficiencies, all using the latest techniques in testing and data science.
For start-ups like these, the dilemma can include the need to differentiate themselves in the market such as focusing on autoimmune conditions, digestive health or even women’s health. The diabetes reversal solutions that have been around longer, are now diversifying into other conditions, taking advantage of the fact that most chronic conditions are connected and can be treated similarly with lifestyle factors once the underlying root cause(s) has been identified. And a single root cause, such as a past Lyme disease infection, can manifest itself in a myriad of ways in different individuals, resulting in such diverse disease labels as multiple sclerosis or depression. But in fact will resolve with a similar approach once the root cause has been addressed.
For an employer there are pros and cons of selecting a single hub or a range of point solutions to fit the varied needs of employees. For the solution-providers it’s a balancing act of differentiation and the need for quick wins and demonstrated efficacy, against the employers’ push for consolidation and simplification. In either case, as long as we don’t lose sight of what is ultimately going to improve the health of employees we can’t go wrong.
