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Framing the Issues Summary Findings HBS/HMS Survey of Executive Sentiment in Healthcare November 14, 2012. Survey Objectives. Capture senior executive sentiment about key trends in innovation, quality, and cost in healthcare Critical and informative Challenging to measure
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Framing the IssuesSummary FindingsHBS/HMS Survey of Executive Sentiment in HealthcareNovember 14, 2012
Survey Objectives • Capture senior executive sentiment about key trends in innovation, quality, and cost in healthcare • Critical and informative • Challenging to measure • Cover a broad range of sectors within the industry • Respondents • Questions • Frame our discussion for the next two days • Develop a survey approach that can be used going forward
Approach • Questions developed by HBS/HMS faculty organizing committee (Chin, Hamermesh, Huckman, McNeil, Newhouse) with help from • HBS survey support (Chase Harrison, Cara Sterling) • AbtSRBI(Benjamin Phillips and Stephanie Lawrence) • Cognitive testing by Abt SRBI • Participants in HBS healthcare executive program • HBS MBA students with healthcare (often clinical) expertise • On-line survey requests sent to 509 invitees to the Forum on Healthcare Innovation • 216 responses as of October 10, 2012
Flow of Findings • Quality • Current • Trajectory • Quality and Cost Trajectory • Overall • By Innovation Category • Role of Key Actors in Healthcare Innovation • Government • Existing Firms • New Entrants
Quality: Current and Trajectory Current Quality Quality Trajectory “Is the quality of healthcare in the US falling behind, keeping pace with, or pulling ahead of that in other advanced industrialized countries?” “How would you rate the quality of healthcare for the average person in the US compared to other advanced industrialized countries, such as Canada, England, Germany, and Japan?”
Quality: Current and Trajectory (Positive Sentiment) Excellent or Very Good / Pulling Ahead 14% Excellent or Very Good Excellent or Very Good / Keeping Pace 19% Excellent or Very Good / Keeping Pace 19% CURRENT Quality Good Good / Pulling Ahead 3% Good / Pulling Ahead 3% Only Fair or Poor Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality: Current and Trajectory (Positive Sentiment) Excellent or Very Good / Pulling Ahead 14% Excellent or Very Good Excellent or Very Good / Keeping Pace 19% CURRENT Quality Good Good / Pulling Ahead 3% Good / Pulling Ahead 3% Only Fair or Poor Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality: Current and Trajectory (Positive Sentiment) Excellent or Very Good / Pulling Ahead 14% Excellent or Very Good Excellent or Very Good / Keeping Pace 19% CURRENT Quality Good Good / Pulling Ahead 3% Only Fair or Poor Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality: Current and Trajectory (Negative Sentiment) Only Fair or Poor / Keeping Pace 8% Excellent or Very Good Good / Falling Behind 12% Good / Falling Behind 12% CURRENT Quality Good Only Fair or Poor / Falling Behind 20% Only Fair or Poor / Falling Behind 20% Only Fair or Poor Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality: Current and Trajectory (Negative Sentiment) Only Fair or Poor / Keeping Pace 8% Excellent or Very Good Good / Falling Behind 12% CURRENT Quality Good Only Fair or Poor / Falling Behind 20% Only Fair or Poor / Falling Behind 20% Only Fair or Poor Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality: Current and Trajectory (Negative Sentiment) Only Fair or Poor / Keeping Pace 8% Excellent or Very Good Good / Falling Behind 12% CURRENT Quality Good Only Fair or Poor / Falling Behind 20% Only Fair or Poor Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality: Current and Trajectory (Mixed Sentiment) Excellent or Very Good / Falling Behind 5% Excellent or Very Good Good / Keeping Pace 18% Good / Keeping Pace 18% Current Quality Good Only Fair or Poor Only Fair or Poor / Pulling Ahead 1% Only Fair or Poor / Pulling Ahead 1% Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality: Current and Trajectory (Mixed Sentiment) Excellent or Very Good / Falling Behind 5% Excellent or Very Good Good / Keeping Pace 18% Current Quality Good Only Fair or Poor Only Fair or Poor / Pulling Ahead 1% Only Fair or Poor / Pulling Ahead 1% Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality: Current and Trajectory (Mixed Sentiment) Excellent or Very Good / Falling Behind 5% Excellent or Very Good Good / Keeping Pace 18% Current Quality Good Only Fair or Poor Only Fair or Poor / Pulling Ahead 1% Falling Behind Keeping Pace Pulling Ahead Quality Trajectory
Quality Sentiment: An Even Split 24% 36% Excellent or Very Good CURRENT Quality Good Only Fair Or Poor Falling Behind Keeping Pace Pulling Ahead 40% Quality Trajectory
Trajectory: Quality and Cost (Positive Sentiment) Decreasing Costs / Pulling Ahead 1% Decreasing Same Costs / Pulling Ahead 9% Same Costs / Pulling Ahead 9% Inflation-Adjusted Cost Same Decreasing Costs / Keeping Pace 2% Decreasing Costs / Keeping Pace 2% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Trajectory: Quality and Cost (Positive Sentiment) Decreasing Costs / Pulling Ahead 1% Decreasing Same Costs / Pulling Ahead 9% Inflation-Adjusted Cost Same Decreasing Costs / Keeping Pace 2% Decreasing Costs / Keeping Pace 2% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Trajectory: Quality and Cost (Positive Sentiment) Decreasing Costs / Pulling Ahead 1% Decreasing Same Costs / Pulling Ahead 9% Inflation-Adjusted Cost Same Decreasing Costs / Keeping Pace 2% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Trajectory: Quality and Cost (Negative Sentiment) Same Costs / Falling Behind 12% Decreasing Increasing Costs / Keeping Pace 21% Increasing Costs / Keeping Pace 21% Inflation-Adjusted Cost Same Increasing Costs / Falling Behind 22% Increasing Costs / Falling Behind 22% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Trajectory: Quality and Cost (Negative Sentiment) Same Costs / Falling Behind 12% Decreasing Increasing Costs / Keeping Pace 21% Inflation-Adjusted Cost Same Increasing Costs / Falling Behind 22% Increasing Costs / Falling Behind 22% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Trajectory: Quality and Cost (Negative Sentiment) Same Costs / Falling Behind 12% Decreasing Increasing Costs / Keeping Pace 21% Inflation-Adjusted Cost Same Increasing Costs / Falling Behind 22% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Trajectory: Quality and Cost (Mixed Sentiment) Decreasing Costs / Falling Behind 3% Decreasing Same Costs / Keeping Pace 21% Same Costs / Keeping Pace 21% Inflation-Adjusted Cost Same Increasing Costs / Pulling Ahead 8% Increasing Costs / Pulling Ahead 8% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Trajectory: Quality and Cost (Mixed Sentiment) Decreasing Costs / Falling Behind 3% Decreasing Same Costs / Keeping Pace 21% Inflation-Adjusted Cost Same Increasing Costs / Pulling Ahead 8% Increasing Costs / Pulling Ahead 8% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Trajectory: Quality and Cost (Mixed Sentiment) Decreasing Costs / Falling Behind 3% Decreasing Same Costs / Keeping Pace 21% Inflation-Adjusted Cost Same Increasing Costs / Pulling Ahead 8% Increasing Falling Behind Keeping Pace Pulling Ahead Quality
Quality and Cost Trajectory: Cause for Concern 33% 12% Decreasing Inflation-Adjusted Cost Same Increasing Falling Behind Keeping Pace Pulling Ahead 55% Quality
Opportunities for Innovation Net Quality Impact (%) Net Cost Control Impact (%)
More Critical to Foster Innovation: Private Sector or Government? Private Sector More Critical Government More Critical
More Critical to Lead Innovation: New Entrants or Existing Firms? New Entrants More Critical Existing Firms More Critical
Summary • Sentiment about quality (current and trajectory) is genuinely mixed • Sentiment about the trajectory for value (quality and cost) is decidedly more negative • Significant opportunities for process innovations to improve value • Within specific innovation categories • Consensus about relative importance of private sector and government • Greater debate over relative importance of existing firms and new entrants