Homecare and Supported Living UK Market Reportq

Homecare and Supported Living UK Market Reportq

The third edition of LaingBuisson’s much respected report on the UK homecare and supported living market, written by the company’s founder, health economist William Laing, is essential reading for anyone involved in this fragmented and growing market. This includes investors, advisors and providers as well as commissioners of these services for which independent providers predominate. Covering the market as it was in 2019, the report was completed in March 2020, just as the UK was going into lockdown because of Coronavirus. The report, therefore, provides a helpful summary of the ‘state of play’ just before it experienced the impact of Covid-19 both operationally and economically and is a valuable tool for understanding the underlying dynamics of the sector.


REPORT AUTHOR
FOREWORD
EXECUTIVE SUMMARY AND HIGHLIGHTS
DEFINING POPULATION HEALTH MANAGEMENT
1. POPULATION AND HEALTH COST
1.1 Drivers of health costs
1.2 The US story
1.3 Chronic disease - the global picture
1.3.1 Latin America
1.3.2 Europe
1.3.3 Russia
1.3.4 Gulf Cooperation Council
1.3.5 Africa
1.3.6 India
1.3.7 China
1.3.8 South East Asia
1.3.9 Australia
1.4 Economic impact overall and by region
1.5 Economic impact on employers
1.6 Conclusions to date
2. HISTORY OF POPULATION HEALTH MANAGEMENT
3. SOLUTION TOOL BOX - WHAT EXISTS AND PROS AND CONS
3.1 Categorisation of services
3.2 Data collection and analysis tools
3.2.1 Health risk assessment
3.2.2 Physical screening
3.2.3 Healthcare information technology systems, data management, data analytics software
3.2.4 Wearables and biosensors (e-health)
3.2.4.1 Consumer wearables
3.2.4.2 Physician/healthcare provider oriented e-health
3.2.4.3 ROI to date and outlook
3.3 Prevention/education
3.3.1 Occupational health programmes
3.3.2 Employee assistance programmes
3.3.3 Wellness programmes, behavioural change and risk factor management
3.3.3.1 Incentives
3.3.3.2 Penalties
3.3.3.3 Conclusions
3.4 Managed intervention
3.4.1 Pre-authorisation/Pre-certification/Utilisation review
3.4.2 Case management
3.4.3 Condition management
3.4.4 Telehealth/’m’health for cost reduction/better care
3.4.5 Pharmacy benefit management/drug adherence
3.5 Delivery mechanisms
3.5.1 Collaboration issues
3.6 Conclusions
4. SUMMARY OF THE DEBATE - KEY LESSONS
4.1 Introduction
4.2 Conclusion: Does PHM work? Yes, but only if done right
4.3 What does ‘doing it right’ mean?
4.4 Lessons
4.4.1 Lesson 1: Define, understand and commit to a ‘culture’ of health and wellbeing
4.4.2 Lesson 2: Establish leadership at all levels, including medical and non-medical resources
4.4.3 Lesson 3: Set a multi-year strategic road map with benchmarked goals, regular measurements and accountability
4.4.4 Lesson 4: Establish a best practice programme design and implement it well
4.4.5 Lesson 5: Engage the community to ensure high participation
4.4.6 Lesson 6: Invest in smart incentivisation
4.4.7 Lesson 7: Recruit, integrate and reward high performing community providers and payers: full system collaboration
4.4.8 Lesson 8: Harness appropriate technology and utilise data
4.4.9 Lesson 9: All players in the health continuum must play their part and follow these lessons
5. KEY CONSUMERS - WHO, WHY AND WHERE?
5.1 Introduction
5.2 Overview of buyers
5.2.1 Corporates (private and state owned)
5.2.2 Governments
5.2.3 Health and life insurers/re-insurers
5.2.4 Hospitals, health maintenance organisations, accountable care organisations and medical practitioners
5.2.5 Individuals
5.2.6 Consolidators and advisors
5.2.7 Healthcare intergovernmental organisations, non-governmental organisations and foundations
5.3 Future trends
6. CATALYSTS - WHO IS PUSHING WELLNESS?
6.1 Overview of suppliers
6.1.1 Category 1 - Direct suppliers or health services companies
6.1.2 Category 2 - ‘Customer-distributor’ hybrids
6.1.3 Category 3 -Enablers
6.2 Category 1 – Health service companies
6.3 Category 2 – Employee benefit consultants
6.3.1 AON Hewitt
6.3.2 Buck Consultants
6.3.3 Mercer
6.3.4 Towers Watson
6.3.5 Willis
6.4 Category 2 – Assistance companies
6.4.1 International SOS
6.5 Category 3 – Pharmaceutical companies
6.5.1 Pfizer
6.5.2 Sanofi
6.6 Category 3 – Enablers
6.6.1 Sodexo
6.6.2 Walgreens Boots Alliance
6.6.3 Apple - HealthKit
6.6.4 Google
6.6.5 Philips HealthTech
6.6.6 Siemens
6.7 Conclusions
7. MARKET OPPORTUNITY - TODAY AND TO COME
7.1 PHM market definition/segmentation
7.2 Workplace wellness market size 2015 - globally and by region
7.2.1 Global
7.2.2 Regions
7.3 PHM sub segments, size, globally and regionally
7.3.1 IT supplier- based approaches
7.3.2 Retail
7.3.3 Summary so far
7.4 Growth trends to date
7.5 Predicted growth
7.6 Assessing potential opportunities by segment and region
APPENDIX 1. GLOSSARY
TABLE OF TABLES
Table 1.1 NCD cost impact by region, 2013 - 2025
Table 2.1 Current state vs. future state drivers of PHM
Table 3.1 Stages required to achieve analytics progress, with example case studies
Table 3.2 Example report
Table 3.3 Worldwide wearable electronic fitness devices shipments forecast (millions of units), 2013 - 2016
Table 3.4 The key elements of wellness programmes by region
Table 3.5 PruHealth outcomes using Vitality
Table 3.6 Summary of four resourcing methods for multi-stakeholder collaborations
Table 3.7 HealthNEXT’s benchmark approach
Table 3.8 HealthNEXT’s multi-year plan approach
Table 3.9 Overall ranking for PHM tools
Table 4.1 Summary of the ‘Employer Health Asset Management Roadmap’
Table 4.2 Employers with wellness champion networks report better outcomes
Table 5.1 The relative importance of motives behind wellness programmes by region
Table 5.2 Top ten health promotion components by region
Table 5.3 Fastest growing wellness programme elements by region
Table 6.1 Notable health service companies
Table 6.2 Purchasing value in healthcare (via RxCollaborative)
Table 7.1 Ultimate market size segmentation
Table 7.2 Wellness penetration by region, using multiple sources
Table 7.3 ‘Top-down’ analysis of workplace wellness market by region, 2015
Table 7.4 ‘Markets and Markets’ PHM software and services market size
Table 7.5 PHM market size by sub segment - indicative size, 2015
Table 7.6 Wellness programme and incentive spending, 2010 -2015
Table 7.7 2025 Potential workplace PHM spend by region
Table 7.8 Aspects of report methodology for evaluating type/timing of opportunities by region
Table 7.9 PHM: Progress of programmes to date, and key customers of PHM services in key global regions
TABLE OF FIGURES
Figure ES1 Estimated regional workplace PHM market size in 2015
Figure ES2 Future growth of the global wellness market in US$bn
Figure 1.1 Growth of the world population from 1950 to 2050
Figure 1.2 Pace of ageing by country 1950 to 2050
Figure 1.3 Medical spend per year by age
Figure 1.4 Number of deaths from disease worldwide, by cause
Figure 1.5 Cost increase as a function of risk factor
Figure 1.6 Health expenditure for OECD countries
Figure 1.7 OECD obesity rates (measured obesity not self-reported obesity)
Figure 1.8 Age-adjusted prevalence of obesity and diagnosed diabetes among US adults, 1994
Figure 1.9 Age-adjusted prevalence of obesity and diagnosed diabetes among US adults, 2010
Figure 1.10 Global cost of five most common NCDs
Figure 1.11 Global impact of NCDs on lost output 2010 to 2030
Figure 1.12 Health conditions by annual productivity cost per person
Figure 1.13 Annual productivity and medical costs ($m) for the average-size employer (10k employees)
Figure 1.14 Impact of health risks on medical expenses
Figure 1.15 Impact of health risks on absence from work and productivity
Figure 1.16 Calculating ROI: critical steps to success
Figure 1.17 What is the evidence base for workplace wellness programmes’ savings?
Figure 1.18 Anti ‘workplace health promotion programmes’ headlines
Figure 1.19 Healthy employees yield wealthy employers
Figure 2.1 The IHI triple aims
Figure 2.2 Percentage of primary care physicians in the US and ROW using electronic medical records in 2009
Figure 2.3 The evolution of medical management
Figure 3.1 Expected growth in healthcare data (petabytes), 2012-2020
Figure 3.2 Venture funding ($m) for companies using predictive analytics (2011-Q3 2014)
Figure 3.3 Use of incentives vs. penalties in corporate wellness programmes, 2013/14
Figure 3.4 Components of overall drug cost trend, 2006-2013
Figure 3.5 PHM toolkit
Figure 3.6 Multi-year plan based on input
Figure 4.1 Truven Analytics benchmark data of the best vs. most employers
Figure 4.2 Key drivers of establishing a culture of health and their impact
Figure 4.3 Employers use of strategic planning for employee health
Figure 4.4 The relationship between the value of the financial incentive and the participation rate in an HRA
Figure 4.5 The integrated health and safety model
Figure 4.6 UK measurements of national wellbeing
Figure 4.7 Core metrics for employee health management
Figure 5.1 The seven main PHM customer types
Figure 5.2 Healthy living offers multiple business opportunities in all sectors
Figure 5.3 Discovery Health’s ability to contain key drivers of medical inflation
Figure 5.4 Prevention vs. intervention - the imminent changes to conventional healthcare
Figure 6.1 Philips Healthcare highlights 2014
Figure 7.1 Global market size (US$bn) of wellness industry clusters, 2013
Figure 7.2 Global survey indicating proportion of employers offering health promotion to their employees by region, 2014
Figure 7.3 HRAs, education and coaching sold only online to global MNCs
Figure 7.4 Future growth of the global workplace wellness market
Figure 7.5 NCD cost distribution by countries for 2013-2025(e)
Figure 7.6 Global heat map: privacy and data protection by country

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