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Discovering the Underlying Opportunity in Healthcare Point Solutions

Written by Risk Strategies Consulting | Apr 4, 2024 3:57:18 PM

Healthcare point solutions are services designed to provide a health, wellness, and/or condition-based service to supplement a benefits plan. These solutions address a specific condition and provide care or a program that meets a need in the healthcare ecosystem. COVID-19 helped accelerate the growth of the point solutions market. Healthcare point solutions can be standalone condition specific or offer broader condition inclusion with wellness, provider networks, or drive hybrid approaches. They often harness the best of what technology’s impact on healthcare has to offer; combining remote care solutions with wearable technologies and partnerships that look to emphasize patient outcomes.

In behavioral health alone, we have seen more than 30 in the market that encompass condition-specific solutions (i.e., areas such as depression, anxiety, autism, eating disorders, substance abuse), offer Employee Assistance Programs (EAPs), and/or provider networks. With behavioral health gaining more attention as a focus of health disparities, many large self-funded employers have turned to behavioral health point solutions to provide quick access to a clinically robust network. Additional trending solutions emphasize Musculoskeletal (MSK), cardiodiabesity, sleep health, and women’s healthcare. These healthcare point solutions have enabled employers to offer more robust benefits to their employees, yet it often results in complex navigation impacting engagement.

There is an opportunity for these solutions to drive a sum broader than their parts. However, a whole health approach personalized to the ecosystem is paramount to addressing the right care at the right time in the right setting. With the continued growth and expansion of healthcare point solutions, ensuring an understanding of how these solutions are engaging members from those with emerging risk to those who have polychronic conditions, by delivering clinical outcomes, closing gaps in health equity, improving the member experience, and driving financial value is key to navigating this growing market for adoption of high value solutions.

As plan sponsors and health plans determine courses of action, the need for consultants with experience navigating these complex challenges and expertise across benefit, actuarial, and data science is paramount to safeguarding effective outcomes and improved experience. Risk Strategies Consulting has designed comprehensive ROI frameworks to facilitate an assessment of these point solutions to help employers understand the value and impact these deliver on improving health outcomes. Our team of experts leverage real-world data, market insights, and conduct comprehensive ROI with dynamic actuarial modeling to advise large employers on impactful strategies that solve for these upcoming challenges with considerations for their ecosystem.

Take a deeper look at the complicated challenges in healthcare impacting both plan sponsors and health plans. Download our white paper, Emerging Trends & Patterns in Healthcare Market Segments.

Learn more about Risk Strategies Consulting.