Disruptive Innovators: Businesses partner with health insurers

Disruptive innovation challenges the status quo, drives change and creates new markets. But what does disruptive innovation mean in regard to health benefits and healthcare delivery?

A few companies tried to answer that question at the 2013 AHIP Institute Thursday, offering new models and strategies to reduce costs and improve care delivery. Whether their strategies are truly disruptive is debatable, but they are certainly departures from the norm.

[See also: Disruptive Innovators: CEO Champions]

Below are two firms who came to AHIP Institute to present their approaches to healthcare innovation.

Weight Watchers International

Weight Watchers is not normally considered a healthcare company, but according to CEO David Kirchhoff, that is changing. He said the organization, a well-known provider of weight management services for the past five decades, only began to think of itself as a healthcare firm with the passage of the Accountable Care Act.

"Weight Watchers ultimately sees our business working more directly with health plans," he said. "Even incubating a health services company within Weight Watchers."

[See also: Disruptive innovation needed to rein in care costs, change system]

Weight Watchers does indeed practice a form of healthcare, specifically, multi-component intensive behavioral therapy. Kirchhoff said that the efficacy of this form of behavioral therapy has been proven in comparative effectiveness studies. "We have a ream of data that shows we knock the ball out of the park from that perspective."

The company is already building relationships with health plans as well as provider organizations.

"I can imagine a day when fully half of the people entering Weight Watchers come through the healthcare system," Kirchhoff said.

Wal-Mart

Most everyone is familiar with Wal-Mart's ability to deliver a seemingly endless variety of products at very low prices. But innovation in healthcare?

Chris McSwain, Wal-Mart's vice president of U.S. benefits, says yes. "For the first time in 50 years, we're working closely with our health and wellness division to create relationships with providers to offer high-quality care to our employees," McSwain said.

The company has worked directly with health systems around the United States to offer specialty care to its employees at contracted prices. These "Centers of Excellence" (COE) are selected by the firm not only for the cost-saving potential, but the ability to provide high-quality care according to evidence-based medical standards, with demonstrably good outcomes.

The COEs are contracted to treat Wal-Mart employees for three major disease conditions: cardiac care, spinal surgery and transplant surgery. The COEs include health systems such as Mayo Clinic and Scott & White in Texas.

"We have direct contracts with each health system and all terms are kept confidential," McSwain said. "The health systems are accordingly expected to provide high-quality care."

He said Wal-Mart views these relationships with providers as a new form of managed care, whereby employers devise new paths to achieve the Institute for Healthcare Improvement's vaunted triple aim: improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of healthcare.