Deloitte Insights

A consumer-driven culture of health

The path to sustainability and growth

The Affordable Care Act has disrupted the US health care market's current fee-for-service economic model. Out of this disruption may emerge an open, consumer-driven health care ecosystem focused on transparency, actionable insights, collaboration, and engagement.

Culture of Health Q&A

New rules, new roles

A consumer-drive culture of health: executive summary

The dramatic transformation occurring in the US health care system is creating both significant challenges and opportunities for current industry participants and new entrants. Standing still in this environment is not an option.

Many health care players understand this and are aggressively pursuing a path that can yield some short-term improvement. However, long-term, this path may lead to diminishing returns. The real winners in the health care arena will be those who understand the profound changes that are reshaping the business landscape and pursue a different path that offers the potential for increasing returns over time.

A key message for incumbents is that effective strategies will require understanding the emerging business landscape, targeting the most promising positions in this new landscape (positions that are quite different from the positions occupied by many current players today), and then aggressively pursuing pragmatic pathways to occupy these positions quickly.

While it is increasingly important to define the role that the company will choose to play, the focus for value creation is shifting to the complex interplay among diverse participants within a broader health care ecosystem. For this reason, all players would be well-served by developing an explicit ecosystem strategy—identifying those with complementary capabilities from the growing number of participants in the ecosystem and working to build scalable relationships that can be mobilized to provide more and more value to target customers.

While the changes described in this paper will take time to play out, the positions that offer the potential for significant growth and profitability can be quickly preempted and will become increasingly difficult, if not impossible, to target and occupy once early movers stake out their claims. Given significant uncertainty, there will be a temptation to wait on the sidelines until the dust settles. Resist that temptation.

If you are a new entrant, there are a growing number of attractive positions to target and occupy that can create economic value. The good news is that technology infrastructures are significantly reducing barriers to entry, commercialization, and scaling. But if the ambition of the new entrant is to grow to become a large enterprise, the new entrant must move quickly as well, driven by a clear view of the emerging roles that will be driven by significant economies of scale or scope.

In sum, the emerging health care ecosystem represents a sharp departure from the traditional dynamics found today and a fundamental restructuring of the industry from health care delivery to a “culture of health.” The transformation will take time, but the shift has already begun.

Warning: this is a complex paper that attempts to capture and make sense of all the moving parts in a rapidly evolving ecosystem, showing how they are connecting and reinforcing each other. So, to help the reader navigate through this material, here is a high-level view of the journey we will take you on, this report is structured in six parts:

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