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Healthcare Provider Consulting

Overview

L.E.K. collaborates with a wide range of healthcare providers including hospitals, ambulatory surgery centers (ASCs), behavioral health providers, primary and specialty physician practices, skilled nursing facilities (SNFs), home health agencies, laboratories and other types of healthcare providers to help them thrive in the rapidly evolving healthcare value chain. We help clients develop and implement unique solutions that respond to challenges emerging from a marketplace impacted by shifting demographics (rising demand of the aging population), increasing “retailization” of healthcare, reimbursement/constrained budget pressure, ongoing vertical integration and consolidation, and a changing regulatory environment.

Client Issues

In this period of unprecedented change, providers are looking to us to help address many questions, of which the most frequent include:

  • In the face of reform agendas and reimbursement pressure, how should we re-engineer our service offerings and business models to be most successful?
    • For providers in the U.S., how can we successfully evolve our capabilities, care models and value proposition to accept bundled payments and other value-based and risk-based reimbursement?
    • How do we best navigate the rapidly changing payer environment?  Should we develop payer capabilities, participate in exchanges, etc.?
  • With increasing patient financial responsibility from HSAs and increased cost sharing, how should we enhance our patient value proposition and sales and marketing efforts?
  • How will new and evolving technologies (e.g., electronic health records, big data analytics, telehealth, digital health) impact our business?
  • What services and capabilities should we own vs. outsource or partner to obtain?  With whom should we partner and how should we structure an agreement with aligned incentives?
  • How will the shift toward outpatient care and the evolution of sites of care (e.g., ASCs, urgent care centers, free-standing emergency departments (FSEDs), workplace and retail clinics) impact our business and how should we respond?
  • In Europe, how will commissioning of healthcare services evolve in the light of reform agendas, and what business models will be most successful?
  • Should private sector businesses assume management responsibility for public facilities with risk transfer?

Examples of Our Work

To learn more about how we help clients create value, please refer to these additional case examples:

  • Developed a strategic growth plan, articulated organizational implications, and developed and supported implementation of ‘go-to-market’ plans for each strategic initiative for a hospital that was experiencing declining financial performance in light of material changes to its operating environment. The work put the hospital on a path to near-term breakeven performance, with a five year path to significant and sustainable profitability.
  • Led a multi-regional, multi-functional cost optimization project management office effort to catalog existing improvement initiatives, identify incremental improvement opportunities, and validate and prioritize initiatives for the leading integrated health system. Successful implementation yielded ~$2 billion of run rate operating profit improvement.
  • Developed five-year strategic plan and action plan of prioritized initiatives and operational priorities for a leading home health company, including comprehensive market assessment, development of discrete service offerings to address customer segments and evaluation of partnership opportunities.
  • Codified, documented and quantified the value contribution for each component of an integrated payer-provider’s innovative, frail-and-elderly, Medicare healthcare delivery model to facilitate market expansion, which led to substantial profitable growth and eventual acquisition by a national managed care organization (MCO) at record-breaking valuation multiples.
  • Created a business development and optimized market entry plan for key geographic expansion market(s) for a leading owner-operator of surgical facilities, including ASCs, surgical hospitals and hospital surgery departments.  The effort positioned the company for substantial growth and positioned the company for acquisition by a leading MCO.
  • Completed commercial due diligence of an orthopedics PPM (physician practice management), including analysis of the market for PPMs, current business model, leadership and operational capabilities, and potential synergies with the investor’s current domestic and international investments.
  • Completed a strategic review of the impact of Italian healthcare reform on the provision of clinic- and hospital-based private diagnostic imagery services.
  • Activated a growth strategy for a provider of dental services that included strategic segmentation, change management program and M&A targeting.

View additional case examples

Please contact us at healthcare@lek.com for additional information.