如何进行细分市场分析MicromarketAnalysis

CLE_MicromarketHOWTOGUIDEMicromarketAnalysisHow-to-GuideCONFIDENTIALThisreportissolelyfortheuseofclientpersonnel.Nopartofitmaybecirculated,quoted,orreproducedfordistributionoutsidetheclientorganizationwithoutpriorwrittenapprovalfromMcKinsey&Company.ThismaterialwasusedbyMcKinsey&Companyduringanoralpresentation;itisnotacompleterecordofthediscussion.TaraHahn/CLFrankKochenash/PTPratKumar/ATTonyUeber/PTPracticedevelopmentdocumentJune2005CLE_MicromarketHOWTOGUIDE1PLANSCANDEVELOPWINNINGPROVIDERSTRATEGIESBYANALYZINGMICROMARKETSSource:IrvingLevinAssociates;TheComparativePerformanceofU.S.Hospitals;TheSourcebook2005ProvidershaveconsolidatedinmanyMSAs…MSADominantnetworkBostonPartnersNorthernCaliforniaSutterPittsburghUPMCNorthernVirginiaInovaMarket14Market16Market13Market15Amicromarketbasedapproach…•Revealsthemostcompetitivecontractingstrategies•Identifieskeyprovidersneededtomakeanetworkviable•Enablestailoringofcaremanagementtoolstomaximizetheireffectiveness•Optimizesspendinglevelsformarketingandcontracting…butcaredeliveryhappenswithinsmallergeographicboundaries•Seventeenmicromarketswereidentifiedbyanalyzinghospitalreferralpatternsbyzipcode•DespiteoveralldominantMSAshare,largeintegrateddeliverysystemdominatesonly3ofthe17micromarketsEXAMPLEMarket9Market8Market12Market10Market11Market6Market7Market5Market4Market3Market2CLE_MicromarketHOWTOGUIDE2PLANSSHOULDCATEGORIZEEACHMICROMARKETBYLEVELOFPROVIDERCONSOLIDATIONMicromarketscategorizedbyHerfindalindexRelativePhysicianconcentrationPhysiciandominatedFragmentedConsolidatedPayor:MarketshaperProviderdominatedHospitaldominatedCLIENTEXAMPLE•Considerrisk-sharing/gain-sharingagreements•Facilitateintroductionofnewhospital/physiciancapacity•Considerclosepartnerships/narrownetworkproductswithkeyhospitals•Facilitateintroductionofnewphysiciancapacity•Tradevolumeforprice•Partnerwiththeleadhospital•PartnerwithphysicianstocreateleveragewiththeleadinghospitalsRelativehospitalconcentrationFragmentedConsolidatedCLE_MicromarketHOWTOGUIDE3RELATIVEPROVIDERCONSOLIDATIONSUGGESTSDIFFERENTPROVIDERSTRATEGIESNetworkConsolidatedFragmentedFragmentedConsolidatedConsolidatedConsolidated•Developanarrownetwork•Channeltopreferredhospitals–Influencephysicianreferralpatterns–Helppartnersdifferentiateclinicalprograms(e.g.,centersofexcellence)–Pickpartnerstomaximizeleverageofnarrownetworkproduct•Proactivelydiscourageconsolidation•Partnerwithleadhospitaltoensureindependenceandaccess•Partnerwithleadhospitaltoensureindependenceandaccess•Bepreparedtointroducenewphysiciancapacity•Ifwilling,helpphysiciansoutofcontracts•Helphospitalsdefendagainstphysiciancarve-out•Partnerwithleadphysicianstoensureindependenceandaccess•Bepreparedtointroducenewphysiciancapacity•Ifwilling,helpphysiciansoutofcontracts•Buildanarrownetworkproductaroundhospitals•HelphospitalsdefendagainstphysiciancarveoutContract•Maintainadvantagedrateswitheachhospital–Usetheimpliedthreatofexclusionfromnetwork–Payforperformance(e.g.,medicalmanagement)•Considergain-sharingwithhospital•Utilizepartnershipagreementstosecurelong-termcontracts•Tieratestochangeofownershipclause•Considerbroaderriskorgainsharingwithhospitalandphysicians•Utilizepartnershipagreementstosecurelong-termcontracts•Tieratestochangeofownership•Maintainadvantagedrateswitheachhospital•Introduceincentive-basedpaymentsforphysicians•PartnerwithdominantphysicianstoimprovecostandqualityHospitalsPhysiciansFragmentedFragmentedCLE_MicromarketHOWTOGUIDE4EXAMPLESOFSUCCESSFULMICROMARKETAPPROACHESSituationTwomajorhospitalsdominateonemarketEachhasexcesscapacity,leadingtosignificantunnecessaryutilizationSituationStand-alonehospitalisloneplayerinmicromarketLargeintegrateddeliverysystem(IDS)dominatesrestoflargermarketLargeIDScontrolsmostMDsinmicro-marketandisusingthemtopressurestand-alonehospitaltojoinIDSApproachHelpedhospitals(byfloatingbond)tomergeandconsolidatetheirexcesscapacityInstitutedgain-sharingwithsurvivinghospitaltocapturetheeconomicvaluecreatedbyconsolidationApproachIntroducednewphysiciancapacitytomicromarkettochannelvolumetolonehospital–ProvidedincentivesforMDstopracticeorincreaseroundinginthecommunityOutcomeReducedunnecessaryutilizationBuiltstrongrelationshipthroughalignedincentivesCapturedeconomicvalueofconsolidationOutcomePreventedhospitalfromjoiningIDSandfurtherincreasingIDSmarketpowerMicromarket1Micromarket2CLIENTEXAMPLECLE_MicromarketHOWTOGUIDE5CLIENTSHAVELEARNEDIMPORTANTLESSONSTHROUGHMICROMARKETANALYSIS•Payorscanshareeconomicvaluebyfacilitatinghospitalcapacityconsolidation•Countertoconventionalwisdom,globalrisksharingmaymakesenseinselectmicromarkets•ThebeststrategytobalancethemarketpowerofanaggressiveintegrateddeliverysystemisNOTtoout-competethemhead-to-head,buttostoptheirprogressinselectmarkets•Consolidationofphysiciansincertainspecialties,e.g.,Oncology,maychangethebalanceofpowerinmanymicromarketsCLE_MicromarketHOWTOGUIDE6UnderstandingcompetitivedynamicsHospitalsPhysiciansDefinemicromarketsDETAILEDAPPROACHFORMICROMARKETANALYSIS•ClassifyDRGs•Maphospitalfootprintsbasedon