What to Watch in 2010: Reform. Medicare. Strategy.

I started out 2009 saying political change, economic volatility and competitive rivalry will challenge every stakeholder—customers, employees, business leadership, and investors. As the year closes out, the health care industry remains preoccupied with health reform – what’s the outcome going to look like, who are the big winner and losers, and what can be done now to prepare for a reformed marketplace.

Going into 2010, my advice is to start early evaluating and planning for new opportunities, and focus on designing strategies to protect core lines of business against threats that lie on the horizon. The following provides a few background resources to help guide strategies around health reform, Medicare and strategic trends.

HEALTH CARE REFORM
The country’s health care system will see sweeping change in 2010: over $750 billion in new expenditures and possibly 30 million uninsured individuals set to receive health coverage. The impact will be huge, affecting every citizen, every provider and every health plan: insurance exchanges, Medicaid expansion, Medicare payment adjustments, individual and employer mandates, increased taxes, and far-reaching overhaul of traditional risk management rules.

Now is the time to for health care entities to prepare. Don’t wait. Business assumptions and operating models need to adapt, quickly. Winners will anticipate change and react quickly in a reformed health care marketplace.

One place to start is evaluating the House and Senate health care reform proposals that will guide Conference Committee negotiations prior to sending legislation to the President. A comprehensive review is Kaiser Family Foundation’s Side-by-Side Comparison.

For a more specific look at health care reform’s affect on Medicare plans, Gorman Health Group’s Executive Briefing provides an analysis on reform’s Impact on Medicare Advantage and Part D.

MEDICARE
For consumers, the Medicare landscape is a complex jumble of product and delivery options. Finding the balance between financial and medical choice makes Medicare confusing, if not intimidating for many seniors. After receiving their copy of “Medicare & You” and searching medicare.gov, seniors start receiving dozens and dozens of heath plan solicitations.

From Medicare Advantage to Prescription Drug Plans to Medigap, making an informed choice about what plan best meets a senior’s needs is a very personal decision.  This recent article in the Wall Street Journal titled Medicare Maze looks at resources available to seniors as well as helpful shopping hints.

The flip side is the challenge faced by health plans: educate seniors, communicate value, abide by massive regulatory requirements, and break out of the sea of sameness that characterizes the Medicare competitive landscape. For Medicare plan sponsors competing for the 3 million seniors turning 65-years old, and those seniors seeking to switch from their current plan, one skill becomes more important than ever–lead generation. Execution must be based on data, laser-focused, and grounded in the core principles of direct response marketing. This article, 4 Steps To Generating Quality Medicare Leads discusses the essential ingredients of high-performance lead generation.

STRATEGIC TRENDS
Health care reform is front-and-center on every health care company’s strategic radar screen. But, waiting in the wings are many other important trends such as medical home, cloud computing platforms, socialnomics, accountable care organizations, comparative effectiveness indicators, and customer transparency.

In light of the massive change that lies ahead, a robust strategic planning process is key to sustainability. Amidst marketplace transmogrification business leaders must be prepared to identify and capture opportunity, and have the capacity to absorb change, manage through obstacles and build on their company’s advantages.

Strategic planning calls for analytical thinking and objective decision-making that continuously works to improve corporate vision and strengthen brand. Management needs answers to tough, introspective questions. A sample of how this process can be structured at the most senior levels in an organization is outlined in Strategic Assessment.

Monitoring mega-trends to plan your strategic future can’t get postponed either. What are the hot consumer trends? Who’s Wall Street tracking…and why? How are innovators positioning themselves?

This coming year promises to be as challenging as any other that the health care industry has seen. Monitoring, analyzing and interpreting trends enables smart executives to predict market change, clarify strategic vision and capture new opportunity. It puts today’s decisions in tomorrow’s context.

One resource, Trendwatching.com, provides research to help companies shape their corporate vision. To both inspire innovation and refine customer sensitivity, their year-end review indentifies 10 Crucial Consumer Trends For 2010.