Recon Strategy
Contact

Insights

Fifteen+ years of
Healthcare thinking.

Several hundred perspectives on the questions facing payers, providers, biopharma, medtech, and digital health — plus our running read on the clinical literature. Start with our sharpest work, or filter to your world.

Sector
All
NEJM opinion

Why the Best AI Won’t Win in Healthcare

  • Biopharma , 
  • Payers , 
  • Providers , 
  • Medtech , 
  • Digital
As advanced AI becomes widely accessible, healthcare companies can no longer rely on superior technology alone for lasting advantage. Instead, they need a coherent AI strategy built around five interconnected choices. Harvard Business Review article.

Read more

Survivorship Is Expanding Cancer Care — How Are Oncology Providers Responding?

  • Providers , 
  • Digital
Survivorship care is increasingly pivotal to cancer care delivery and …

Read more

AJMC: More frequent visits to primary care can save net $30-40 PMPM for top 20% highest risk commercial members

  • Payers , 
  • Providers
A new AJMC study from consulting firm Recon Strategy is the first to s…

Read more

Kidney transplantation, improved but still a significant missed opportunity

  • Payers , 
  • Providers , 
  • Institutional
In order to make a more immediate and significant impact on dialysis and kidney waitlist, OPOs need to ensure that significantly more potential donors are identified, and all necessary steps are taken to ensure that a potential donor becomes an actual organ donor.

Read more

Walmart Health didn’t test the opportunity in rural underserved markets

  • Providers
What lessons can be drawn from Walmart’s precipitous shut down of its …

Read more

Are some of Kaiser’s regional ambitions starting to pay off?

  • Payers , 
  • Providers
PDF: Are some of Kaiser’s regional ambitions starting to pay off? We h…

Read more

What should school nurses do (and not do)? A call for further research

  • Providers
About the author: Alyssa Idusuyi is currently a high school senior att…

Read more

What’s so special about One Medical in the eyes of Amazon? A few quick thoughts

  • Providers , 
  • Digital , 
There isn’t a bricks-and-mortar primary care acquisition out there tha…

Read more

The coming site-of-care shock for infusions

  • Biopharma , 
  • Payers , 
  • Providers
There’s a major disruption looming in how the site-of-care for infusio…

Read more

The ongoing physician affiliation land grab in Pennsylvania’s Capital District

  • Providers
Closed vs. open Hospitals can compete for patient referrals either by …

Read more

Optum opening new competitive terrain in Revenue Cycle Management

  • Payers , 
  • Providers
What is revenue cycle management? Revenue cycle management (RCM) is th…

Read more

Profit engine swap-outs: How UPMC sustained itself after the Highmark decoupling

  • Payers , 
  • Providers
UPMC’s decoupling from Highmark exposed a critical vulnerability: econ…

Read more

The Puzzling Future of Healthcare

  • Biopharma , 
  • Providers , 
  • Digital , 
This post is from a talk at the 2021 Link Ventures CEO summit. Origin…

Read more

Iora Agonistes: High-touch primary care in Medicare Advantage is no sure bet after all

  • Providers
Iora Health was one of the original primary care transformers offering…

Read more

Four plausible rationales for incumbent hospitals to embrace hospital@home despite the potential to divert “heads from beds”

  • Providers
We identify four different business strategy rationales for hospital@h…

Read more

WMT’s MeMD acquisition: too small a play to make the difference

  • Providers
Last week, WMT acquired MeMD, a virtual provider in Arizona. Per the p…

Read more

How much are Humana’s value-based care models really taking out of utilization?

  • Payers , 
  • Providers
All that effort for only 0.4% savings Since 2014, HUM has reported on …

Read more

Walmart Health: Will the fifth attempt at clinics be the charm?

  • Providers , 
Eighteen months ago, WMT opened its first Walmart Health clinic attach…

Read more

How does OptumCare manage its physician staffing once the big deals are done?

  • Providers
OptumCare’s acquisitions usually make headlines.  But what happens whe…

Read more

A tale of two cities: Referral networks of orthopedic surgeons in Miami and Seattle

  • Providers , 
  • Digital
Summary: We conducted a comparative analysis of the referral networks …

Read more

AI in healthcare III: COVID-19 applications and implications

  • Biopharma , 
  • Payers , 
  • Providers , 
  • Medtech , 
  • Digital , 
COVID-19 has accelerated the adoption of AI in healthcare. AI based to…

Read more

Buying kit for a leadership position in the @Home revolution? Implications of Optum’s acquisition of naviHealth

  • Payers , 
  • Providers
Summary NaviHealth is a leader in post-acute care management; since i…

Read more

Covid’s backhand blow: payer mix degradation and the threat of renewed payer/provider rate brawls

  • Payers , 
  • Providers
Among Covid’s many repercussions, the recession shock will drive a sus…

Read more

Medicare Advantage’s durable – but underexplained – post-acute care advantage

  • Payers , 
  • Providers
Health Affairs has put out another study – this one by Skopec and team…

Read more

Strategy in the Time of Covid

  • Biopharma , 
  • Payers , 
  • Providers , 
  • Medtech , 
  • Digital , 
Preamble A recent post from Recon Strategy outlined the longer-term st…

Read more

The day after: Implications for hospitals, payers, biotech and more…

  • Biopharma , 
  • Payers , 
  • Providers , 
  • Medtech , 
  • Digital
Even as our priority today is dealing with the Covid crisis, healthcar…

Read more

Bolting a full-risk engine onto an urgent care chassis in New York

  • Payers , 
  • Providers
Last month, Warburg Pincus closed on previously announced plans to acq…

Read more

Choosing your customers wisely: are hospitals the right place to engineer the future of healthcare (and the software services to support it)?

  • Providers , 
  • Digital
MSFT’s pathbreaking alliances in healthcare services are impressive an…

Read more

Full-service vs. self-service: an emerging bifurcation in healthcare

  • Providers
A clinical vignette: the cases of Jane and Joe Imagine if you will tw…

Read more

Facing new vertically integrated competitors, WellSpan and Capital Blue Cross prepare for a long siege

  • Payers , 
  • Providers
Summary The Capital Region of Pennsylvania is shifting in “real time”…

Read more

OptumCare’s legacy entanglements could slow its site-of-service shift

  • Payers , 
  • Providers
By bringing together accountable-minded physicians, urgent care and am…

Read more

There’s always a bigger fish: healthcare services giants are looking anxiously over their shoulders

  • Payers , 
  • Providers , 
  • Digital , 
With the closing of the CVS/AET and CI/ESRX combinations, healthcare s…

Read more

Consider this speculative scenario on WMT-HUM: nibbling at the bottom and taking a slice off the top of the healthcare delivery pyramid

  • Payers , 
  • Providers , 
WMT is in talks with HUM about a relationship enhancement, possibly an…

Read more

United’s Medicare Advantage footprint and OptumCare network do not overlap much (so far)

  • Providers
United’s OptumCare promises a lot of value for health plans.  An integ…

Read more

What precisely lies behind UPMC’s $2B investment in three new specialty hospitals?

  • Providers
Last December, UPMC announced plans to spend $2B on three new specialt…

Read more

Consider this speculative Amazon scenario in your strategic planning

  • Payers , 
  • Providers , 
Amazon has many puzzled about its plans for healthcare. Arguably, Amaz…

Read more

How can Optum be in only 35 out of 75 target markets while also being available to 70%+ of the US population? An analytical speculation

  • Providers
During the UnitedHealth quarterly earnings call earlier this month, La…

Read more

The UPMC/Highmark brawl spills into Philadelphia’s backyard – what happens next?

  • Payers , 
  • Providers
(For background on Pennsylvania market, please take a look at previous…

Read more

Ochsner signs LOI to enter northern Louisiana and secure a medical school affiliation

  • Providers , 
  • Institutional
(For Louisiana market context, please take a look at previous notes on…

Read more

With the DaVita Medical Group acquisition, OptumHealth deepens its presence in existing markets rather than adding new ones

  • Payers , 
  • Providers
OptumHealth and its proposed acquisition target DaVita Medical Group (…

Read more

United’s ambulatory delivery system OptumCare can reach 70% of the US population

  • Payers , 
  • Providers
Who will be the first to take integrated health care delivery national…

Read more

Allegheny Health Network adds micro-hospitals to its ground game

  • Providers
UPMC’s recent spectacular deal-making careen through central Pennsylva…

Read more

Marrying into the right family pays off! Update on revenue cycle management joint venturing

  • Providers
Back in 2013, Dignity and Optum formed a joint venture for revenue cyc…

Read more

UPMC’s race to the sea and the tentative steps towards Highmark-Geisinger alliance

  • Payers , 
  • Providers
On May 10, Highmark and Geisinger announced plans for a clinical joint…

Read more

Urgent care gets drawn into system-level market share battles in the Big Apple

  • Providers , 
Warburg Pincus, the new majority owners of CityMD, a 68 site urgent ca…

Read more

An ad page in the NEJM and the future of cancer care

  • Providers , 
  • NEJM
I am not sure how many docs continue to do this, but I still read the …

Read more

Rapid cycling to get medications right: a potential use case for coupling wireless patient monitoring with remote support?

  • Providers , 
  • Digital , 
Summary Cheap home devices are starting to generate a flood of high f…

Read more

The many ways in which decreasing volatility in individual health care utilization is valuable

  • Providers
It is a long-standing hypothesis shared by many providers that communi…

Read more

Ochsner solidifies its position in northern Louisiana (updated)

  • Providers
Please see update at the end of the post. With new two affiliations, O…

Read more

Biopharma risk-sharing: what needs to happen

  • Biopharma , 
  • Payers , 
  • Providers
A couple of years ago, we addressed the question of whether drug compa…

Read more

Context is King – When to use an Agile corporate strategy?

  • Biopharma , 
  • Payers , 
  • Providers , 
  • Digital , 
“Agile corporate strategy” (as defined in a previous post) is already …

Read more

Mercy Health exits the insurance business and curtails ambitions for its state-wide provider alliance

  • Payers , 
  • Providers
Earlier this month, Mercy Health announced deals to dismantle HealthSp…

Read more

Rewarding patient loyalty vs. earning patient loyalty

  • Providers
A new article in JAMA recommends that ACOs and health systems develop …

Read more

Centene bringing a new managed care strategy to The Big House?

  • Payers , 
  • Providers
Correctional health and correctional pharmacy 2.2M people are incarcer…

Read more

The Walgreens-Advocate deal: end of urgent care’s strategic neutrality in Chicago?

  • Providers , 
This past January, Walgreens assigned operational control of 56 in-sto…

Read more

Observations on NextGen ACO’s first cohort of participants

  • Providers
Earlier this month, CMS announced the first cohort of Next Generation …

Read more

Outcomes patients want: Could it be that the more common the condition, the worse doctors understand the outcomes patients seek?

  • Providers
Leif Solberg and team published research last month contrasting how pa…

Read more

Emails substituting for visits: Evidence points to “yes” but providers need to answer a lot of emails to replace a single visit

  • Providers , 
  • Digital , 
Earlier this month, researchers released a study of patient-initiated …

Read more

Ohio’s Mercy-Summa alliance grows contracting teeth

  • Payers , 
  • Providers
Mercy Health – the largest system in Ohio – has recently formed a Clin…

Read more

Convenience care, telemedicine and breaking down barriers to geographic competition – a speculation

  • Providers , 
  • Digital
A few problems Geographic barriers to the entry have long protected pr…

Read more

Working paper: the coming age of algorithmic medicine

  • Payers , 
  • Providers , 
  • Digital , 
Summary In this working paper, we develop the following thesis. In the…

Read more

The Ochsner Health Network: has Ochsner gone “a hospital too far”?

  • Providers
Over eight months between October 2014 and June of this year, Ochsner …

Read more

Can convenience care be a platform for an insurance product?

  • Payers , 
  • Providers , 
Summary A Portland-based urgent care operator is launching a health p…

Read more

So what if PCPs in ACO practices are not paid differently?

  • Providers
In a recent study, Ryan, Shortell, et al analyzed the composition of P…

Read more

Comparing the emerging national networks of Cleveland Clinic and Mayo Clinic

  • Providers
The build-out of the Cleveland Clinic and Mayo branded networks contin…

Read more

A sizeable step forward but miles still to go: CMS’ Next Generation ACO model

  • Payers , 
  • Providers
CMS has issued a “Request for Applications” describing its Next Genera…

Read more

Cosgrove moves south: competitive implications of the formation of the Midwest Health Collaborative

  • Providers
A few days ago, Cleveland Clinic announced the formation of the Midwes…

Read more

The “weaponization” of ACO narrow networks: Strategic destabilizers which compel their own replication?

  • Payers , 
  • Providers
In theory, narrow networks built around a single provider or a network…

Read more

Ochsner and River Parishes: one type of endgame for managing redundant hospital capacity (updated)

  • Providers
Please see update at end of post. If value-based care broadly delivers…

Read more

Boeing’s model for creating product-based competition among providers

  • Providers
Summary Boeing is creating a benefit design model which sets up provi…

Read more

Apple HealthKit, provider partnerships and walled gardens: three observations

  • Providers , 
  • Digital
A number of observers have noted that the Apple’s partnership with Epi…

Read more

Boiling the Ocean…or not

  • Payers , 
  • Providers , 
  • Digital , 
We've all heard the term, "Boiling the Ocean" to refer to an approach …

Read more

MA hospital relative prices by payer

  • Payers , 
  • Providers
Here's a quick look at relative prices in MA using CHIA data for you t…

Read more

Bring it on: Highmark brings in a long-distance ally to help compete vs. UPMC in cancer care

  • Providers
Summary Allegheny Health Network (AHN), the major delivery system in …

Read more

Staked out territory by Massachusetts hospital systems

  • Providers
In 2011, we would tell our payer clients (tongue firmly ensconced in c…

Read more

Marrying into the right family: the bets underlying United’s revenue cycle management joint venture with Dignity Health

  • Payers , 
  • Providers
Market for outsourced revenue cycle management could be big The revenu…

Read more

Declining value of the EMR walled garden? An emerging signpost from Cleveland Clinic

  • Providers , 
  • Digital
Quick follow-up to our post about the Epic-eClinicalWorks deal: Today…

Read more

Change in tactics or change of heart? Speculations on the eClinicalWorks–Epic interoperability announcement

  • Providers , 
  • Digital
Epic is famous for its intense focus on interoperability across its ow…

Read more

Metrics alone will not unleash the market: Porter and Lee ignore the demand side to the peril of their proposed strategy

  • Providers
Summary Michael Porter and Thomas Lee have articulated a strategy for…

Read more

Quiet after the storm: Is there an emerging competitive equilibrium in Ohio?

  • Providers
Summary In August and early September, several Ohio provider systems …

Read more

Strategic “crowd-out” via narrow networks: an emerging case study in Wisconsin

  • Payers , 
  • Providers
Last week, I argued that, if payers want to secure competitive advanta…

Read more

ACO proliferation and provider “all-payer” care models inexorably lead to tighter network strategies

  • Payers , 
  • Providers
A new study in JAMA (by McWilliams et al.) looks at the Medicare expen…

Read more

Making flanks something for the enemy to worry about: the Cleveland Clinic-Promedica deal and the emerging battle for northern Ohio

  • Payers , 
  • Providers
Summary Earlier this year, Catholic Health Partners, the largest prov…

Read more

Ambidextrous strategy: PART 2 – Scenario Implications

  • Payers , 
  • Providers
In our last post we introduced two potential scenarios. "Provider bas…

Read more

Ambidextrous strategy: PART 1 – Payer and provider strategy for two very different worlds

  • Payers , 
  • Providers
It seems like every day there’s some news outlining strategic actions …

Read more

When do you know ACOs are here to stay?

  • Payers , 
  • Providers
Answer:  When they form an industry association! Back in February, a …

Read more

Cleveland Clinic’s bold land grab in care improvement: the Community Health Systems deal

  • Providers
Summary The deal locks in an option for Cleveland Clinic to grow its …

Read more

Risk-taking providers in private exchanges: Medica’s “My Plan” private exchange

  • Payers , 
  • Providers
At a TEDMED conference a couple years ago, I had to write some sample …

Read more

Getting the troubled Highmark-West Penn relationship back on track: an outside-in speculation

  • Payers , 
  • Providers
Summary Highmark and the West Penn Allegheny Health System (WPAHS) ar…

Read more

Romance of convenience: perspectives on the IASIS-Aurora joint venture

  • Payers , 
  • Providers
Summary Two major hospital systems have agreed to a joint venture to …

Read more

Readmissions rate fallacy

  • Providers
Today’s piece in Kaiser Health News that hospitals' readmissions rates…

Read more

Rescuing the condition-focused ACO from CMS

  • Payers , 
  • Providers
Summary The case for an oncology ACO can be compelling but CMS rule…

Read more

Transitioning from patchwork to quilt: NY and PA’s path to integrating HIEs at the state level

  • Payers , 
  • Providers
Last month, NY and PA announced plans for how they will integrate data…

Read more

Heartland Health: Marching towards Kansas City with Mayo on its shoulder

  • Payers , 
  • Providers
Earlier this month, Heartland Health signed a deal with the Mayo Clini…

Read more

Franchising specialties: model for breaking down geographic barriers to competition?

  • Providers
Summary Geographic barriers to provider competition are a headache fo…

Read more

Home health’s LHC Group decoupling from the stock market: where is it going next?

  • Providers
The PE firm TPG is reportedly considering investing in LHC, a publicly…

Read more

Lumeris, NaviNet and the emerging battle for cloud-based ACO enablement

  • Payers , 
  • Providers
Summary Administrative clearinghouse NaviNet has been acquired by 3 B…

Read more

Compete by creating more competitors: the Heartland Health deal and Aetna’s strategic jiu jitsu

  • Payers , 
  • Providers
Yesterday, Aetna announced a deal with Heartland Health (an integrated…

Read more

Aetna and Best Buy: a new twist on retail in healthcare

  • Payers , 
  • Providers
Aetna has struck a deal with Best Buy to sell four online coaching pro…

Read more

“Savings illusion” can become savings reality in the long haul: baby boomers to the rescue

  • Payers , 
  • Providers
A recent article in the NEJM argues that cost savings from quality imp…

Read more