The Deloitte Center for Health Solutions, part of Deloitte LLP, produces research that is objective and data driven. Unlike many think tanks and foundations, we do not lobby for change. Our mission is to develop innovative, practical and workable solutions to systemic issues of the U.S. health system. Our research is solution driven and embraces a diversity of viewpoints. 

We do not begin addressing a problem with a preferred solution in mind; rather, we endeavor to highlight facts, trends and opinions relevant to understanding a problem completely and to offer solutions for consideration by key stakeholders. A key differentiator is that our solutions are actionable. 

Second, our research is focused on problems that cut across multiple stakeholders in the industry. Many of our topics impact relevant parties in the health care system, including payors, providers, life sciences, large employers, and the federal and state government, but also intersect with other sectors such as banking, retail and others. We collaborate with both the private and public sector to get things done. We address overarching transformational themes and burning platforms that have the ability to transform the U.S. health care system.

Below is a list of studies** the Center is committed to completing in 2008. This list of topics is subject to change. 

Research Projects in Progress

Retail Clinics
Retail health clinics are quickly becoming a disruptive innovation in primary care delivery. As more and more clinics open across the country, this paper answers four key questions:

• What is retail medicine and how is it different from traditional primary care delivery?
• What are the current trends in growth of retail health clinics and their use, and what are the characteristics of their users?
• What forces will drive or impact retail medicine going forward?
• How will retail medicine affect key stakeholders in the health care system?

Disease Management and Retail Pharmacies
The emergence of innovations such as retail clinics, medical tourism, alternative medicine, cyber visits and natural remedies (to name a few) suggest a significant shift from conventional models of service delivery and payment to a consumer-centric system of care in which price, quality and service delivery are key. Disruptive health care innovations present an industry paradigm with new players, new delivery models, new ways of partnering and new value propositions. The retail pharmacy industry is in a key position to take advantage of disease management (DM) trends and deliver DM services effectively and profitably.

This report will explain:

• How retail pharmacies can leverage existing assets (convenient locations, 24/7 operating models, prescription fulfillment services, consumer marketing, brand positioning, retail clinics
  and health and personal care products) and collaborate with health plans or disease management vendors as a possible market entry strategy

The ROI of Targeted Therapies
Personalized medicine is a highly disruptive technology that will create fundamental changes in the way health care is practiced, developed, funded, insured and financed. In the future, patients who were once treated with empirical methods will be treated by moieties designed to address their specific phenotypes, genetic makeup and environmental exposure history. This model of care will disrupt actuarial risk methods, clinical treatment protocols, therapeutic supply chain models and diagnostic methods, which may create barriers for the adoption of personalized medicine entry strategy.

This study will:

• Examine key factors in evaluating the return on investment of adopting or investing in personalized medicine
• Help various stakeholder groups estimate the value proposition for them to actively participate in the research, product development, reimbursement programs and delivery of personalized medicine

Medical Tourism
This report will:

• Analyze the growing trend of medical tourism, focusing on both domestic and international segments
• Consider elements such as traveling for domestic centers of excellence, traveling domestically for price, traveling for international centers of excellence, and traveling internationally for price

Evidence-based Medicine
Evidence-based medicine is viewed in policy circles as a common denominator for determining what interventions should be covered by Medicare and other payors, and their relative effectiveness compared with other options. In most of the world’s organized health systems, evidence-based medicine is the basis for the services that are provided; in the U.S. system, no such mechanism exists.

In this analysis, we will:

• Define evidence-based medicine
• Characterize applications that are appropriate and inappropriate; describe tools useful to organizations in developing evidence-based practices
• Opine to the potential relevance that evidence-based medicine will have in public policy and private sector activities

Recently Completed Research Reports

Connected Care: Technology-enabled Care at Home (March 2008)
This report:

• Explores how the effective application of in-home technologies leads to increased medication adherence, reduced avoidable post-acute complications and improved self-care management of chronic conditions
• Projects the net result is a potential annual savings of 20 percent or more – a $400 billion savings to the U.S. health care system  

2008 Survey of Health Care Consumers (Published: February 2008)
This representative online poll of 3,000-plus Americans ages18–75 provides important and timely perspective on consumers. The survey:

• Identifies distinct consumer segments based on behaviors, attitudes and unmet needs related to health, health care and health insurance(see Survey Segmentation) 
• Sets a baseline against which to track evolving relationships between consumers and doctors, hospitals, health plans, medications and devices/implants (see Survey Fact Sheet Library) 
• Explores implications for providers, plans, life sciences and the government

The Impact of ICD-10: Turning Regulatory Compliance into Strategic Advantage (Published: February 2008)
This brief examines:

• The background and history of the International Statistical Classification of Diseases and Related Health Problems (ICD) movement
• An overview of the key differences between ICD-9 and ICD-10
• The impact of ICD-10 adoption on providers, plans and other key stakeholders
• Long-term implications of this new coding system on health information interoperability

The Medical Home: Disruptive Innovation for a New Primary Care Model (Published: January 2008)
This study:

• Compares and contrasts the major models of a medical home
• Addresses the significance of this model in health care reform
• Determines the most viable model based on return on investment

Consumer-Directed Health Plans: Current Trends, Emerging Opportunities (Published: December 2007)
This report analyzes available trade and peer-reviewed studies to:

• Update the current state of CDHP enrollment and operations
• Summarize the studies and the reported experience of CDHP participants
• Offer a strategic perspective for executives considering CDHPs' impact on their organizations

Coordinating Chronic Care Management Through Health Information Exchanges: Better Care, Lower Costs (Published: October 2007)
This report examines the:

• Economic and clinical benefits that HIE-enabled chronic care management can provide for patients and the health care industry as a whole
• Potential cost savings HIE use could produce in a hypothetical model segment of the chronic care population
• Several innovators who are using HIE for chronic care management programs

Pay for Quality: A Strategic Perspective (Published: August 2007)
This report examines the:

• Definition of “quality care” as both safe and effective
• Process of how hospitals, payors and community leaders can collaborate to achieve the safest and most effective care in a community
• Recent flurry of transparency efforts, including the introduction of high deductible savings accounts, retail medical clinics and report cards, and how consumers can process all this new information to choose the best provider of care

 ** This research agenda is formulated based on input from an internal steering committee of Deloitte Firms' practitioners, as well as an external advisory panel that comprises top executives representing various stakeholder perspectives, including: health plan, provider, life sciences, federal health, policy and employer.

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