Integrated Health Management (IHM)

Oliver Wyman is committed to helping health insurers compete on the basis of quality and affordability. Sustainability rests on shifting to more effective strategies for managing escalating utilization and unit-cost trends. Over the past five years, a significant portion of our practice has been focused on the development and implementation of Integrated Health Management (IHM) models with delivery system and health plan clients.  Our experience has been that health management, financing, and delivery models can be redesigned to dramatically improve the cost and quality of care while also improving both the physician and consumer experience.

To support the industry in health management and delivery system transformation, Oliver Wyman has developed a robust clinical economic model, which includes a proprietary clinical segmentation engine that stratifies population and medical cost based on unique disease characteristics and the nature of effective healthcare interventions. Using an outcomes-based clinical database, the model codifies the specifics of the addressable population, expected penetration rates, and natural time-to-maturity for each IHM program. Ultimately this unique model allows our clients to calculate and measure cost savings across and within population segments over time.

Our integrated approach toward improving health management not only drives near-term performance, but also can be applied to fundamentally transform traditional insurance operating models. Moreover it extends beyond the plan to address the needs of all stakeholders, including providers, employers, members, and others. 

Examples of recent IHM engagements include:

 

Experts

Tom Main, Mike Weissel, Mike Lovdal, Michael Main, Mark Luck Olson, Terry Stone