This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Entrepreneurs and their upstart companies are challenging the health care industry’s high costs, frequent lack of transparency, and outdated processes. These innovators are responding to opportunities created by artificial intelligence, internet-based technologies, and regulatory pressure to provide value-based, outcome-driven care on an individual level. But entrepreneurs must find incumbent partners to navigate the risks and uncertainties inherent in health care and to understand its complex processes, regulatory approvals, and patient sensitivities.
For their part, many payers and commercial vendors recognize that the status quo is unsustainable. The United States is experiencing stagnating patient outcomes despite oversize increases in costs. In response, the Center for Medicaid and Medicare Services (CMS) and Congress have championed new reimbursement plans that increase efficiencies and outcomes.
Tackling health care’s recurring problems and scaling these new models require entrepreneurship and fresh thinking, but many incumbents will attempt to control the transition to health care’s future. They will fail in this misguided effort. Those that adapt to a changing environment—by listening to entrepreneurs, responding to the demands of consumers, and urgently scaling new experiments—will thrive.