PROSPECTIVE STRATEGIES
  • Why Prospective
  • Consulting
  • Solutions
  • Market Solutions
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Consulting Services.
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Strategy, Advancement and Transformation
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Advancing strategic health initiatives through market discovery, product solutions and business transformation.
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Strategic Market and Product Development

  • Visioning & road-mapping
  • Target market opportunity & risk assessment 
  • Market & customer segmentation
  • Competitive intelligence
  • Product design & pricing
  • Marketing and brand messaging
  • Business & financial modeling 
  • Product portfolio integration
  • Product lifecycle management
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Program Transformation

  • Enterprise program strategy & management
  • Enterprise product function
  • Business performance enhancement
  • Program integration & operational synergies
  • Business model design
  • Stakeholder alignment and engagement

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Technology-based Solutions

  • Analytic solutions for market intelligence and health programs/products
  • Solutions with CMS Public Use Files
  • Digital health device integration for health plans
  • Cost and Stars/quality performance measurement
  • Vendor procurement strategy & integration

Industry Applications

Medicare Advantage / Part D
  • MA program & benefit design
  • Prescription Drug Plans (PDP)
  • Dual Special Needs Plans
  • Risk-based initiatives
  • Population health
  • Value-based design
  • Quality and star ratings

Medicaid
  • Medicare-Medicaid Integrated Programs for Dual Eligibles
  • Medicaid managed care programs
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Commercial/Employer
  • Employer Group Waiver Plans (EGWP)
  • Medicare Supplement ("Medigap") plans
  • PBM procurement
  • Retiree Drug Subsidy (RDS)
Pharmacy Benefit Management (PBM)
  • Pharmacy benefits & formulary design
  • Marketing content & strategy
  • Reporting & analytics
  • Specialty pharmacy
  • 340B program market assessment

Innovation / Technology
  • CMS innovation models (bundled payments, ACO, etc.) 
  • Data analytics with CMS Public Use Files
  • Consumer decision analysis
  • Digital health device integration (e.g. medication adherence)
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Case Studies

Case Study: Specialty Drugs for Medicare/Medicaid
A Pharmacy Benefit Manager engaged Prospective Strategies to formalize its Specialty Drugs management services for its Medicare Advantage and Medicaid clients. Prospective helped uncover key market differences between commercial and government program segments in order to better match the clients’ products and services with marketplace demands. Prospective analyzed competitive market trends and demographic profiles in order to help the client maximize its product position. This enabled the client to successfully position its product offering across a broad spectrum of market segments.
 
Case Study: Value-based Care Market Opportunity
CMS offers health providers the opportunity to participate in Episode-based Payment (“bundled payment”) models. These models include financial incentives to lower the cost of medical services and supplies, including expensive medications. Prospective Strategies was engaged by a Pharmacy Benefit Manager to scope related market opportunities and identify potential buyers for outsourced specialty drug solutions. The effort involved significant data manipulation using CMS public data sources. The client was able to narrow their sales focus with a prioritized list of targets and become more effective in its marketing efforts.
 
Case Study: Employer Group Waiver Plans (“EGWPs”)
Private and public employers can take advantage of the Medicare Advantage / Part D programs to sponsor health plans for their Medicare-eligible retirees. These plans are known as Employer Group Waiver Plans, or “EGWPs.” Prospective Strategies assisted a client with a broad range of support services including market entry, vendor procurement, business model design, financial risk management and marketing content.
 
Case Study: Therapy Services Market Assessment
Prospective Strategies was engaged by its client to assess potential expansion opportunities with therapy services. The project included both general market analysis and segmentation as well as the identification of potential M&A opportunities. The client appreciated the health industry insights that Prospective Strategies provided and the data-oriented approach used to target opportunities. As a result, the client was able to move forward with confidence and successfully expanded its portfolio of services.
 
Emerging: Market Intelligence for Health via Public Use Files
Public and government demands on healthcare transparency are creating new opportunities for market intelligence, cost efficiencies and more targeted health solutions. Prospective Strategies assists payers and providers in discovering how the proliferation of publicly-available health data for Medicare, Medicaid and Exchange programs enables enhanced market intelligence, operational insights and improved efficiencies. Major benefits include competitive product offering information, value-based care applications, medical/pharmacy cost benchmarking, and M&A applications. Prospective helps clients uncover these “hidden” data opportunities and translate them into specific business opportunities.
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612.552.2228
​​​info@prospectivestrategies.com

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New Product / Services Launch
Benefit Design / Market Research
Portfolio Risk Management
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​Expertise: Medicare/Medicaid, Pharmacy Benefits Management, Self-insured Employers
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  • Why Prospective
  • Consulting
  • Solutions
  • Market Solutions
  • Insights