Corporate Venturing in Healthcare and health care insurance. CbusineZ: the cases and the organization. Slider voor TIAS Executive MBA 2015

1. CbusineZ
Corporate venturing in health insurance
J. de Groot

2. Introduction
2
Drs J.G.B. de Groot
Joep.de.groot@cz.nl
Jgbdegroot
Currently:
board of CbusineZ
Past:
DSM and Managing partner The Essence Consulting
Experience in venturing:
- Set up 6 companies as a managing director
- Served on 26 boards as a (non-)executive director
- Involved in > 40 M&A deals

3. Index
3
Our environment
The goal of CbusineZ is to change the behaviour of the healthcare system
Cases:
Hearing aids
Benchmarking
eMental Health
Communication platform
Corporate Venture Office
Organisation and alignment
Staff
CVM: expert system for monitoring & portfolio management

4. 4
The cost of healthcare have risen sharply
Rise cost of hospitalcare in
Netherlands last 5 year
Cost increase in AWBZ
(elderly care) in 10 year
30%
to 20 mrd €
66 %
to 21 mrd €

5. 5
In
1970:
72
year
In 2020
there are
3,3 mln 65+
Life expectancy has risen
LINH, RIVM,
+3
And will increase the coming years
65+ in
2010:
2,5 mln
This will lead to an increase in the number of
elderly people
Baby
in
2010:
83jr

6. 6
We live longer.... But not always healthy...
LINH, RIVM,
50% doesn’t
exercise enough
40% over weight
15% obesity
27% smokes
Unhealthy lifestyle is an important reason for
chronicle illness

7. 7
463.000
569.000
1.1 mln
1.2 mln
Because of higher life expectancy & unhealthy
lifestyle the number of chronically ill will rise
Depression COPD Diabetes heartcondition
Can you imagine what this means for care delivery?

8. Index
8
Our environment
The goal of CbusineZ is to change the behaviour of the healthcare system
Cases:
Hearing aids
Benchmarking
eMental Health
Communication platform
Corporate Venture Office
Organisation and alignment
Staff
CVM: expertsystem for monitoring & portfolio management

9. The goal of CbusineZ is to change the
behaviour of the health care system
9
Ederly care
home
Hospital
Interne
Cardio
Geriatrie
Neuro
Rev.
GP
Home
Homecare(
psychologist
2e line mental
health
Psychiater Vpk team
Pharma
Fysio
retail
Medical
outcomes
Costs
Customer
satisfaction
Our goal is to set up or create
ventures that changes the
system and thereby improving
quality or reducing cost

10. We set up ventures that improve “the game”
10
Ederly care
home
Hospital
Interne
Cardio
Geriatrie
Neuro
Rev.
GP
Home
Homecare(
psychologist
2e line mental
health
Psychiater Vpk team
Pharma
Fysio
retail
Collective services
unclog
missing
Setting up a
missing ‘function’
in the value chain
Examples:
Benchmarking
eMental health
Self management
tools
“unclog” the
system by
introducing a
best practice
or low cost
option
Examples
Hearing aids
H&S service
Disease mngt
IT system
Collective services
Services that require critical mass and are above an
institution own interest
Examples
contracting and invoicing eplatform
Nationwide informal care initiative
Care purchasing for cities
unclog
Missing

11. The venture can be small, but the effect on
healthcare and CZ can be substantial
11
New venture
Ederly care
home
Hospital
Interne
Cardio
Geriatrie
Neuro
Rev.
GP
Home
Homecare(
psychologist
2e line mental
health
Psychiater Vpk team
Pharma
Fysio
retail
Venture with limited
profitability
Substantial effect on costs
or driver for enhancing
purchasing function
Example Effect
VECOZO Largest administrative data platform
(contracts, invoices)
Reduction on FTE in
backoffice
Psy Health
Direct
eHealth treatments for depressions, fear,
burnout
Reduced cost of
interventions and
improved purchasing

12. To create tipping point in policy related areas we
use the Minimal Required Energy strategy
12We assemble the minimal
needed set of partners:
For competences
and/or
launching customers
Product &
services 1.0
Implement and proof
to the healthcare
sector that the
innovation is succesful
Expand step by step
Include new partners
and (often) open up
the governance
structure

13. Index
13
Our environment
The goal of CbusineZ is to change the behaviour of the healthcare system
Cases:
Hearing aids
Benchmarking
eMental Health
Communication platform
Corporate Venture Office
Organisation and alignment
Staff
CVM: expertsystem for monitoring & portfolio management

14. Hearing aids: yearly € 20 mln potential
savings... But how to open up the market?
14
Prices could be slashed in
half
A completely closed
market
retail
Leverancier
Importeurs
1250
525
Our analysis showed that
hearing aids could cost less
then 50% of the 2012 price
The market was strictly divided
and attempts to break the
power in the past had been
punished by market leaders

15. Having the info and a credible threat to existing
players CZ succeeded in the purchasing project
15
1 2
We set up Tonen (a hearing
aid service):
- Better quality (at home)
- Low price (€ 500)
Hard to find a supplier
offer
Purchasing
project
Reduce
suppliers
Use Tonen
price as
reference
Even the largest suppliers
reduced their prices with 40-
45%

16. To open up the € 6 billion black box we
started a benchmark initiative
16
Mental Health was a
complete black box
6 billion
Health care insurers became
responsible for purchasing
mental health services
A sector of 6 billion... No one
had a clue on outcomes!
CbusineZ, the 3 large health insures and a
VC started KZN a benchmark initiative

17. Using MRE strategy the sector was
forced/seduced into cooperating
17
A BV (“ltd”) with 5
shareholders
Modern, ‘new’ mental
health institutions as
customers
Sector very resistant
to idea of ROM and
benchmarking
A foundation with a
board of patients,
mental health and
healh insurers
The whole sector
participates
Sector can
improves its
performance and
health insure can
purchase based
on value
Professionals still
hesistating

18. Using eHealth a depression can be treated just as
effectively with half the cost and time
vv Using eHealth
3 Face tot Face + an ehealth
program
Of
eHealth programm &
coaching on telephone
cost: ca € 300 - € 400
g Current depression treatment
1st line 8 conversations
€ 560
2nd line: 8-12 conversations
€ 1200
+
Same effect
55% of
patients
would prefer
eHealth

19. We introduced a JV to remove the barriers for
the usage of eMental Health
19
Adaption of
eMental
Healht
Prices of eHealth were
to high
Tarrifs for treatment not
high enough
Knowledgde on how to
use eHealth was low
JV with mental
health
provider
Lower prices
Change policy
to stimulate
eHealth
Invested in JV and changed
the policy
By removing the barriers and
promoting we now see a, carefull,
upscale of the usage of eHealth

20. eLabs create mental health interventions in co
creation using gaming techniques
20
The eLabs are corporations.
The members are mental
health institutions and
Cbusinez.
The interventions are created
in co creating between
patients, care professionals
and Serious Game designers
- Autisme
- Addiction
- Psycho trauma
Video based
training for skill
for autism
patients
‘quest for a
better life’

21. VECOZO is the platform that facilitates
communication between institutions and health insurer
21
Healthcare
provider
Healthcare
provider
Healthcare
provider
Health
insurer
Health
insurer
Health
insurer
VECOZO:
Reduction in back office cost
At providers and HI
Being the the Facto standard there are
not many doublings or data
incompatiblities in the Netherlands

22. CbusineZ portfolio
Jan 2015
voorheen
22

23. Index
23
Our environment
The goal of CbusineZ is to change the behaviour of the healthcare system
Cases:
Hearing aids
Benchmarking
eMental Health
Communication platform
Corporate Venture Office
Organisation and alignment
Staff
CVM: expertsystem for monitoring & portfolio management

24. CbusineZ organisation: the elements have to
aligned
24
Organisation
Culture
Process &
Tools
Finance
People
Strategy
Corporate
Venture
Office

25. Position in the CZ organisation:
at board level
25
Board
CZ
Marketing
Healthcare
procurement
Sales
Customer
service
Declaration
services
Staff
Board
CbusineZ
Legally
CbusineZ is a separate legal entity
with its own board
Functionally
To the CZ organisation the
CZ-CbusineZ board present
themselves as one
So CbusineZ is organised at C-level
CSF

26. CbusineZ organisation structure
26
Executive board
Arno van Son Joep de Groot
Ria Yap
Business managers
Gertjan van Rossum
Investment managersSupport
Angelique Bonte
Stephan Hulsbergen
Freek van Gerwen Berry MortierJeroen Nugteren
Finance
Lianneke Mol
Myrthe van HoekCarolien Oppeneer
Legal Intern
Nicole van Loy

27. CbusineZ network: CbusineZ, Venture managers
and CZ innovators
CbusineZ event:
(Every 3 months)
Deal flow
Presentation on relevant
topic
(eg strategy, innovation
lessons from Jobs)
Thought provoking topic:
(eg design, serious game)
Networking
17
CZinnovators
Venturemaangers
CbusineZ
Executive board
A. van Son J. de Groot
R. Yap
Business managers
JH Willemse B. v.d Kallen U. Soffers
GJ van Rossum H. Agten
Investment managersSupport
A. Bonte T. Talen

28. CbusineZ organisation: the elements have to
aligned
29
Organisation
Culture
Process &
Tools
Finance
People
Strategy
Corporate
Venture
Office

29. CbusineZ attracts employees from CZ and
‘reprograms’ them
30
14
Board
CZ
Marketing
Healthcare
procurement
Sales
Customer
service
Declaration
services
Staff
Venture
Opera
CbusineZ
Investment managers
Venture manager
Consultant
1
1
2
3
2
3
Intensive coaching program:
from “corporatee” to innovator
Attitude
- Results Instead of process
- Don’t tell me why it can’t be
done, tell me what you need
- Connect instead of protect
Skills
- Focus, focus, focus
- PRISMA (problem solving)
Speed
- Enourmous acceleration

30. CbusineZ organisation: the elements have to
aligned
32
Organisation
Culture
Process &
Tools
Finance
People
Strategy
Corporate
Venture
Office

31. The CVO needs a formalised process and tools
33
0.
Idea
Generation
1.
Screen
lead/idea
3.
Develop
mature
Venture
2.1 New Venture
2.2 Participation
M&A
BP Start up Scale up Expansion
Exit
Venture
4.
Exit
Venture
dealflow en innovatie-mngt Cbusinez 18-okt-11
Innovaties
naam soort CVM-status BMngr Mijlpaal gereed% gereed
NIEUWE VENTURES CVM-status
Businessplan 1 1/2 dermatologie NV NV-2 Opstart + M&A-3 TT 01-12-11 25%
Introductie PROMS NV NV-2 Opstart JvV/JdG 01-09-11 95%
Matching Talen: marktplaats voor Vp NV NV-2 Opstart TT 01-12-11 30%
Nieuw Concept voor B&G (profielgericht verzuimmngt) UVV NV-2 Opstart TF 09-07-11 10%
Centrale inkoop voor v&v huizen NV NV-1 Businessplan JN 01-02-12 0%
Premium Care & Living NV NV-1 Businessplan BLE ?
PARTICIPATIES CVM-status BM Mijlpaal % gereed
Plannings- communicatiesysteem voor mantelzorg NV MA-2 Screening aanbod NvL 01-10-11 90%
Fusie en schaalvergroting WMO KT Part MA-2 Screening aanbod JdG 15-11-11 50%
Bekijken mogelijke participatie in Medicinfo van APO Part MA-2 Screening aanbod JdG 01-12-11 25%
Fusie PROMs en Miletus & aanscherpen CQI Part MA-2 Screening aanbod JdG 01-12-11 0%
Verkoop Huisartsenscan aan derde partij Part Ex-4 Onderhandelen voorwaardenABO 01-01-12 50%
Projecten CVM-status
Zorgregelaar Proj PJ-4 Uitvoering ABO 01-04-12 25%
Lichtere cardio processen met ehealth (Philips) Proj PJ-3 Ontwerp TK/JdG 29-06-11 10%
ZDF: Proces rondom verstrekking aan- en uittrekhulp verbeteren Proj PJ-3 Ontwerp JD 22-06-11 10%
ZDF: serious game ontwikkelen Proj PJ-2 Opstart JdG 01-04-12 50%
Mental ehealth in 2e lijn Proj PJ-1 Projectplan NS 10%
Verbeteren inzet Best Doctors proj PJ-1 Projectplan ABO 5%
IDEE EN VERKENNINGFASE 1-2
Arbo diensten te koop? 2. verkenning TT 90%
Informatieuitwisseling binnen ouderenzorg met MMG 2. verkenning HA ? 75%
Ondersteuning BMI 30-35 2. verkenning TT 70%
Model ziekenhuis met Bernhove 2. verkenning JdG 50%
Bekijken mogelijkheid KZN voor fysiotherapie 2. verkenning GvR 50%
KZN voor AWBZ ism buurtzorg&omaha systeem 2. Verkenning HA ? 25%
Qiy als alternatief voor het EPD (incl investering/toezicht) 2. Verkenning WCA 01-09-11 10%
Kwaliteit meten door gezondheidswinst te bepalen 2. verkenning JdG 10%
DICA als benchmark voor oncologie 2. verkenning JdG 10%
Obesitas ondersteuning met mobiel (icm Rabobank) 2. verkenning JdG 5%
Deal Flow
1. Market Map
2a. Strategic goal for the parent
2b. Needed results
3. Business goals for the Venture
4a. Needed links with the parent
4b. Needed links with other
Ventures in the portfolio
5. JV partner selection and abilities
to be transferred
Strategic Goal Map
Strategic Goal Map Portfolio Mngt
Zorgaanbod
realiseren
Kwaliteit
verhogen
Kosten van zorg
verlagen
Zelfmanagement
mogelijk maken
Strategische
waarde (nu-3jr)
Essentieel
Hoog
Bijdragend
Beperkt
Portfolio Mngt
Business
plan
Marketing &
sales
Partner
network
Organisatie
Product
Intellectual
Property/
Strategic assets
Delivery
processes
Managing
director
Team & key
personnel
Structure &
governance
Financial
performance
Financial
structure
Control
strategy
Organisation
Product
Financial
Strategic goal
BP Start up Scale up Expansion
ValueoftheVenture
Time
Develop mature venture
Core
Venture Mngt

32. Deal flow list facilitates progress by transparency
and killing projects that won’t progress
34
dealflow en innovatie-mngt Cbusinez 18-okt-11
Innovaties
naam soort CVM-status BMngr Mijlpaal gereed% gereed
NIEUWE VENTURES CVM-status
Businessplan 1 1/2 dermatologie NV NV-2 Opstart + M&A-3 TT 01-12-11 25%
Introductie PROMS NV NV-2 Opstart JvV/JdG 01-09-11 95%
Matching Talen: marktplaats voor Vp NV NV-2 Opstart TT 01-12-11 30%
Nieuw Concept voor B&G (profielgericht verzuimmngt) UVV NV-2 Opstart TF 09-07-11 10%
Centrale inkoop voor v&v huizen NV NV-1 Businessplan JN 01-02-12 0%
Premium Care & Living NV NV-1 Businessplan BLE ?
PARTICIPATIES CVM-status BM Mijlpaal % gereed
Plannings- communicatiesysteem voor mantelzorg NV MA-2 Screening aanbod NvL 01-10-11 90%
Fusie en schaalvergroting WMO KT Part MA-2 Screening aanbod JdG 15-11-11 50%
Bekijken mogelijke participatie in Medicinfo van APO Part MA-2 Screening aanbod JdG 01-12-11 25%
Fusie PROMs en Miletus & aanscherpen CQI Part MA-2 Screening aanbod JdG 01-12-11 0%
Verkoop Huisartsenscan aan derde partij Part Ex-4 Onderhandelen voorwaardenABO 01-01-12 50%
Projecten CVM-status
Zorgregelaar Proj PJ-4 Uitvoering ABO 01-04-12 25%
Lichtere cardio processen met ehealth (Philips) Proj PJ-3 Ontwerp TK/JdG 29-06-11 10%
ZDF: Proces rondom verstrekking aan- en uittrekhulp verbeteren Proj PJ-3 Ontwerp JD 22-06-11 10%
ZDF: serious game ontwikkelen Proj PJ-2 Opstart JdG 01-04-12 50%
Mental ehealth in 2e lijn Proj PJ-1 Projectplan NS 10%
Verbeteren inzet Best Doctors proj PJ-1 Projectplan ABO 5%
IDEE EN VERKENNINGFASE 1-2
Arbo diensten te koop? 2. verkenning TT 90%
Informatieuitwisseling binnen ouderenzorg met MMG 2. verkenning HA ? 75%
Ondersteuning BMI 30-35 2. verkenning TT 70%
Model ziekenhuis met Bernhove 2. verkenning JdG 50%
Bekijken mogelijkheid KZN voor fysiotherapie 2. verkenning GvR 50%
KZN voor AWBZ ism buurtzorg&omaha systeem 2. Verkenning HA ? 25%
Qiy als alternatief voor het EPD (incl investering/toezicht) 2. Verkenning WCA 01-09-11 10%
Kwaliteit meten door gezondheidswinst te bepalen 2. verkenning JdG 10%
DICA als benchmark voor oncologie 2. verkenning JdG 10%
Obesitas ondersteuning met mobiel (icm Rabobank) 2. verkenning JdG 5%
Simple list with
Ventures & projects
with their status and
milestone deadline
Managers want to show progress
The deal flow makes the progress transparent.
Managers want to show progress to the board and
the rest of the CbusineZ community
Facilitates killing projects
Corporate habit:
We have invested a lot of effort in this project, so
it would be a shame to stop now...
Kill and kill early!
Ventures/projects that won’t progress are killed!
“Don’t be temped to let it simmer”

33. Create a Strategic Goal Map… enhance it
with every phase and use it for monitoring
35
1. Market Map
2a. Strategic goal for the parent
2b. Needed results
3. Business goals for the Venture
4a. Needed links with the parent
4b. Needed links with other
Ventures in the portfolio
5. JV partner selection and abilities
to be transferred
Strategic Goal Map
Establish the strategic goals the
company wants to achieve with this
venture
Detail needed business results,
needed links & partners
The Strategic Goal Map is needed
to monitor the Venture and to
organise the links with the parent

34. We had no tool to analyse organisational
maturity and to coach the venture director
36
How good are the ventures in the
portfolio?
BP Start up Scale up Expansion
ValueoftheVenture
Time
Develop mature venture
Core
How can we help ventures to
progress to the next phase?

35. We review on 13 aspects to get a complete picture
37
Business
plan
Marketing &
sales
Partner
network
Organisatie
Product
Intellectual
Property/
Strategic assets
Delivery
processes
Managing
director
Team & key
personnel
Structure &
governance
Financial
performance
Financial
structure
Control
strategy
Organisation
Product
Financial
Strategic goal
BP Start up Scale up Expansion
ValueoftheVenture
Time
Develop mature venture
Core

36. Based on literature, experience and case
study we devoloped our own rules set
38
Venture management
literature
Subject literature
Experience
Cases
CbusineZ Venture Management
Heuristic rules set

37. Per phase, per subject categorie 3-5 questions are
developed (total :350)
39

38. CASE
What do
you think?

39. Thank you for your attention
and have fun
venturing
41