Yesterday, the big 800lb gorilla in the PHR market, WebMD announced 3rd quarter earnings that were quite mixed. While its public portal business continues to see strong growth in uniques (now over 83M visitors/month) and advertising revenues that grew 26%, its private portal business continues to produce lackluster results, with flat revenue and holding steady with 124 clients. Even worse for the private portal business, WebMD is projecting a net decline of some 8% for this division in the 4th quarter.
Strong growth for the public portal reflects what other studies and recent surveys have shown: Consumers continue to turn to Dr. Net for a second opinion, self-triage, or simply advice on how to deal with a specific condition. What is interesting in the case of WebMD is that despite the increasing power and sophistication of search engine technology from Google and the more recently introduced Microsoft Bing, consumers still look to a site like WebMD’s to provide more structured content that is easy to search, review and assist them in managing their health or the health of a loved one.
Zero growth and projected contraction in Q4 for the private portal operations of WebMD is a different story. The private portal business serves both the employer and payer markets wherein WebMD hosts a member or employee PHR for a client. Since late 2007, Chilmark Research has been tracking WebMD’s private portal business as a barometer for sponsored PHR adoption by employers and payers. Now one might easily assume that the downturn in the economy and the lay-offs of hundreds of thousands of employees may have something to do with WebMD’s Q3 results for its private portal business. Problem is: WebMD has been reporting lagging results for this line of business for as long as we have been tracking it so something else must be at play.
Late last year I had a discussion with a senior executive at BCBS-MA. During that conversation I asked what motivated them to take the bold move (at least it was at the time) to allow members to export their claims data to Google Health (BCBS-MA was one of the first payers, if not the first, to allow claims data to be exported by the consumer to a site outside of the payer’s control, in this case to Google Health). The answer, it was a simple business decision. BCBS-MA was spending a lot for WebMD’s private portal and few members were using it. So instead of spending that money on WebMD, the decision was made to turn over the data to the member/consumer allowing them to export it to Google Health and let the member decide how they wished to use their data. Thus, like BCBS-MA, other payers are likely not seeing tremendous adoption and use of their WebMD-hosted PHRs and are not increasing their investments in the service.
On the employer side there may be some contraction in use due to employee lay-offs and a tightening of the belt by employers, but this is likely a very small factor in why WebMD has failed to grown this line of business. Other factors at play are:
Employees still remain reluctant to participate in an employer-sponsored PHR due to concerns of privacy of their health data and how that data may be used against them e.g., deny a promotion.
The efficacy of employer-sponsored PHRs in lowering MLRs (medical loss ratios) and subsequently health insurance costs is far from proven, thus employer ROI is in question.
WebMD has a reputation of being expensive and difficult to work with. Chilmark has also heard some rumors that WebMD is putting very little into improving the capabilities of the private portal platform,- its on life-support. This last point should not come as a surprise considering the results of this business line.
So what does this mean to the broader market?
First, consumers are increasingly turning to sites such as WebMD’s to gather information to assist them in their health and wellness decisions. The WebMD property is a very strong brand, remains one the top go to sites for health information, their iPhone app has consistently ranked as one of the top health apps and thus WebMd can command a premium from advertisers. Unlike most Health 2.0 companies who also seek to leverage the all too common internet advertising model to drive business with little success, WebMD is actually doing it quite successfully.
But WebMD has a major problem in its private portal business and rather then make a concerted effort to put this business back on the right track, the company seems perfectly content to milk this cow for all its worth. That strategy provides an opening for other companies to step in.
The challenge for new entrants, however, will be their ability to provide a comprehensive health and wellness solution that is comparable, if not improves upon the WebMD offering. Today, while there are plenty of products and services in the market that attempt to address various health and wellness needs of employers, there are virtually no solutions that provide as comprehensive a portfolio of services that WebMD currently provides. Employers and payers are looking for options (this was part of the justification for some employers who came together to create Dossia and the separate efforts of Aetna and United Health Group), there is demand, but few options exist outside of creating your own.
Ideally, through acquisition(s), partnership(s) and merger(s) such a solution can emerge to serve the employer and payer markets. Now the question is: Who will step up to the plate and make it happen.