Ready to dive into the world of healthcare, pharma, and biotech consulting? If you’re looking for a career that has a real impact on people’s lives, you’re in the right place! But before you can land that dream job, you’ll need to navigate the healthcare consulting case interview.
In this article, we’ll discuss:
- How to succeed at a healthcare consulting case interview
- A healthcare consulting case interview example
- 4 tips on acing your healthcare case interview
Let’s get started!
What You Need To Know To Ace a Healthcare Consulting Case Interview
Healthcare consulting is a specialized area of the consulting industry that provides expert advice to help healthcare organizations. It’s also called life sciences, biotech, or pharma consulting.
Healthcare is a complex industry with many different sub-sectors of specialization:
- Pharmaceuticals and biotechnology firms produce life-saving drugs, vaccines, and other products that help people recover from illness and injury.
- Healthcare providers include many professionals who administer healthcare services, including doctors, dentists, physical therapists, and nurses. It also includes the settings in which care is provided, such as hospitals, clinics, and long-term care facilities.
- Healthcare payers are health insurance companies and government entities that pay for healthcare services and care. They focus on processing patient eligibility, enrollment, claims, and reimbursement.
- Medical device companies create a range of products, from surgical tools to imaging equipment, that help diagnose and treat illnesses.
From navigating the regulatory landscape to managing complex stakeholder relationships, healthcare consultants must be well-versed in the industry’s intricacies.
You don’t need to become a walking encyclopedia of healthcare knowledge to land a job in healthcare consulting. Just ensure you have a solid understanding of the basics and can speak intelligently about them during your interview.
A Healthcare Consulting Case Study Interview Example
To do well on a healthcare consulting case interview, we recommend using the same structured approach as for other types of case interviews. There are 4 parts to this approach:
- Opening – Understand the client’s problem and ask clarifying questions.
- Structure – Identify the key issues underlying the client’s problem and organize them in a structured way.
- Analysis – Use a hypothesis-driven approach to gather data and evaluate options.
- Conclusion – Present your recommendation.
Our Comprehensive Guide on Case Interview Prep goes through each step in more detail.
Let’s walk through a healthcare case interview. Try answering each section of the case on your own to practice!
Client’s Problem
Interviewer: Our client is a large health insurance company, HealthyCo. They currently serve 5 million members across the U.S. They’re considering launching a new disease management program for one disease to offer more effective care to their members. The program involves hiring and training a team of specialized health coaches to manage members with a specific condition, such as heart disease.
Each health coach will handle a portfolio of members, providing the necessary support to help them manage their disease, such as reminders to take drugs or diet suggestions. Studies suggest that health spending can be reduced by 5% by staying in touch with members every month.
HealthyCo has asked us to recommend if they should go ahead with the program and outline the necessary steps to make it a success.
Step 1: Opening
First, restate the client’s problem to the interviewer to confirm your understanding. This is also an opportunity to check your knowledge of the healthcare sub-sector, stakeholders, and context.
Pretend you’re the candidate and think about how you’d approach this before reading on.
Candidate: HealthyCo is considering launching a preventative program. My understanding is that healthcare payors, like HealthyCo, are responsible for underwriting insurance policies, assessing risk, assigning premiums, and managing financial aspects of health insurance coverage.
HealthyCo’s goal is to analyze the feasibility of the disease management program. As an insurance provider, this preventative program will help their financial goals of lowering their costs while improving patient health. They also want a plan on how they can ensure it is successful.
Is this understanding correct?
Interviewer: That is right. The program is part of HealthyCo’s strategic question of whether or not they should focus on preventative care.
Candidate: Before we dive in, I want to better understand:
- What are the responsibilities and limitations of the health coaches in the program?
- How many members can each health coach contact monthly, and what are the associated costs?
- Are there any limitations or constraints on resources or funding?
Interviewer: Let me provide some additional context:
- The health coaches will conduct all activities remotely via phone and email. They will typically be registered nurses who prefer to work from home.
- Each coach can only contact 8 members per day. They’ll work 25 days per month.
- The annual costs per coach include a salary of $60,000 and an additional 15% for training, benefits, laptops, and other expenses. There are no other program costs.
Step 2: Structure
Consider the information you’ve received and take a moment to formulate a hypothesis on how our client can understand the profitability and impact of the disease management program. A well-structured approach would involve identifying 3 to 4 key topics, each with their respective sub-issues to examine thoroughly.
Try writing a hypothesis yourself before reading further!
Candidate: We need to understand the economics of a disease management program and what potential risks should be considered.
I hypothesize that the best focus for the disease management program would be a specific demographic or type of disease that would yield 1) substantial improvement in patient health and 2) high healthcare cost savings. I’d consider common diseases, particularly those that affect older people.
The candidate is making an educated hypothesis and knows that the interviewer will need to provide more data to do the calculations.
To validate this hypothesis, identify the key issues you’d need to understand to determine the best disease to use health coaches for and the economics of the health coach program. Since you want to demonstrate you can problem-solve in a structured and analytical way, ask for a minute to outline your thoughts.
Candidate: I’d like to walk through how I’d approach our client’s problem. Here are a few areas of questions that would inform our work.
1. Member Considerations
- What are the different types of member segments and disease types?
- What is the future trajectory for each disease (e.g., is the type of disease trending downwards or upwards)?
- Is there a demonstrated demand for the program?
- What are the alternative programs or solutions currently available to members?
2. Program Savings
- How would implementing a preventative program impact the healthcare costs of each disease or age group?
3. Program Costs
- What are the costs of using health coaches for each disease or age group?
- What specific costs are associated with program implementation, including salary, training, benefits, and other expenses?
4. Internal Resources
- What resources would be required to implement the program?
- Would the health coaches be new hires or existing personnel allocated to the new program?
5. Risks and Considerations
- What potential regulatory and liability risks should be identified and addressed to ensure success?
- Are there other stakeholders who would be negatively impacted by this program?
- What potential responses could be expected from competitors, and how might that impact the program’s success?
Don’t worry if you didn’t capture as much detail in your issue tree! The important thing is demonstrating that you can structure your thoughts and break down complex problems.
Step 3: Analysis
The interviewer will show you some exhibits with quantitative data. This tests your ability to synthesize information, do mental math, and summarize your insights.
Interviewer: One of your key questions was about understanding what groups of members the client serves.
HealthyCo categorizes its members into 3 main groups: group members, which are employer-sponsored plans, individual members under 65, and individual members over age 65.
Our client knows that preventative programs work best for individual members over 65, so we will focus our analysis on this group.
What can we infer from this data?
Before reading the candidate’s response, take a moment to consider what analysis or insights you could draw from the exhibits.
Candidate: Thank you for sharing this data. I need a moment to digest it.
About 65% of HealthyCo’s members are group members. These members are typically healthier than the other member groups because they are younger, working professionals. I do not believe this would be the best group to target for the disease management program because their healthcare costs are low.
I believe the ideal focus for the preventative program would be the over age 65 segment. This is because these older members are generally the sickest, which means they are more likely to drive higher costs and would be ripe candidates for the program.
Additionally, focusing on diabetics, assuming all are Type 2, would be a strategic choice as this disease affects 40% of the 65+ age segment.
To confirm this current thinking, I’d like to calculate how many members HealthyCo has who are 65+ and diabetic. Next, I would want to understand the costs of providing this program.
Interviewer: You are headed in the right direction. How would we calculate the number of members in that group?
Candidate: We know HealthyCo currently has 5 million members. From the exhibit, 20% of members are in the over 65 age segment, and 40% of members in that group have diabetes. Therefore, I would multiply those numbers to arrive at the number of diabetic members over the age of 65.
Number of diabetic members over 65
= 5 million members x 20% of total members x 40% that are diabetic
= 400,000
There are 400,000 HealthyCo members that we can target for the disease management program.
Next, we’d want to understand the program costs and savings to determine whether this program will pay for itself. Do you have any data on this?
Interviewer: Our client has told us that their current average monthly cost for anyone 65+ is $300 per member, but for people with diabetes, it’s 4x as much.
Candidate: That is helpful to know. We can use that data with the health coach information previously given to estimate the program savings.
I’ll summarize what we know to calculate the cost per coach, the number of members each coach can handle, and the total potential savings:
- The annual costs per health coach include a salary of $60,000 and an additional 15% for training, benefits, laptops, and other expenses.
- Each coach can only handle 8 members per day. They work 25 days per month.
- The disease management program can reduce health costs by 5%.
- 400,000 HealthyCo members have diabetes and are over 65.
- For people over age 65 with diabetes, the monthly cost per member is $300 x 4.
My calculations are:
What is the cost per coach?
= $60,000 base salary x (1 + 15% in other costs)
= $69,000 in cost per coach
How many members can each coach handle?
= 8 members per day x 25 days per month
= 200 members per month
How many coaches do we need to serve the diabetic members over 65?
= 400,000 diabetic members over 65 / 200 members per coach
= 2000 coaches
What is the cost for all coaches?
= $69,000 in cost per coach * 2000 coaches
= $138,000,000 in cost for all coaches
What are the potential health spending savings per member per month?
= $300 average cost per 65+ member x 4 diabetic factor x 5% average program savings
= $60 per diabetic member over 65 per month
What are the total health spending savings in a year?
= $60 per diabetic member over 65 per month x 400,000 diabetic members over 65 x 12 months per year
= $288,000,000 health spending savings per year
However, we need to subtract the costs of coaches to understand the true cost impact.
What is the overall cost of the health coach program per year?
= $288,000,000 health spending savings per year – $138,000,000 in cost for all coaches
= $150,000,000 annual savings
Therefore the program would save HealthyCo $150,000,000 per year in health spending costs on diabetic members over 65 while improving their health. If the program goes well, we could likely roll out health coaches to other disease areas with similar results.
Interviewer: Are there other opportunities HealthyCo can explore?
The interviewer wants to test if you can brainstorm under pressure. You can ask for a few seconds to gather your thoughts. Remember to present your ideas in a structured approach rather than listing all the things that come to mind. This is also an opportunity to showcase any healthcare industry knowledge.
Candidate: I would want to explore 3 areas:
1. Other diseases which could benefit from health coaches
- If we can prove a program for diabetics over age 65 works, can a similar program be provided to diabetics in the individual or group category?
- Could we roll our healthcare coaches to manage other diseases prevalent among our over 65 members?
2. Resource constraints
- Is it realistic to train or hire 2000 coaches? How long would this process take?
- Who will manage the program?
3. Regulatory implications
- Are there any regulatory challenges to address, such as the legal implications of offering a preventative program?
Step 4: Conclusion
The best recommendations go beyond “the answer” using the 5R’s Approach:
- Recap the problem
- Recommend the solution
- Give your reasons and analysis
- Address potential risks
- Retain the client by outlining the next steps your team would work on to achieve the client’s goals.
Before you read the answer, give it a try using the 5R’s approach.
Interviewer: What would you recommend to HealthyCo?
Candidate: HealthyCo wants to know if they should launch the coaching program for disease management.
I recommend that they launch the Health Coaching program, with an initial focus on members who have diabetes and are over age 65. HealthyCo can potentially save $150M by launching this program and positively impact the health of many older patients. The program will help the company save more than the coaches’ costs and has the potential to scale to other age and disease groups.
A risk is the difficulty in hiring, training, and managing 2000 coaches. To mitigate this, HealthyCo could dedicate an experienced program manager to lead the initiative.
The next step would be to launch a pilot program to validate assumptions, such as the projected 5% cost reduction and coach capacity. HealthyCo could test a smaller group of coaches in one state.
4 Tips on Acing Your Healthcare Consulting Case Interview
1. Understand the Unique Dynamics in Healthcare
Familiarize yourself with the regulatory environment, reimbursement models, stakeholder dynamics, and other nuances to demonstrate your industry knowledge.
2. Demonstrate Your Interest in Healthcare
Mention any relevant experience or courses, such as internships or healthcare-specific education. Even in a case interview, the interviewer will likely start with a behavioral question to get to know you as a candidate.
3. Use a Structured Breakdown of Key Issues
Consulting firms don’t expect you to know the answers to cases off the top of your head. They’re evaluating your approach to problem-solving.
You can use an Issue Tree, a consulting tool, and a visual diagram that breaks down a larger problem or question into several smaller questions.
4. Learn About Healthcare Consulting Firms
Get to know the firm you want to interview with. Does the firm specialize in a particular niche in healthcare? What kind of healthcare topics align with your interests?
Check out our List of Life Sciences Consulting Firms to create a list of consulting firms to apply to.
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In this article, we’ve covered:
- Essential knowledge for excelling in a healthcare consulting case interview
- A real-world healthcare consulting case study interview example
- Top 4 tips to excel in your healthcare case interview
Still have questions?
If you have more questions about the healthcare consulting case interviews, leave them in the comments below. One of My Consulting Offer’s case coaches will answer them.
Other people prepping for their healthcare consulting case interview found the following pages helpful:
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