How Does Online Learning Stack Up Against the Traditional Classroom?

Online Learning Programs

The prevalence of distance or online learning programs has grown consistently for more than a decade, driven by more and more people seeking flexible and affordable options to further their education and open the door to new career opportunities. Notably, the 2017 Distance Education Enrollment Report prepared by the Digital Learning Compass organization indicates the number of enrollments for online programs has grown for 14 straight years with more than 6 million students enrolled in online courses in the U.S. during 2015*.

 

 

 

 

 

 

 

 

Online learning programs have altered the entire education landscape. Web-based courses have been integrated into the learning curriculum for all types of organizations, including corporations (e.g., workforce training), higher education institutions, and K-12 schools and programs. Several factors drive the popularity of online education programs, including accessibility, career advancement opportunities and affordability.

  • Accessibility – Online courses allow individuals to work at a pace that accommodates busy schedules and are accessible anytime, making education possible even for the atypical student
  • Career Advancement – Approximately 72% of online students report job and employment goals as the primary driver for pursuing online learning, including transitioning to a new career field and earning academic credentials in a current field of work
  • Affordability – Online learning programs are generally more affordable than traditional brick-and-mortar programs given that schools don’t have to incur the same level of overhead to support online students

Efficacy of Online Learning

There are undoubtedly many advantages to online learning programs, but as popularity continues to grow, it is only natural to wonder about the degree to which online students are successful relative to their classroom counterparts. To that end, many studies have been conducted in which the performance of online students has been measured against the performance of students in traditional classroom settings. Most recently, Connections Academy, an accredited K-12 online public school, completed an assessment of the performance of the students enrolled in its virtual schools. Connections Academy’s students identify as belonging to one of the following categories: academically advanced; struggling academically; experiencing health issues; struggling with bullying issues; and seeking greater flexibility. This creates a unique dynamic considering many of the individuals with these characteristics have complex needs, which tend to result in poor academic performance. Nevertheless, the study indicated there was no statistical difference in the performance of students enrolled in online programs when compared against a similar cohort of students in traditional brick-and-mortar schools. Said differently, the study showed that students who pursued online learning programs attained the same level of achievement and success as those who pursued traditional education programs.

As enrollment in distance or online learning programs increases, people will continue to question the efficacy of online learning. Studies have shown there isn’t much of a correlation between the cost of a degree and the quality of education. However, it’s important for students to thoroughly research and assess the particular program in question to determine whether it serves as an appropriate alternative to traditional education.

* Digital Learning Compass:  Distance Education Enrollment Report 2017

The Future of Retail?

During a recent trip to Seattle (to attend the ACG conference of course), I happened to find myself in front of the Amazon Go store. For those who aren’t on the bleeding edge, Amazon Go is a new retail concept where the shopper engages an app, enters the store, picks up whatever they want, and walks out . . . no check-out, no scanning, no cashiers, just lots of big brother cameras and highly accurate RFID and location technology. So far, Amazon has invested millions in its first Seattle location, and they intend to open several more stores this year, likely in San Francisco, Chicago and Los Angeles.

As a shopping experience, it feels more like a shop-lifting experience. I was nervous walking out the door with a sweet new coffee mug in hand, but then a friendly email from Amazon landed in my inbox a few minutes later telling me how much my Amazon account had just been charged. The assortment is interesting – Amazon calls it an ‘urban market,’ which felt more like an upscale, new age 7-11 to me – with lots of food and beverages, from snacks to millennial-friendly, ready-to-eat meals. The experience is cool and seamless – apparently the technology actually works. The novelty of not having to wait in a line or even scan your items is striking and compelling, not too dissimilar from exiting an uber ‘without paying’ (at least in the traditional sense!).

The first Amazon Go location is approximately 1,800 square feet – again similar to a 7-11 but without the Slurpee machines. It also happens to be located right near a couple of Amazon’s large towers, so thousands of true believers walk by this store every day. I suspect the concept will be a home run in other cities with large, tech-savvy populations. As long as the prices are reasonable, there’s no reason why consumers won’t absolutely love it. Regarding prices, based on my cursory walk-through you know you’re not in Dollar General (or 7-11 for that matter), but the prices didn’t feel egregious either. I didn’t see any overt Whole Foods branding, but there were plenty of 365 house-branded items on the shelves. Let your mind run wild with the Whole Foods angles. . .

What does this mean for every other brick & mortar retailer? Watch out. Amazon will have a huge head start on the incumbents, and they can effectively subsidize new store construction by increasing the cost and number of annual Amazon Prime memberships. The learning curve is steep and expensive with bottoms-up redesign and technological refit of Walmart or Kroger’s installed base of stores a massive undertaking to contemplate. There remains the question as to whether the purchasing public will fully embrace a ‘no touch’ shopping experience with limited or no contact with employees. Consumers will always look for suggestions, help with returns, and directions where to find products in the store. But, for my part, I enjoyed the smooth experience. If you have the opportunity, go check out a Go store whenever you get a chance.

How Efforts to Reduce the Cost of Healthcare in the U.S. May Impact Patients, Payors, and Providers

$3,300,000,000,000: That is how much the U.S. spent on healthcare in 2016, and that number is only rising. The price of medical care has grown over 2,000% since 1960—compared to just over 500% for the consumer price index as a whole. In total, Americans’ health care tab represented approximately 18% of GDP, while the OECD average healthcare spending amounted to only 10% of GDP.[1]

 

 

 

 

 

 

 

 

 

Of more concern, the U.S.’s outsized healthcare spending does not yield commensurate results. Life expectancy at birth in the U.S. is 1.8 years lower than the OECD average of 80.6 years, and instances of many chronic diseases, such as diabetes, are meaningfully higher in the U.S.[2] For example, an estimated 7.8% of adults live with diabetes across all OECD countries, while an estimated 10.8% of Americans suffered from the condition as of 2015. Furthermore, a recent study by U.S.A. Today argues that the U.S. is “the most dangerous place in the developed world to give birth” today.[3] Germany, France, England, and Canada, for example, see an average of fewer than 10 maternal deaths per 100,000 births. The U.S., on the other hand, has seen maternal deaths rise from just over 15 to 26.4 per 100,000 births since 1990.

 

 

 

 

 

 

 

 

 

 

Clearly the quality of America’s care is not proportionate to its price, and something needs to change. People and organizations throughout the nation are aware of this asymmetry and working to reform the state of healthcare via a multitude of potential solutions. Many companies, for example, are undertaking initiatives to transform their employee health programs in an attempt to abate costs while ensuring high quality care. High profile examples include Amazon, J.P. Morgan, and Berkshire Hathaway’s recently announced nonprofit joint venture to provide “simplified, high-quality and transparent healthcare” for their collective employees, and General Motors striking employee coverage deals directly with health systems rather than using insurers as intermediaries.[4],[5]

Despite these and other headline-catching initiatives from some of the country’s largest companies, the most meaningful shift in the healthcare landscape is likely healthcare payors’ slow transition to outcomes-based reimbursement models. In contrast to traditional models of care in which physicians are compensated for each procedure performed, payors are increasingly “focused on delivering the highest quality outcomes at the lowest possible costs,” according to a 2013 McKinsey study. [6] In practice, this translates to payors setting explicit expectations of healthcare providers in the form of key performance indicators such as patient readmission rates and relative costs. In the clinic, these manifest in reduced variation in costs per procedure between providers as well as coordinated patient care across specialties and health systems to avoid redundant treatments and incentivize long-term outcomes.

McKinsey estimates that continued advancement in the area of outcomes-based reimbursement could save the country $1 trillion  over the next decade. Ultimately, though, prospective paths to improve the current state of healthcare in the U.S. are diverse, and there is likely no silver bullet. Rather, continued experimentation and iteration upon models that produce promising results will contribute to a slow-but-sure shift away from the status quo.. If instead we choose to stay the course, historical trends suggest the consequences will be continued suppression of both the nation’s economy and its collective health. While nobody is certain what the nation’s healthcare landscape will look like in a decade, providers who deliver high quality care at defensible prices are poised to thrive as a result of the U.S. healthcare system’s paradigm shift. Regardless of the mechanisms employed to change the nation’s healthcare landscape, the characteristics that will differentiate practices in coming years are clear.

[1] https://www.wsj.com/articles/why-americans-spend-so-much-on-health-carein-12-charts-1533047243
[2] https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-2017/life-expectancy-gains-and-increased-health-spending-selected-high-income-countries-1995-2015_health_glance-2017-graph5-en
[3] https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/07/26/maternal-mortality-rates-preeclampsia-postpartum-hemorrhage-safety/546889002/
[4] https://www.reuters.com/article/us-amazon-healthcare/amazon-berkshire-jpm-form-healthcare-company-to-cut-costs-idUSKBN1FJ1NF
[5] https://www.wsj.com/articles/gm-cuts-different-type-of-health-care-deal-1533582121
[6] https://healthcare.mckinsey.com/sites/default/files/the-trillion-dollar-prize.pdf

Out with the Old, In with the New

Vocational training is out, and Career and Technical Education (“CTE”) is in. They sound similar, but is there a difference? Last century’s vocational programs included training for various jobs such as a trade worker or technician. The primary objective was to prepare high school students not seeking higher education for the work force after graduation. In recent years this has changed. CTE offers a more extensive pathway to success, one that prepares students of all ages for higher education as well as meaningful jobs in high demand 21st century trades and professions. The objective of CTE is to align high school education with postsecondary options as well as prepare students for a career at whatever point they decide to pursue one.

One major difference in CTE is that not all training occurs in the walls of high school. While some education still takes place in high school, it can also occur at community colleges, for-profit schools and industry trade associations, all at a fraction of the cost of a four-year institution. CTE offers both academic and career-oriented courses, many including opportunities to gain real-world work experience through internships, on-the-job training and certifications, depending on the field of study. CTE provides students with a wide range of career possibilities that include both skilled and diverse trades. Currently, the National Career Framework has developed 16 designated career clusters, which serve as an organizational tool for schools in their curriculum design and a navigation guide for students on their path to success in education and career.

According to the Bureau of Labor Statistics, most of the new jobs created in the next decade fall into a handful of these career clusters, including health science, information technology, construction, transportation, and hospitality. At the same time, the average tradesperson today is 56 years old and has approximately 10 years remaining until retirement. In many cases, these jobs cannot be replaced by technology, but they do require specific training and skill. As this skilled group reaches retirement and more skilled jobs go unfulfilled, two outcomes are certain: the demand and wages for these jobs will increase. CTE fulfills employer needs in these skilled areas and allows students to take on less debt to achieve an in-demand career.

The most effective CTE programs have well-prepared educators and targeted internship opportunities for professional development. They tend to maintain partnerships with businesses that provide students with authentic work experience as well as a strong relationship between the technical field of study and the core academic subjects. CTE is an investment by schools and educators, allowing students to learn and prepare for quality jobs. The next hurdle is scaling the most successful programs so that as many students as possible can take advantage and enjoy successful careers.

Summer Outdoor Retailer (“OR”) Wrap Up

Denver hosted its first summer, and only second overall, OR the last full week of July. The OR show moved to the Mile High City last year after a long run in Salt Lake City given its growth and some of the key participants not seeing eye-to-eye with the State of Utah and its approach to the use of public lands. Denver was a great host, and attendance robust. Thousands of companies, from large to small, came to show off their wares and point the way forward for the outdoor industry. From my consumer investment banker point of view, interest and participation by corporate development teams and private equity firms was high, demonstrating the continued enthusiasm institutional investors have for this highly attractive space. Here are a few takeaways from my time on the floor:

The Cooler Wars – We all remember the cola wars, right? We’ve now entered the era of the Cooler Wars. Yeti’s astounding rise awakened people to the realization that the market for $350+ coolers is a lot larger than one might think (or, in fact, that a market for $350+ coolers even exists). The fast followers are legion. From old stalwarts including Igloo and Coleman, to brands expanding into the fast-growing segment from ancillary markets like Otter Box, to newcomers like Rovr and Kysek, the conference room floor was dotted with plastic and metal boxes that keep food and drinks cold for days on end. Is there room at the top for another one, two, or three leaders in the high-end cooler market? That remains to be seen but given how similar many of the product ‘innovations’ seem to be copied from competitors, we may well be approaching ‘peak cooler.’

Kids Are Off Trend – That isn’t to say we’re having a population decline in children, but the number of child-focused companies and offerings at OR seemed significantly down from prior years. There remained the usual presence of kids’ shoes and clothing, but the number of toys and accessories for children has declined. One area of relative strength and innovation is flexible play structures – think slack lines with flexible ladders, trampolines to be tied between trees, and the like.

Target Market Expansion in Clothing – As clothing companies strive to find new avenues of growth, many have turned to simply targeting a different audience with the same, or similar, gear, but through different marketing channels and messages. One of the first to do this, arguably, was Carhartt. Long known for rugged work wear, consumers are now just as likely to see the well-known logo at a summer BBQ or ball game. Dickies has followed a similar path broadening its offerings to include more casual wear. We also noted some highly specialized brands, think fishing and hunting, testing the waters in hiking and camping lines, and vice versa. It’s worthy to note, however, Under Armor attempted to tap into the hunting market by offering a line of its clothing in camouflage patterns, though the results have not been overwhelmingly successful.

Venture Out – One of our favorite areas to see up-and-comers and do some trend spotting continues to be the Venture Out section of the floor. Conceptualized to concentrate smaller, fast-growing companies in one area, Venture Out is a great place to spend a few hours looking for innovation. Indeed, many of the product enhancements seen upstairs may well have germinated in the Venture Out area.

While the current economic expansion is quite long in the tooth, there is no doubt things continue to hum along at a robust pace. With unemployment rates very low, steady economic growth, and wages beginning to rise, Americans are able to both engage in outdoor hobbies and interests and have the money to spend on the goods which facilitate those pursuits. This summer’s OR reflects that state of affairs with more energy and engagement than we’ve seen in a couple of years. Fingers crossed the good times continue to roll.

The Growth of Pet Services (Part 2) . . . a continuance from last week’s #shoptalk blog

Returning to our discussion of the rapidly expanding pet services’ industry, the location-based pet care/pet hosting business is also evolving. Camp Bow Wow, a large franchisor of dog day and overnight care, was acquired by VCA in mid-2014, and since then numerous models have sprouted up in dense urban and suburban areas. Cities such as Boston, New York, Chicago, Dallas and Toronto, among others, have businesses that largely operate a hub and spoke model with the spokes being doggy daycare, and the hub being a hosting facility (oftentimes near the city’s large airport). While the model holds promise, few companies have achieved significant multi-market scale. Challenges include the cost of real estate, finding the right type of workers to service a highly demanding clientele (pet parents), and brand names that, while sporting strong local recognition, mean little in adjacent markets. Several players have also attempted to partner with large multi-family, residential real estate players and contract for the entire property where the service is part of renters’ lease agreements, akin to the cable industry’s model.

Grooming, oftentimes offered by a hosting facility, is a particularly interesting area given the humanization dynamics (pets are extensions of their owners…or is it vice versa?), the recurring revenue nature that hair growth drives (as well as a propensity to roll around in stinky stuff), and the sense of community that a local groomer engenders. Petco, PetSmart and other pet specialty players all offer services and smaller, high profile players such as Woof Gang Bakery (a franchisor) are growing rapidly.

Lastly, to bring the services’ continuum to a natural close, the pet death services space is also exhibiting rapid growth. While exact market size figures are difficult to extract, industry sales are estimated at more than $100 million. While that figure pales in comparison to the $20 billion+ human funeral industry (an average human funeral costs approximately $8,000), the segment is growing at an estimated rate of 10%+. It’s estimated that approximately 50% of funeral home directors in the U.S. also offer pet services, up roughly 15% over 2011. Those numbers are sufficient to draw the attention of both new entrants and institutional investors. And, as in the death services’ market for humans, scale matters. Notably, Ontario firm Gateway Services has embarked upon a consolidation strategy both in Canada and in the U.S., and The Pet Loss Center is similarly active in several states.

While caskets, turns, headstands, and other memorabilia (you can even turn remains into diamonds) are cheaper than their human equivalents, price points can nonetheless be significant. Cremation may run several hundred dollars (smaller pets cost less), burial plots cost $500-$1,000 (depending on location) with an additional annual maintenance fee of approximately $30-$50. Urns can cost from $6 for a paper varietal to $20 at Walmart, all the way up to $2000 for custom vessels, depending on substance and level of artisanship. Caskets run a similar spectrum from relatively cheap durable cardboard to expensive metals. There are even services that will scatter your furry friends’ ashes, with costs varying by location.

In summary, the pet services’ market is varied and growing….and for those of you who aren’t completely satisfied with hosting, grooming, etc,, we’d be remiss not mentioning an even more tailored service provided by Neuticles, a company specializing in artificial testicles for neutered pets, helping the beloved creatures maintain their confidence and dignity!

Increasing Prevalence of Surgeries Performed in an ASC Setting . . . continued

As mentioned last week, in this blog we’ll look at specialties that are well positioned to transition some patient cases to an ASC setting, and what factors, including reimbursement decisions, patient outcomes, and technology are a fit with ASCs.

Importantly, while some procedures may be a good fit for ASCs, the ultimate determination as to where a patient is treated is driven by their personal profile. Unique individual factors need to be considered when patients choose to undergo a procedure at an ASC, including medical history and familial / social considerations (such as access to assistance post-surgery). Clear insights into these factors can help a physician determine whether a person is a good fit for a procedure in an ASC from patient health and financial outcome perspectives.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

As discussed in previous blogs, establishing an ASC can be an expensive proposition, but one that opens new avenues of growth for a practice.  The cost of funding a buildout of an ASC can also be shared with prospective new investment partners in the form of private equity groups or through joint ventures with local or regional health systems.

We’re here to help

Partnering with specialty physician practices as they evaluate strategic alternatives for their businesses represents a significant portion of our work in the healthcare space. As a healthcare investment bank, MHT is extraordinarily active in the market, recently completing anesthesiology, dermatology, hospitalist and emergency physician deals.  We would love to be a resource for you as you consider the rapidly evolving healthcare landscape and the implications for your practice.

Trends in 21st Century Classroom Design

It is said that the some of the most valuable learning experiences occur outside of the classroom. While real-world experiences are undoubtedly critical for one’s development, could this well-known adage also stem from a century of ineffective classroom design? A growing number of educators are starting to think so. As technology transforms curriculum and facilitates teaching, it has become apparent that standard desks in neatly aligned rows are no longer sufficient to engender optimal outcomes for both students and teachers. Instead, educators are opting for flexible learning spaces that integrate technology, encourage connectivity and emphasize hands-on learning. As a result, the traditional classroom is undergoing some big changes – from the type of furniture, to tools, to layouts.

Traditional desks and chairs are being replaced by soft seating, ottomans and configurable tables. Portable furniture that stacks, folds and rolls is increasingly necessary. Tablets, Chromebooks and interactive displays are infiltrating classrooms across all grade levels. Some learning spaces are even furnished with makerspaces, or workstations equipped with 3D printers, craft and hardware supplies, electronics and more, to encourage tinkering and innovation. And while outfitting classrooms with new technology and furniture is crucial, the physical design of the room plays just as an important role. Schools are renovating and constructing new classrooms with brighter colors and larger windows, maximizing natural light.

Creating these new learning spaces comes at a price, and there’s no doubt that educational spending on capital outlays (facilities and hardware) has tightened in the last decade. However, after years of underinvestment, spending is anticipated to reverse as school districts launch initiatives to modernize classrooms. According to survey results, 53% percent of public schools in the U.S. need to spend money on repairs and renovations, and an estimated $197 billion would be needed to complete these modernizations. Even with renovations underway, much works remains to modernize public K-12 classrooms.

Like everything else, schools are adapting to the rapidly evolving, tech-driven world. Schools are breaking the traditional mold in favor of learning spaces that foster adaptability and creativity. The intended results are a profound impact on student engagement, and ultimately, student success and performance.

Source: National Center for Education Statistics

The Growth of Pet Services (Part 1)

While it’s no secret that the pet products’ space has been viewed as attractive for quite a while (look no further than Nestlé’s reported pending acquisition of Champion Petfoods for approximately $2 billion), pet services have increasingly garnered attention and affection from sophisticated players due to its attractive macro dynamics, and in part as a means to “Amazon proof” a business model. Consistent with the humanization of pets, a host of services stands ready to serve these four-legged friends and their human parents. Offer a human service, wait a few years, and voilà, you’ll likely find the equivalent service for pets.

Institutional and strategic capital is “flocking” to the industry, broadly speaking. The pet services’ space (includes grooming, boarding, walking, training, pet sitting, exercise and yard services) was estimated domestically to be $6.11 billion in 2017 an increase from $5.76 billion in 2016 and growing at 6.3% a year, significantly more than the rate of any other pet category. Globally, the same is trending in Europe, Pacific Rim Asia, Australia and New Zealand, and Brazil, among others.

Services run the gamut from marketplaces (geared towards pet sitting and walking), to location-based services (daycare, hosting, grooming, spas) to death services’ business.

Let’s examine one of these spaces in more detail . . .

The dog sitting space, particularly several marketplaces dedicated to pairing pet parents and providers, has attracted a great deal of attention and capital. A recent APPA survey indicates that 35% of all dog owners, and 67% of all cat owners, reported the need for some use of pet sitters over the prior 6 months. With nearly 89.7 million dogs in approximately 60.2 million households, and nearly 94.2 million cats in approximately 47.1 million households in the U.S., that aforementioned 35% and 67% add up. The U.S. market for dog walking and sitting services is estimated at $2.3 billion and is growing at 3.1% annually. Most notably, Rover.com (which merged with its large competitor DogVacay in March 2017) and Wag.com have achieved significant prominence in North America. Rover.com/DogVacay has raised over $310 million to date, while wag.com has raised over $365 million, including a recent infusion of $300 million from SoftBank.

This phenomenon is also playing out globally, with several rapidly growing services in Western Europe such as DogBuddy, Holidog.com, serving as prime examples. While many of these models have yet to achieve profitability (challenges have included: demand that outstrips supply – a common phenomenon in emerging marketplaces; customer acquisition and retention; and lack of national brand awareness), they are the clear market leaders and, much like other marketplaces (e.g., Airbnb, Uber), it seems likely that large markets will support one or two large players with smaller players perhaps finding a space in hyper-localized, or hyper-niche areas.

Look for the continuance of “Growth of Pet Services” when we explore location-based pet care/pet hosting, grooming and pet death services in more detail.

Sources: American Pet Products Association; Crunchbase