As I mentioned in a recent blog, the future of health care access, delivery, and costs in the U.S. remains uncertain, with lots of speculation, especially relative to the future life of the Affordable Care Act. The new year will bring change for the health care industry in the United States, as organizations prepare to adapt under the administration under President-elect Donald J. Trump.
Over the course of the past decade, the health care industry has witnessed significant changes, challenges, and opportunities, and what the future will bring, both in the short-term and the long-term, remains unclear, creating a lot of anxiety for individuals, employers, insurance companies, hospitals doctors, and all health care providers and consumers. An annual report by PwC’s Health Research Institute (HRI), “Top Health Industry Issues of 2017,” surveyed both consumers and health industry leaders to learn how they will balance the new administration’s approach to health care.
According to the report, some of the critical forces expected to have the most impact on the U.S. health-care industry include the following:
Diet-related health issues, including obesity.
Drug companies will better engage with patients to justify prices, show value and satisfy calls by regulators who want them to work more closely with the people who use their products.
Using emerging technologies, such as drones and artificial intelligence.
Moving from “volume to value.” Both the Centers for Medicare & Medicaid Services (CMS)and private plans are asking providers to take on more downside risk.
Many individuals are enrolled in high-deductible health plans, causing providers to modernize their payments systems.
More than 3,000 retail clinics are in operation. This, along with the rise of telemedicine and other delivery systems, has prompted medical schools to rethink how they train young doctors.
Drug prices again are facing public and political attention, as the industry moves to regulate itself in response to pressure.
The three main strategies key health-care players are expected to use to address these forces are all centered on value creation: Adapting for value, innovating for value, and building for value.
The shift to value-based care models is forcing many health-care providers and organizations to adapt. Health-related organizations, both new and traditional, are addressing the shift toward value-based care through invention and innovation, with a focus on population health, and the rise of new, emerging technologies.
Health organizations are building new solutions to issues raised by this shift, through pilot programs, partnerships, and other forms of collaborative efforts. According to the report many of the seeds of the 2017 issues were sown in 2007. Some of the top health industry issues back then were:
Obesity is the new smoking, with employer incentives considered to push employees to lose weight.
Industry embarks on digitalization with slow electronic health record (EHR) uptake.
“Volume to value” is in early days, as CMS begins its push to tie payments to quality and drive the industry toward greater transparency.
Consumer-directed health plans start to grow. Just three million Americans have consumer-directed plans.
Retail clinics are in their infancy. In 2006, 90 are in operation and about one in 10 consumers have been to one.
Drug prices draw scrutiny as 42 blockbuster products lose their patents in 2007, representing $82 billion in sales.
Although exact details of Congress’ and President-elect Trump’s plans to repeal and replace the Patient Protection and Affordable Care Act (PPACA) remain unknown, 2017 will certainly bring continued innovation, emerging technologies, and new business models within the health-care industry.