Top Healthcare Industry Issues

Top Healthcare Industry Issues

At the end of 2017, the PricewaterhouseCooper (PwC) Health Research Institute released their annual report of top healthcare issues they forecasted for 2018. The report identified 12 forces that they divided into three categories:

  1. Cross-sector collaboration
  2. Strategic investments
  3. Creating efficiency

This comprehensive report identifies in detail the challenges faced by healthcare professionals and the opportunities to make the health industry end the year on a strong note. A brief explanation of the 12 forces outlined in the report is listed below.

Cross-sector Collaboration

Healthcare leaders and industry organizations must work together to find suitable solutions to address these issues:

  • Opioid crisis: collaboration is necessary to address the prevention of prescription and non-prescription opioid misuse, alternative treatments for chronic pain management, support for those struggling with addiction, expanded access to overdose reversal drugs, etc. There were 64,000 overdose deaths due to opioids in 2016 alone and half were prescribed by a doctor.
  • Social determinants: factors such as income, education, nutrition and housing can negatively affect healthcare outcomes. The shift toward prevention and value-based care can help reduce costs and reduce admittance to emergency rooms and hospitals. Offering extended care services such as nutritionists, social workers, behavioral health specialists and community health workers could save providers both time and money. Most importantly, it will give individuals the resources to live overall healthier lives.
  • Price transparency: rising healthcare costs are leading to more states considering passing laws to control prices on hospital costs and require drug companies to report the cost of drugs and explain any pricing changes they are implementing.
  • Natural disasters: the aftereffect of hurricanes, tornadoes, wildfires, etc., wreaks havoc on health systems and pharmaceutical supply chains – from destruction of physical structures to displaced patients to product shortages. This all affects the revenue cycle of every type of health care provider. Planning for such disasters must be in place for uninterrupted communication and alternate care protocols.

Strategic Investments

Healthcare organizations will need to invest in a variety of systems in order to stay on top:

  • Medicare Advantage: this private alternative to government offered Medicare is becoming more attractive to Baby Boomers. These plans must offer high quality experiences in order to win new customers. Offering additional services such as medical education, coaching, health monitoring and social support as helpful measures to prevent disease, reduce social isolation and promote healthier lifestyles.
  • Complicated health reform: the Affordable Care Act (ACA) is still in place, but it is more complicated than ever. Efforts continue to “reduce and cap Medicaid spending, expand access to lower-premium health insurance, loosen ACA consumer protections, soften the individual and employer mandates and repeal ACA taxes and fees,” according to PwC. Health organizations need to closely watch the policy changes in this uncertain time.
  • Internet security: cybersecurity breaches are far too common in medical settings. Hospitals are especially vulnerable to ransomware attacks. The massive connected systems in these settings must be made as secure as possible to protect sensitive patient data. Staff must also be continually trained on security practices. Planning for such manmade disasters must be in place to quickly and effectively respond.
  • Patient experience: with the vast amount of competition in the medical arena, healthcare organizations will be able to set themselves apart from others by offering a positive patient experience at every touch point. Investments in these services will be paramount: outstanding customer service, online scheduling/bill paying, convenient communication tools, welcoming office space, social media experiences, etc.

Creating Efficiency

Efficiency breeds productivity. As such, these issues prevail:

  • Artificial intelligence (AI): computers can make some tasks more efficient and safer in a healthcare setting. Automation for tasks like virtual personal assistants, data analysts, chatbot and email communications, research and analytics, financial and tax reporting and more can lighten the load on your staff while improving efficiencies and boosting revenues. AI will not entirely replace your workforce, but it can provide supplement support for tasks that can be automated.
  • Healthcare middlemen: pharmacy benefit managers (PBMs) and wholesalers will be tasked with proving their value in the supply chain. Their pricing and rebate practices are under more scrutiny and new laws may require PBMs to share pricing information.
  • Real-world evidence: according to PwC, “as the 21st Century Cures Act takes effect, the industry may see new opportunities to use these data for faster, less costly FDA approvals and freer communication with payer formulary committees.” Consumers are willing to share data to ensure the safety and efficacy of a drug.
  • Tax reform: the lowered federal corporate tax rate could help put US companies on a more equal playing field with foreign competitors in regard to operations investments, organizational structure and more. These tax provisions will require updates to financial reporting systems.

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