Health Care Policy: Issues and Trends

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In other words, health care providers may be working hard but are they working "smart". How is health care moving the barriers of the hospital walls? This outlook reviews the current state of the global health care sector; explores trends and issues impacting health care providers, governments, other payers, and patients; and suggests considerations for stakeholders as they seek to deliver high-quality, cost-efficient, and smart health care. Public and private health systems have been facing revenue pressures and declining margins for years.


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The trend is expected to persist as increasing demand, infrastructure upgrades, and therapeutic and technology advancements strain the already limited financial resources. As a result, spending is expected to be driven by aging and growing populations, developing market expansion, clinical and technology advances, and rising labor costs.

As health care costs increase though, affordability and insurance coverage remain problematic. Health care providers are also collaborating to gain competitive advantage. Health care stakeholders are pursuing new cost reduction measures, such as developing alternative staffing models, shifting patients to outpatient services, and reducing administrative and supply costs.

8 Themes Reveal Key Healthcare Trends

In addition, they are exploring new revenue sources such as intellectual property IP capitalization, investing in JVs, commercializing their foreign assets, and launching new companies and philanthropic organizations. The health care industry is participating in risk-bearing, coordinated care models and continues to move away from the traditional fee-for-service FFS system. Stakeholders are moving from volume to value through reform policies, programs promoting operational efficiency, technology use, population health management, wellness, and addressing the social determinants of health.

Health care providers can also look at deploying innovative care delivery models based on data and analytics. Health systems worldwide share overarching health policy and regulatory goals—ensuring quality care and patient safety, mitigating fraud and cyber threats. Digital health care technology solutions addressing better diagnostics and more personalized therapeutic tools are leading to the challenge of data protection. The trends in data management and security include cognitive computing, cloud-based, interoperable electronic health records, and Internet of Things IoT.

Cybersecurity and data risk management continue to be front and center, especially with patients taking a more active control of their health, and wanting access and reliability to their data. Holistic approaches to investments in people, processes, and technology will be key to regulatory compliance.


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  • A thorough assessment by health care businesses to understand how recent and upcoming policy changes will impact organizational priorities is an imperative. Health care providers also need to explore strategies to build second-line defenses to reduce their administrative, financial, and reputational exposure. Exponential technologies are driving less expensive, more efficient, and more accessible care delivery on a global scale.

    A few trends which impact care delivery are:. Organizations may meet some of the objectives of care delivery through digitization of the health care system. Organizations should consider strategic investments in people, processes, and premises enabled by digital technologies. Hospitals can provide more personalized care through better engagement with consumers and elevate patient experience by using digital solutions to aid omni-channel patient access, including customer apps, patient portals, personalized digital information kits, and self-check-in kiosks.

    Other digital channels, and tools to enhance provider-consumer interactions include:. Health care organizations should consider extending their focus beyond price and quality of care to creating a customer-centered relationship. Health care has an opportunity to learn from other industries consumer products, financial services, and hospitality, as examples how to more effectively target, serve, communicate with, and retain customers and patients.

    US and Global health care industry trends | Deloitte US

    Workforce challenges in the health care industry, such as staffing shortages in hospital specialties and nursing shortages are evident across the globe. Compounding the problem is a scarcity of next-generation skills to guide and support the transformation to becoming patient-centric, insight-driven, and value-focused organizations.

    When planning for the future of work, health care organizations will need to assess the physical proximity, automation level, and talent category. Digital technology, robotics, and other automated tools have enormous potential to resolve current and future health care workforce pain points. Health care providers should embrace strategies where talent can collaborate with technology to improve efficiency instead of competing against each other. In today's rapidly evolving marketplace environment, key business issues are converging with impacts felt across multiple industry sectors.

    What are the key trends, challenges, and opportunities that may affect your business and influence your strategy? He leads a multi-disciplinary team who serves clients through consult Terri has a personal passion a Please enable JavaScript to view the site.

    Add to my bookmarks. Still not a member? Explore content Download the report View or download the infographic Creating a positive margin Strategically moving from volume to value Responding to health policy Investing in exponential technologies Engaging with consumers Shaping the workforce of the future View the full infographic Explore more outlooks Meet the authors Related topics. US health care providers: Sensors collect data about the physical and chemical properties of the body and local environment, which are used by algorithms to produce useful information.

    Conclusions

    Wrist-worn wearables for entertainment and wellness and fitness applications are a key contributor to the rapidly growing market traction for these devices. Moreover, high demand and penetration of smart wearable devices have resulted in an increasing demand for wearable sensors. Based on the type, the wearable sensor market can be segmented into accelerometers, magnetometers, pressure sensors, motion sensors, force sensors, temperature, humidity sensors, gyroscopes, biosensors, image sensors, touch sensors, and others.

    Based on the application, the wearable sensor market can be segmented as wrist wear, eyewear, body wear, footwear, and others. Future wearables could be more hidden by adding a thin film inside your favorite jewelry to measure biometric data [and] activity levels. Questions remain regarding these advancements, including the ability of a single wearable to produce all the data an individual will have interest in monitoring. Industry experts believe that the crucial point for wearable technology will be when consumers can connect and integrate their homes to drive efficiencies with the click of a button.

    Increasingly, genomics and personalized medicine enable us to get therapy customized to our own molecular makeup. To date, only a few examples of genomic information have been used in making decisions about treatment, yet the research is robust and is moving forward quickly. Government regulation will continue to play a large role in the future of genomics.

    Different government entities have responsibility for the separate parts that comprise genomics: According to Nikhil Krishnan, a senior analyst at CB Insights, interest in genomics and personalized medicine will continue, because of the opportunities it represents, including This progress is visible across 4 major segments: The adoption of telemedicine technology increased from However, problems remain for telehealth and telemedicine adoption, because of existing state regulations regarding the patient—doctor relationship and licensing.

    This has limited the use of telemedicine, particularly in multistate scenarios that involve a patient at home or in a nonoffice situation, when a patient may be using a mobile device. Artificial intelligence could organize patients' treatment plans better, and could also provide physicians with all the information they need for effective decision-making. As the wellness trend continues, the primary site of care has shifted and medical virtual reality has also become an area with numerous opportunities.

    The Global Wellness Institute estimates that the wellness industry grew worldwide by Trends driving the wellness industry include at-home blood testing, promoting degree wellness, fitness festivals, and marijuana for well-being. Technologic advances will continue to have a large impact on the delivery of healthcare and will affect all stakeholders in some way. The depth and breadth of the current technology applications on the market will quickly be surpassed by a robust pipeline of new offerings that surpass older ones in functionality and market transformation.

    To have a positive and long-lasting effect on healthcare, successful innovations must provide a meaningful return on investment, whether clinical, economic, or both. In some cases, new metrics will be needed to determine such value calculations. In the postrecession, post-ACA marketplace, there had been little significant supply chain change until , when the money flow revelations regarding the pharmaceutical companies Turing, Valeant, and Mylan occurred. Those manufacturer-level insights led to a continuing release of information and analyses regarding the value propositions among the supply chain stakeholders.

    The middlemen that are typically within the supply chain include pharmacies, physician offices, hospitals, PBMs, distributors, and wholesalers. Although mergers and acquisitions have been happening since , the focus on value and value-based purchasing since has forced another look into the supply chain, which was accelerated by the manufacturer revelations. Beyond the high costs of specialty drugs, there is a significant need for all stakeholders, especially employers, to better understand the excess costs in the value supply chain.

    As was seen in the logistics sector, inefficient delivery of packages or changing standards drove innovation with solution offerings. The same is now occurring at a rapid pace in the healthcare sector, where previous standards do not apply and innovation to improve outcomes of care from the system is a major driver of change; this includes the lack of transparency throughout the drug supply chain and the role of third parties ie, middlemen in unnecessarily increasing costs via duplicative or needless services.

    This is especially significant, because it is affecting the ability of employers to meet their fiduciary obligation. Although the impact of middlemen in increasing healthcare costs has been known for decades, it has only in recent years been identified as a key issue. Few opportunities exist for employers to affect the cost of traditional and specialty drugs. Yet, price and rebate transparency issues continue to play a significant role in adding to the already high cost of specialty drugs, and much of this is caused by our current managed care or supply chain middlemen.

    These healthcare middlemen typically include drug wholesalers and distributors that purchase, inventory, and sell drugs to independent and chain drugstores, supermarkets, mass merchants, mail order pharmacies, hospitals, and physician offices 27 ; medical suppliers and clinics that sell specialty drugs primarily to physician-owned and -operated clinics, hospitals, and hospital-owned outpatient clinics, and may also supply some self-administered drugs to specialty pharmacies, as do wholesalers; and PBMs and pharmacies, in the form of retail, mail order, and specialty pharmacies.

    There are many stakeholders concerned that PBM consolidation and vertical integration are reducing competition in healthcare. Future solutions should address the underlying issues and focus on member outcomes, plan performance, and real-time claims adjudication. Early examples include the net cost of drugs, based on the list price at the time of dispensing and formularies.

    Dispensing and claim-processing using nondispensing drug utilization review services paid to be licensed professionals through separate administrative fees, which is typically done retrospectively, could be done in real time. Manufacturers device, diagnostic, or pharmaceutical could also be included in shared-risk arrangements for drug-related outcomes that would be measured through real-time and retrospective analyses. Recently, Amazon announced its entry into healthcare, without specifics or details as to what it plans to do.

    Other nonhealthcare information technology firms are focusing their research on health-based solutions that will challenge traditional drug manufacturers. With an uncertain legislative path and a nonpolitician president in the White House, economic concerns about who and how much would be paid for drugs cloud the future.


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    Misaligned metrics that have been selectively, clinically or economically, driven need to be balanced in a way that relates to the multiple stakeholders who are now sharing in the outcomes of risk-taking. Patients as consumers, physicians and others as providers, and manufacturers and their supply chain, need to rethink their metrics in a more meaningful way, and with an efficiency-oriented, actionable matrix for alignment toward achieving optimal patient outcomes.

    Government agencies are beginning to make a difference and create change within their areas of regulatory authority. These actions affect the public and private sectors. This results in plan sponsors and employers reporting information to the IRS so that the agency can match up appropriate coverage to the costs incurred by a specific patient or member of the plan. In the absence of coverage, the IRS can levy a fine to the taxpayer. In addition, various manufacturer assistance programs may lead to fraudulent IRS reporting resulting from such programs being conducted outside of normal benefit administration and reporting systems through the plan sponsor or by the patient as a member.

    Typically, the patient is unaware of the assistance as a reportable benefit or of the amount of assistance provided. Without federal action to change the healthcare market dynamic or to empower states, the marketplace will be further fragmented by public or private sector lines being drawn. Private sector healthcare can innovate and grow with the markets' desire to offer benefits to employees. Unlike the public sector, the Employee Retirement Income Security Act and other market factors allow for transformation that has drawn providers and insurers to focus more on the private sector.

    This includes continued withdrawing from ACA exchange plans, as well as reducing risk exposures by the states through limiting coverages or requiring cash payment for services to let patients determine their own reimbursement options. Although the market landscape remains unchanged from a legislative perspective, continuing market evolution has resulted in providers facing decreased reimbursement and consumers with limited access to health plans by metropolitan statistical area across the country.

    This has resulted in commercial health insurance through traditional carriers and self-funded employers driving market change. We identified 8 key themes that comprise many more trends that will affect the — US healthcare marketplace.

    Four critical health care trends for 2018

    In addition to these individual trends, the pace of change over time remains accelerated, along with economic factors that continue to deal with mitigating cost drivers. It remains to be seen what, if any, legislation comes out of Congress to the president's desk for signature. Nonetheless, these themes will continue to move forward and play out actively in the marketplace, effectively transforming the business of healthcare from the way it was in January Dr Vogenberg and Mr Santilli have no conflicts of interest to report. National Center for Biotechnology Information , U.

    Am Health Drug Benefits.

    Six trends for health care providers and health plans to watch

    Find articles by John Santilli. Rural Healthcare Outside of the largest cities and some suburban hospitals where many health systems have formed, many patients in the United States receive care from smaller, rural institutions that offer challenges for patients and providers. Workforce Change Employment in the United States is undergoing intense changes, and an analysis of government data from a survey by the Pew Research Center shows that employment in occupations that require more education and training are on the rise, and many workers are realizing that retraining and upgrading their skills are lifetime commitments.

    Offering consumer-directed health plans eg, health reimbursement arrangements, health savings accounts and a health maintenance organization plan. Creating an organizational culture that promotes health and wellness, including incentives or rewards related to health and wellness. Open in a separate window. Integrated Care for Population Health In a typical integrated network, the payers stipulate a framework whereby provider groups agree to care for a specific patient population with the goal of reaching or surpassing a predetermined set of quality and cost benchmarks.

    Technology Acceleration and Transformative Market Impacts Wearable sensors are small but crucial components of consumer technology that enables smart devices to track and monitor several parameters, such as movements, temperature, speed, muscle activity, and blood pressure. Improved, more precise treatments based on patients' genetic code and possible adverse events. Supply Chain Drug and Revenue Disruption In the postrecession, post-ACA marketplace, there had been little significant supply chain change until , when the money flow revelations regarding the pharmaceutical companies Turing, Valeant, and Mylan occurred.

    Conclusions Although the market landscape remains unchanged from a legislative perspective, continuing market evolution has resulted in providers facing decreased reimbursement and consumers with limited access to health plans by metropolitan statistical area across the country. Accessed August 10, Rural America in These Times. Rural America's population is shrinking for the first time ever. Accessed January 22, National Rural Hospital Association.

    Medicare cuts hurt rural America. Accessed September 7, What is health care consumerism? Diverse millennials now outnumber boomers: The state of American jobs: Accessed January 23, Key findings about the American workforce and the changing job market.

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    Accessed September 8, Work from home in National Business Group on Health. Accessed January 31, Society for Human Resource Management. The State of Employee Benefits: Insights and Opportunities Based on Behavioral Data: Midsize Employer Edition

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