Agenda 2018: PwC Health Research Institute’s top health industry issues of 2018

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According to the consultants at PwC, the top health industry issues of 2018 will be …

 

Issue No. 1: The healthcare industry tackles the opioid crisis

Opioid overdoses are now the leading cause of death for U.S. adults younger than 50. This is a phenomenon too big to solve by only one player – there is a role for everyone across the healthcare landscape, from prescribers, to payers, to the pharmaceutical industry, in order to reverse this trend.

Issue No. 2: Social determinants come to the forefront

The United States spends more on healthcare per capita per year than any other nation, but lags in outcomes. To improve health while saving money, the industry needs to expand the borders of healthcare. This means thinking beyond the four walls of the hospital and looking holistically at the full profile of a patient, beyond their specific health issue.

Issue No. 3: Price transparency moves to the statehouse

With no clear legislative path for federal action on health reform, states are starting to take matters into their own hands. Over 30 states are now considering legislation that would directly control drug prices and shine a light on cost changes. It is important to watch what happens at the state level, as past state healthcare reform efforts have been brought to the national stage.

Issue No. 4: Natural disasters create devastation that lasts long after the event passes

Natural disasters such as hurricanes and wildfires can wreak havoc on health systems, manufacturing supply chains, and financial operations both in the short and long-term. Health systems and pharmaceutical companies who conduct proactive scenario planning can increase the pace of recovery and avoid making premature decisions that could do harm in the long-term.

Issue No. 5: Medicare Advantage swells in 2018

Medicare Advantage is projected to cover nearly 21 million people in 2018, a 5 percent increase over 2017, providing a new competitive opportunity for health insurers. However, many eligible consumers don’t know these plans exist, so insurers must work to raise awareness of options, and tailor those options to best meet patient needs.

Issue No. 6: Health reform isn’t over, it’s just more complicated

While the chance to repeal and replace the Affordable Care Act (ACA) through a single piece of legislation may be dead, the Republican party will likely continue to pursue health reform in 2018 through a more fragmented approach. 2018 will likely bring continued efforts to reduce and cap federal Medicaid spending, expand access to lower-premium health insurance, loosen ACA consumer protections, soften the employer and individual mandates and repeal ACA taxes and fees.

Issue No. 7: Securing the internet of things

Following a year marked by major, industry wide cybersecurity breaches and a 525 percent increase in medical device cybersecurity vulnerabilities reported by the government, hospitals must take quick, decisive action to maintain data privacy, secure the thousands of connected medical devices on their networks and protect patients. Companies should treat cybersecurity incidents as a “non-natural” disaster, and invest more in planning, defensive measures and personnel.

Issue No. 8: Patient experience as a priority and not just a patient portal

Today’s consumer is used to sophisticated shopping experiences, in which retailers harness consumer information to tailor how they interact with customers. As the healthcare industry turns toward paying more for value instead of volume, health companies will need to take this same approach and make strategic investments to improve patient experience.

Issue No. 9: Meet your new coworker, artificial intelligence

Utilizing artificial intelligence (AI) could help put the human touch back into health by reducing bureaucracy and administrative duties that can take time away from personalized care. Companies are bringing in AI to make administrative tasks a lot quicker, such as screening drug candidates, streamlining finance processes, adverse event reporting and more.

Issue No. 10: Healthcare’s endangered middlemen

Under increased scrutiny, intermediaries such as PBMs and wholesalers must prove value and success in creating efficiencies or risk losing their place in the supply chain. To prove their worth and prevent having their businesses disrupted by new entrants such as Amazon, intermediaries must evolve to be more than just a pass-through serving a contracting function, by increasing price transparency and taking responsibility for more of the value chain.

Issue No. 11: Real-world evidence a growing challenge for pharma

Changes at the FDA will prompt pharmaceutical and life sciences companies to adjust their approach to collecting and using real-world data gathered outside of randomized controlled trials, something that could potentially save the system millions of dollars. As the 21st Century Cures Act takes effect, the FDA will be required to consider additional uses of real-world evidence for drugs and medical devices, including incorporating this data to support new indications.

Issue No. 12: Tax reform moves forward

Changes such as a corporate tax rate reduction and a shift to a territorial system will require new strategies from health organizations, and may demand rethinking of business models and supply chains.

 

Source: “Top health industry issues of 2018,” PwC Health Research Institute