10 Top Health Industry Issues for 2016

10 Top Health Industry Issues for 2016

In 2016, the healthcare industry will undergo major changes in efforts to adapt to meet challenges posed by the "New Health Economy," which includes the rise of consumerism, the focus on value, downward pressure on costs, technological innovation and the impact of new entrants. Those are among the predictions offered in a report on the top health industry issues, by the Health Research Institute of PwC, with research based on a survey of 1,000 customers and interviews with dozens of health industry leaders. (Photo: Fotolia)

Merger Mania Expected to Continue

2016 will see continuation of consolidation trends that have emerged in recent years. The report says that federal approval of large industry mergers announced in 2015 “could spur a chain reaction of further consolidation.” While the most noteworthy examples from 2015 include consolidation among insurers, and within pharmaceutical and life sciences, that trend also is evident among providers focusing “on growth that enhances their bottom lines and brands.”

IT Implications: For providers, further consolidation means more work lies ahead in bringing together IT systems as interoperability and information exchange will continue to be important. (Photo: Fotolia)

Controlling Drug Costs

High prices for pharmaceuticals have received increased attention from the public, and pressure is rising for pharma companies to better justify the prices and efficacy of their products. There is a lack of accepted data on outcomes performance for drugs, and more industry cooperation is necessary.

IT Implications: Collaborative data collection and analysis efforts within the healthcare industry “will lay the groundwork for new, mutually agreed upon pricing and value models, based on robust and credible information,” the report suggests. (Photo: Fotolia)

Care in the Palm of Your Hand

Smartphones, connected medical accessories and apps have been underutilized until now, but in 2016, care will begin to shift into the palms of consumers’ hands, helping to drive down costs, increase access and fulfill the public’s desire for “anywhere, anytime” monitoring, diagnosis and treatment.

IT Implications: It’s not just digital technology, says Tsouderos. “What we’re talking about here is the move away from providing care in the hospital, moving care out into the community and into patients’ hands. It’s decentralization of care, and the only way you can do that is with a strong IT system that is reliable, secure and private.” (Photo: Fotolia)

Cybersecurity Concerns Come to Medical Technology

As security breaches become more common and costly, medical device cybersecurity will emerge as a major issue in 2016. It will force device companies and healthcare providers to take pre-emptive action to maintain trust in medical equipment and to prevent breaches that could cripple the industry.

IT Implications: Providers’ medical devices that are connected to networks offer a back door for cyber attacks, Tsouderos says. “There could be a backlash if there is an incident that causes harm to a patient.” (Photo: Fotolia)

Consumers Emerge as New Money Managers

With high-deductible health plans now common, out-of-pocket expenditures are growing for consumers, while uncompensated care costs are rising. In 2016, consumers will begin to manage their own health spending “in ways that will ripple across the industry,” the report says. They’ll use new services for healthcare planning, and they’ll be looking for ways to increasingly shop for care.

IT Implications: Providers are struggling to deal with point-of-service collection while managing cost, and they are embracing consumer-centric tools and services. Banks and other entrants are looking to play in this area of healthcare, requiring closer integration with providers’ financial systems, Tsouderos says. (Photo: Fotolia)

Behavioral Healthcare is No Longer on the Back Burner

As awareness grows of mental health issues, industry stakeholders will increasingly recognize the impact that these conditions have on consumers’ quality of life, productivity and associated healthcare expenditures. Demand for these services is expected to grow in 2016.

IT Implications: There is more demand for services, and providers are having trouble meeting it, Tsouderos says. “We expect there to be an increase in the use of telehealth services to reach out to patients and meet this demand,” she says. “Beyond face-to-face video consults, there also could be the development of artificial intelligence tools to aid in diagnosis and treatment in coming years.” (Photo: Fotolia)

Care Moves to the Community

Reducing healthcare costs will continue to incentivize the industry to treat patients in the most cost-effective setting. Health systems in 2016 will pursue lower-cost care settings more aggressively and creatively than before. As a result, hospitals will continue to develop creative community extension strategies, and will partner with lower cost care settings, such as retail clinics or urgent care centers.

IT Implications: Care coordination and information exchange are essential components of any move that takes patients outside the four walls of the hospital for treatment. EHRs will need stronger integration capabilities to gather patient information. (Photo: Fotolia)

New Databases Improve Patient Care, Consumer Health

High hopes surrounding big data investments in healthcare have been dampened by the challenge of converting large and diverse datasets into practical insights. In 2016, the health industry will begin to use these data in new ways, thanks to high-tech so-called “non-relational” databases that will better be able to handle and analyze unstructured data. Only 17 percent of healthcare providers have been able to integrate population health analytics into their EHR systems.

IT Implications: New databases also will be able to incorporate data from all kinds of sources and pull insights out of them, Tsouderos says. (Photo: Fotolia)

Biosimilars Gain Traction to Reduce Drug Expenditures

Similar to generic drugs, biosimilars are near substitutes for an original brand drug once the original loses patent protection. Biosimilars are derived from living organisms; they are expected to bring significant price discounts compared with branded versions of biologics.

IT Implications: Biosimilars will give providers another lower cost option for treating patients. Physicians and insurers hope biosimilars will bring choice and competition to offset rising drug costs. IT systems will need to incorporate these drugs as options for clinicians to choose when prescribing. (Photo: Fotolia)

Solving the Medical Cost Mystery

Healthcare providers are facing increased demands to offer better value for what’s spent for care. That’s hard to do when you don’t really know what your costs are. In 2016, providers will expand efforts to better understand and calculate costs. This understanding is crucial in finding better calculations for bundled payments, and even more important in defining the value of healthcare services.

IT Implications: Transparency in pricing has been vexing for healthcare providers, and accurate pricing will be increasingly important for consumers, who are paying more out of pocket for care. Tsouderos says systems need to get a grasp on their components of cost if they are to wring costs out of their operations. (Photo: Fotolia)

Want more?

The PwC report on the top health industry issues of 2015 is available here.