5 forces reshaping US healthcare

The $5 trillion U.S. health industry is in the midst of transformative change generated by what PwC describes as a collision of forces.

A new report, published Thursday by PwC's Health Research Institute, outlines the five forces driving this transformative change.

"Individually, not one is enough to move the entire $5 trillion health ecosystem. But acting together, over a decade, they can have significant impact," PwC said.

Below are PwC's five forces reshaping healthcare.

1. Rise of consumerism. This in the long-term likely will help grow the market for platforms and support as well as wellness by driving consumers to options that are cheaper, more efficient and convenient, while also helping them get and stay healthier longer, PwC said. "Companies building systems that can handle and analyze these consumer data, and protect them, while offering consumers ways to shop for care and make better health decisions, likely will find fertile markets," the report states.

2. Shift from volume to value. This trend, driven by the federal campaign to link 90 percent of Medicare payments to quality programs, and half to alternative payment models by 2018, will likely have the most immediate impact. "This trend, which likely will send shock waves throughout the ecosystem, essentially flips the health industry's economic model on its head. Today's revenue could become tomorrow's expense for healthcare providers, especially for-profit organizations with business models that rely on high utilization," PwC said. "Organizations are finding burdens related to these quality measures are multiplying."

3. March of technological advances and digitalization. PwC describes technological advances and digitalization as "a looming tidal wave, visible on the horizon as little more than a swell." The firm projects the cumulative effect of major technological advances, such as machine learning and artificial intelligence, 3D printing and the use of digital health data, likely will grow the diagnostics and therapeutics, platforms and support, and wellness markets in the long term.

4. Decentralization of care. This will help encourage consumers to obtain care anytime, anywhere, thanks to the spread of virtual care and remote patient monitoring, the embrace of alternate venues for care, the increased use of clinician extenders and the seamless sharing of data among stakeholders, PwC said. The shift remains slow-moving, though evidence of it already can be found throughout the health industry.

5. Surge in interest in wellness. A renewed focuson wellness and health management could ultimately siphon revenues out of the health industry by reducing utilization of treatments and services intended for sicker individuals, PwC said. The firm cites various micro trends around wellness that are converging, including the hiring of dietitians and nutritionists by grocery store chains and retailers, the popularity of wearable fitness trackers, a detectable shift in the American diet and a flurry of wellness-oriented incentives provided by employers, insurers and others.


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