Top health industry issues of 2013
The pace of change in healthcare is expected to accelerate in 2013, with factors such as consumerism, the increased effects of technology and budgetary pressures all converging on an industry that consumes nearly one of every five dollars of the country's economy according to PwC's Health Research Institute.
1. States on front lines of health reform
The spotlight of ACA implementation will move to the states in 2013, as they decide whether to expand Medicaid, as well as who will run the state health insurance exchanges and how to regulate their insurance markets.
2. Caring for dual eligibles
With Medicaid expansion expected to add more than 16 million people to the program in the coming years, the number of "duals" – those eligible for both Medicare and Medicaid – are also expected to rise. States are increasingly turning to managed care companies to help manage this population.
3. Employers rethinking their role in healthcare
It used to be that employers and healthcare were inseparable. But last year's Supreme Court ruling and the reelection of Barack Obama will see many employers rethinking their role in providing health benefits, now that the ACA implementation is assured.
4. The consumer healthcare revolution
Consumers are increasingly taking a direct role in how healthcare dollars are spent. This, along with the advent of state health insurance exchanges, will see insurers adopt consumer-centric practices from the retail industry.
5. Customer ratings affect healthcare companies' bottom lines
Consumer reviews of healthcare companies will have direct revenue stream consequences for healthcare companies. Insurers could face bonus payouts of as much as $3 billion, while providers could see payment hold-backs of as much as $845 million.
6. Goodbye cost reduction, hello transformation
Providers have been focused on reducing costs via labor productivity initiatives and supply chain cost savings, but are now moving into the next phase of full-scale transformation of their care delivery models.
7. Laying the foundation of population health management
Medicare's ACO program and patient-centered medical homes have provided the foundation for improving population health, but expect other collaborations to build on this and fuel the growth of population health management.
8. BYOD: weighing the cost of convenience
Hospitals will continue to walk the tightrope of balancing the convenience of letting their nurses and doctors use their own mobile devices at work, while also needing to find a way to keep patient data secure. But hospitals have some catching up to do, as only 46 percent currently have a strategy to regulate the use of mobile devices.
9. The new pharma value landscape
Pharmaceuticals and medical devices face a long, arduous and expensive path to market, but the final hurdle is no longer regulatory approval -- it's getting reimbursement.
10. Medtech braces for excise tax
The 2.3 percent excise tax on medical devices that went into effect Jan. 1 could prompt a wave of company consolidations in the $380 billion global industry. Most likely targets: small device companies with fewer than 50 employees.