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PwC Health: Tech, Regulatory Measures Will Play Major Role in 2014

January 10, 2014
by Gabriel Perna
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The changing nature of healthcare reimbursement and the empowered healthcare consumer movement are integral parts of the Health Research Institute at PriceWaterhouseCoopers (PwC)’s recently unveiled annual top health industry trends report.

Many of these trends have an informatics tint to them. The PwC HRI team recently conducted a webinar to explain the trends in-depth and outlined why certain movements and innovations will take precedent in 2014.  In the webinar, the thought-leaders at PwC HRI surmised that providers and payers are realizing they need to step up innovation, thanks to penalties for readmissions, hospital-acquired infections, and the like. Overall, the shift to a value-based reimbursement system has an overhead effect on many, if not all, of its trends.

Trend eight, “Fail fast, frequently, and frugally for true innovation,” touches upon this. Counter to traditional operational models such as Six Sigma, healthcare organizations need to embrace failure in order to properly innovate, says Chris Wasden, managing global healthcare innovation leader at PwC Health Research Institute (HRI).

“They need to look at innovation not in the sense of how do I eliminate failure, but rather how do I fail at the lowest cost per failure, iterate, and then improve,” Wasden said. Only 27 percent of organizations he says formally manage innovation, which is critical for achieving breakthroughs in embracing new business models. He pointed to Oakland-based integrated healthcare provider, Kaiser Permanente as an example of a company that has managed to embrace failure in a good way.

In trend six, “Technology is the new workforce multiplier,” PwC HRI looked at how payers and providers are using technology, specifically analytics, to meet with the demands of an aging population. Wasden explained how 19-hospital Bon Secours Health System, based in Marriottsville, Md., is using predictive analytics to curb its readmissions rate. He also talked about Virtuwell, from Boston-based Partners Healthcare, which uses algorithms to diagnose and customize treatment plans for 40-plus route conditions online.

Trend one, “Companies rethink their roles in the new health economy,” is about population health management, and how payers and providers are increasingly joining forces to manage costs and improve outcomes.

Beyond regulatory demands and the move to value-based care, the other main theme in PwC HRI’s list was the empowered consumer movement. Trend five, “Social, mobile, analytics and cloud come together,” is about this sweeping change in healthcare, and the role technology plays in that development. As Wasden explained on the webinar, consumers in technology are now expecting better service from their providers and payers through these technologies.

“They want to make appointments online, like they how they can book hotels or airlines. These experiences need to be in healthcare,” Wasden said. Aetna, the Hartford-based payer, and Partners are two companies, Wasden says, that are ahead of the game in this area. Aetna is linking its mobile app, iTriage to its member management system, allowing members to find a doctor in their network. Partners’ Center for Connected Health has integrated home health monitoring systems with its electronic health record (EHR).

Mobile health (mHealth) apps will play a big role in this consumerism, something even physicians are beginning to admit. While only 27 percent of physicians encourage patients to use a mHealth app, 59 percent of physicians and payers believe widespread adoption of mHealth apps is unavoidable in the near future.

Trend four, “picking up the pace of price transparency,” is about the employer-led effort to bring healthcare consumers better choices when choosing their care. Cece Connolly, managing director of PwC's HRI, said meaningful healthcare price data has helped this transparency movement blossom, with venture capital investors putting approximately $400 million into it over the last three years. She cited when the federal Centers for Medicare & Medicaid Services publicly released hospital charge information from hospitals across the U.S.

While most healthcare consumers don’t know what they pay for prescription drugs, doctor visits, etc., Connolly said this will change in 2014. “Employers are more aggressive in this new space, and with the new health exchanges, that will begin to open up pricing information,” she said.

The other five trends can be found here.

You can follow Gabriel Perna on Twitter at @HCI_GPerna.