PWC’s Take on Health Reform Effects

With the advent of health “reform” in the United States, many seers will be sharing their views of the future health care world.  Price Waterhouse Coopers put out a report called “HealthCast” which follows up on one released in 1999 that looked ten years out.   This time PWC looks out to 2020, subtitling the report  ” The customization of diagnosis, care and cure.”   (PWC Report) This customization is said to be driven by chronic disease, the digitization of health care and a broadened appreciation of the factors influencing health.

PWC identifies six “vectors” that will create the framework for health care in 2020:  incentive-based payment; broad-based regulatory reforms; funding redistributed from sickness to wellness; patient communication and engagement; electronic medical records and other health IT; and the need to reconfigure the health care workforce to more primary care physicians and nurses.  Five “touchpoints” will shape individuals’ relationships with “health delivery models”:  coordinated care teams; fluent navigators; patient experience benchmarks; medical proving grounds (basically a next generation of medical tourism oriented toward innovative care rather than low cost)  and care-anywhere networks.

PWC’s recommendations for health “stakeholders” are:  develop incentives that encourage partnership; work on regulatory reforms that encourage innovation; plan for the funding redistribution; provide individuals with better information; explore workforce models with more flexibility and prepare for a more complex IT framework.  The report unfortunately is a little too much of what it sounds like here; a fair amount of non-specific, buzzwordy talk.  It does offer a useful perspective and should stimulate some thinking, but doesn’t comment on some obvious tensions in the trends.  Incenting care by guidelines will not be fully consistent with individualization of care.  Given demographic and other trends, it is very, very unlikely that any cost will shift from chronic disease care, in fact those costs as a percent of total spending will undoubtedly continue to go up.  If we have as much unnecessary care as it appears in the system, why do we need more medical personnel?