PWC on 2014’s Health System Trends

Who knows what will happen to the future of health care?  PriceWaterhouseCooper thinks it at least has an idea of what the key issues for 2014 will be, and they look a lot like the issues of 2013.   (PWC Report)  The report lists ten areas to watch, which include health organizations blurring the payer/provider line; an increase in corporate venture capital; growth of private exchanges; the effect of social media and other HIT; use of technology to deal with health workforce shortfalls; new approaches to clinical trials; fail fast for testing innovations; Medicaid’s financial problems and counterfeit drug problems.  What!! Nothing about the continuing implosion of the reform law, which clearly will dominate everything in 2014.  In any event, the report does offer some insight into these issues and the implications they may have for health care companies.  Looking at a couple of the specific areas, private exchanges clearly are gaining rapid momentum and are functioning well.  They will inevitably facilitate a defined-contribution approach by employers, which allows control of year-over-year health benefit spending by companies.  Notwithstanding the buzz on price transparency, consumers have little better real information about what a service will cost them and the concept is having no significant impact on prices or spending.  Mobile apps, social media, etc. have their greatest appeal to relatively young, healthy consumers and so cannot and will not have any major effect on health care spending.  The use of technology to maximize health resource capacity utilization is important and regulatory barriers are a primary barrier to expansion of telemedicine, retail clinics and service provision by various classes of health professionals.  Removal of those regulatory barriers could facilitate a reduction of costs and spending.  The health reform laws expansion of Medicaid eligibility is eventually going to devastate the federal and state budgets if it is not scaled back.  Almost all the people signing up under the reform law are getting Medicaid and subsidizes and a large percent are likely not truly eligible but there are no fraud checks.  Health plans participating in managed Medicaid need to be careful to not get caught in the crossfire and backlash.  We will have our own set of major trends for 2014 in an upcoming post.