PWC on Next Year’s Top Health Issues

By December 22, 2017 Commentary

Well, it is the time of year for people to start talking about the next annum and what it might bring for health care.  Here is PWC’s version.   (PWC Report)   The top three areas health care organizations should be focused on, according to the firm’s Health Research Institute, are cross-sector collaboration, strategic investments and creating efficiency. Wasn’t that helpful?  In terms of specific issues, the first is tackling the opioid crisis, mostly by trying to limit access to prescription opioids.  Sorry, but not sure that is where the problem is.  How about we secure the border a little better and figure out why so many people think their lives suck badly enough that they need to depart this world via pharmaceuticals.  Issue number two, more focus on social determinants of health.  This is definitely an appropriate focus for better health, but tends to lose sight of the most important factor–individual responsibility, regardless of circumstances.  No one is going overcome environmental limitations if they don’t understand their own responsibility.  Issue number 3, more action at the state level on price transparency.  Maybe, but states are even more subject to the big bucks from lobbyists than the feds are, so don’t expect much that actually makes a difference.  And when it comes to drugs, ham-handed ideas like those in California aren’t going to solve the problem.  It needs a national solution.  Issue number 4, dealing with the health impacts and aftermath of national disasters.  Yep.  Issue number 5, the continued growth of Medicare Advantage.  This has been and looks like it will continue to be a critical source of growth for insurers, so they do need to be able to market effectively and manage care better.  And providers will increasingly be expected to, and may want to, bear part of the risk, so they need sound IT, actuarial and care management resources.  One unstated issue in the report, but a very important one, is preparing for CMS to begin screwing down on payments, as they always due to meet budgetary pressures.

Issue 6, what is going to happen with health reform?  Looks like the individual mandate is a goner and the exchanges are not generally delivering affordable health care coverage.  No one can predict what is going to happen with stabilization payments (i.e. bribes to health plans to offer exchange coverage).  As the report points out, health organizations just need to anticipate any of a number of possible changes and have reactions planned.  Number 7, cybersecurity, especially for medical devices and equipment.  Can’t argue with that one, don’t want the North Koreans messing with your pacemaker algorithm or your hospital bedside monitor.  Number 8, emphasis on patient experience.  Yeah, yeah, yeah, been hearing that for years.  The problem is that what patients often want has little to do with actual outcomes that create better health, or do you make patients happy or do you do what has been shown to improve health.  Issue 9, more use of artificial intelligence.  Just hope it’s better than the human one, which hasn’t done so well with fixing health care issues.  Oh wait, it is built by humans, never mind.  And last, probably least, lets worry about the fate of health care middlemen, like PBMs and wholesalers.  Hey, dude, things change, get over it.  If you can’t provide real value, why should anyone want you to get a piece of the health care dollar?  Well, that’s enough snippiness for one day.

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