Think Globally, Act Locally

Accelerated healthcare spending is a global challenge, so are there consistent worldwide themes that may lead to solutions? If all healthcare is local, then might it defy a global solution? Enter PricewaterhouseCoopers’ report, “Health-Cast 2020: Creating a Sustainable Future.”

PwC surveyed more than 500 senior executives of hospitals and hospital systems, physician groups, payers, governments, medical supply companies, and employers in 27 countries, including the United States. It also conducted in-depth interviews of more than 120 healthcare thought leaders, including policymakers, employee benefit managers, and top executives of healthcare organizations in 16 countries. From this emerged interesting commonalities and potential global solutions.

The interviews yielded six specific findings. First, essential health spending is expected to increase at a much higher rate than in the past; experts believe it will reach nearly 21 percent of the U.S. gross domestic product and, on average, 16 percent of GDP in other Organisation for Economic Co-operation and Development (OECD) countries. Not surprisingly, governments, hospitals, and physicians are seen as having the greatest opportunity to eliminate wasteful healthcare spending.

Second, there was widespread support for a health system with shared financial risks and responsibilities. To me, this is one of the major take-home lessons from this report, as cost sharing seems to be a universally important concept.

Third, health systems face challenges related to cost, quality, and consumer trust, and 80 percent of survey respondents cited transparency in quality and pricing as a key contributor to global healthcare sustainability. This demonstrates the need for public accountability and a global recognition that “sunshine is the best disinfectant.”

Fourth, preventive care and disease management programs have untapped potential to enhance health status and reduce costs, but require industrywide integration for realization of benefits. In the United States, this is axiomatic; without coordination of care, we will never be able to fix our broken system.

The fifth finding notes: “In support of more empowered consumers, interest in pay-for-performance and increased cost sharing is soaring.” Notably, in the survey, 70 percent responded that pay-for-performance is critical, and 85 percent of those questioned said it’s here to stay.

Sixth, information technology is an important enabler for resolving the healthcare cost crisis. Yet information technology is not a solution in and of itself — broader implementation, standardization, and globalization of health-care information is needed for progress to be made.

FINDING COMMON GROUND

Can we create a sustainable worldwide health system with common characteristics? PwC researchers identified seven key features of sustainable health systems, whether they are led by governments, networks, or health-related organizations: (1) a strategic balance between public and private interests, (2) a worldwide digital backbone with better use of technology and interoperable electronic networks, (3) incentive realignment — systems that will manage access to care while promoting public accountability, (4) clearly defined quality and safety clinical standards, (5) strategic resource deployment —allocation that satisfies competing demands, (6) innovation that continuously improves treatment, efficiency, and outcomes, and (7) flexible care settings and expanded clinical roles for improved patient access.

These attributes might sound familiar to our readers. The digital backbone, incentive realignment, public accountability, and, most notably, the central role of the patient are themes we have emphasized. I would like to challenge our biotechnology industry to create the sustainable healthcare system of the future and actively support the themes outlined in “HealthCast 2020.”

What is your organization doing to create this sustainable system? What leadership in your organization builds upon the lessons in “HealthCast 2020?” I am interested in your feedback so we can continue the dialogue initiated by this compelling report. As always, you can e-mail me at « david.nash@jefferson.edu», and please visit my blog at «http://nashhealthpolicy.blogspot.com».