2018医疗行业热点话题（英文版）_54页-3mb

2018 Health Industry Summary

Core Content

The PwC Health Research Institute's 12th annual report outlines the key challenges and opportunities facing the healthcare industry in 2018. The year is characterized by resilience in the face of uncertainty, with a focus on cross-sector collaboration, strategic investments, and creating efficiencies to improve patient outcomes and organizational stability.

Main Issues and Key Points

1. Opioid Crisis

• Context: Opioids are the leading cause of death for US adults under 50, with over 64,000 overdose deaths in 2016.
• Trends:
  • Healthcare organizations are collaborating to prevent misuse and improve treatment for chronic pain.
  • Initiatives like Aetna's five-year plan and CVS Caremark's opioid prescription restrictions are being implemented.
• Technology Use: AI is being used to monitor and reduce inappropriate opioid prescriptions.
• Implications:
  • Greater attention to social determinants of health is needed to prevent addiction.
  • Partnerships with community organizations can help identify and manage at-risk patients.
  • Use of data sharing and community-based interventions can lead to cost savings and better health outcomes.

2. Social Determinants of Health

• Context: Social factors such as education, income, and housing significantly impact health outcomes.
• Trends:
  • Healthcare organizations are expanding their care teams to include social workers, nutritionists, and community health workers.
  • Programs like ProMedica's food insecurity screenings and Humana's community partnerships have shown positive results.
• Implications:
  • Federal and state governments are increasing focus on value-based reimbursement models.
  • Organizations that neglect community engagement may face reputational and financial risks.
  • Data sharing is critical to understanding and addressing social needs.

3. Price Transparency Movements

• Context: States are taking more control over healthcare pricing and transparency.
• Trends:
  • Over 20 states have passed or are considering pricing transparency legislation.
  • Laws require manufacturers and providers to report drug costs and price changes.
  • PBMs are being held accountable for managing copayments.
• Implications:
  • Pricing decisions must consider consumer perception and value.
  • Legal and regulatory uncertainty is increasing, requiring strategic planning.
  • Non-legislative forces, such as public ballot measures and legal challenges, are influencing future regulations.

4. Natural Disasters

• Context: Natural disasters have long-term impacts on healthcare systems and pharmaceutical supply chains.
• Trends:
  • Disasters lead to health system closures, financial disruptions, and population displacement.
  • Resilient organizations are investing in physical and virtual backup systems.
• Implications:
  • Scenario planning and communication strategies are essential.
  • Financial stability and reputation management are critical in the aftermath of a disaster.
  • Organizations should evaluate insurance policies and prepare for potential credit downgrades.

5. Medicare Advantage Expansion

• Context: As more Baby Boomers become eligible, Medicare Advantage (MA) plans are expanding.
• Trends:
  • MA plans are competing for a growing population of tech-savvy seniors.
  • Quality ratings and customer experience are key to success.
  • MA plans are investing in digital health services and community engagement.
• Implications:
  • Customer experience is becoming increasingly important.
  • Partnerships with digital health companies and community organizations are enhancing service delivery.
  • MA plans are showing cost savings and better health outcomes through innovative models.

Strategic Focus Areas

To overcome uncertainty and risks in 2018, healthcare organizations should focus on three key areas:

1. Cross-sector collaboration to address the opioid crisis and social determinants of health.
2. Strategic investments in technology, data sharing, and community partnerships.
3. Creating efficiencies through AI, real-world evidence, and improved supply chain management.

Conclusion

2018 is a pivotal year for the healthcare industry, marked by the need for resilience amid rising costs, regulatory uncertainty, and social challenges. By focusing on collaboration, innovation, and strategic planning, healthcare organizations can better serve their patients and adapt to the evolving landscape.