Bedless hospitals. Mega hospital and insurer mergers. A growing consumer appetite for virtual health interactions.
Those are among PwC's predictions for top healthcare industry trends for the new year in a report released today.
"2016 will be a year of firsts for players within healthcare as the industry adapts to the main forces driving the new health economy: The rise of consumerism, the focus on value, downward pressure on costs, technological innovation and the impact of new entrants," PwC said in an announcement.
The upcoming year will also be marked by how well the healthcare industry handles greater demand with rising costs and trends like industry consolidation, according to Kelly Barnes, PwC's US health industries leader. "It will be businesses that prioritize addressing consumer needs and increasing value that should succeed," Barnes said.
The report identifies the following 10 forces that will have the most impact in 2016:
Merger mania: PwC said the industry will see more high-profile mergers and acquisitions in 2016 as regulators debate how consolidation impacts consumers. Consolidation creates larger health systems and insurers, so branding is critical. The report notes that well-known healthcare systems may have a market advantage; Americans are willing to drive further for care from a well-known system. However, consumers are not willing to pay more for care from top-ranked hospitals.
Escalating drug prices: The industry will search for a fair drug pricing formula in the upcoming year, according to the report. Prices have reached a "boiling point," and the way to reach some sort of agreement will require collaboration among insurers, patients and new value-assessment groups.
Biosimilar drugs: One way to combat skyrocketing prices will be biosimilar drugs, according to the report. These drugs are near substitutes for original brand drugs and could bring significant price discounts.
Cybersecurity concerns: Even "best in field" hospitals will struggle to attract patients if they are hacked, PwC said, citing research from its Health Research Institute's 2015 consumer survey. Consumers are especially concerned about the vulnerability of connected medical devices to security breaches and cyberattacks. And recent hacks of organizations, including insurance companies like Anthem, show that organizations that are unprepared to deal with breaches can face lawsuits, lost revenue and harm to their reputations, the report states.
Technology gives more power to consumers: Adoption of health-related smartphone apps has doubled in the last two years, from 16 percent of consumers in 2013 to 32 percent this year, according to the report. Both technology and shifts in financial incentives mean "care will begin to move into the palms of consumers' hands," PwC said.
Behavioral healthcare moves to the forefront: After years of being on the backburner, the industry will start to recognize that mental health is important to the well-being of employees and consumers, according to the report. Indeed, PwC notes that one out of five American adults experiences a mental illness every year. These conditions cost businesses more than $440 billion each year. Healthcare organizations and employers will look at behavioral care as "key to keeping costs down, productivity up and consumers healthy," the report said.
Care moves to community settings: Value-based payment models will prompt healthcare systems to "pursue lower-cost settings more aggressively than before while employing creative approaches to distributing care." This may mean eliminating inpatient care and creating more bedless hospitals and virtual care centers where clinicians oversee patients from a variety of locations. Such changes in care delivery will be "fueled by alternative payment models, technological advances and powerful new database tools," according to the report.
Consumers become "money managers." Higher deductibles and co-insurance mean consumers will need help managing health spending. And this will require the industry to create new tools and services, such as payment plans and pricing information, to help consumers pay for services.
High-tech databases: New database tools and the resulting deep data analysis of information on health consumers will provide valuable insights necessary to improve patient care and consumer health, according to the report.
Cost of care: Healthcare systems seeking value-based care will "dig in to calculate the true cost of services," in the process finding ways to improve efficiency as well as care.