The next phase of U.S. healthcare reform will reflect a concerted effort to keep people well, out of the hospital and more actively engaged in managing their own health, according to findings from a report issued this month from PricewaterhouseCoopers (PwC).
In response to the global recession and pressure to reduce rising healthcare costs associated with chronic diseases, U.S. and global government and health leaders see the potential for individuals to take greater ownership of their health and the need for fundamental structural changes in the health system to help them do so, according to the New York City-based firm.
Over the next five years, PwC expects the trend will lead to health industry business model changes, more regulatory reforms focused on efficiency and effectiveness, greater investments in prevention and a growing role for IT to enable information-sharing and provide interactive, customized care in a virtual world.
For the year-long study, nearly 600 government and health leaders in 20 countries, including 50 U.S. health leaders were surveyed by PwC's Health Research Institute. Findings included:
- Consensus that individuals have the greatest influence on their own health status, but that physicians have the greatest external influence on changing patient behavior.
- Ninety-seven percent agreed that patients should have some responsibility for managing their chronic conditions such as obesity, asthma, diabetes and heart disease. Of those, 76 percent of U.S. health leaders and 57 percent of global leaders think patients should have a "great deal" of responsibility in this.
- Eighty-two percent of U.S. health leaders and nearly three-quarters of global health leaders (74 percent) believe that unhealthy behavior will become increasingly unacceptable in their country.
- Lack of willpower was cited as the biggest barrier keeping individuals from managing their own health.
Ninety percent of U.S. health leaders and 84 percent of global health leaders surveyed by the company believed that the merging of IT and healthcare is a factor for change. PwC said 58 percent of U.S. health leaders and 45 percent of global health leaders said they expect personalized medicine to be an important and growing development that will change healthcare delivery.
Health education, greater awareness and increased patient responsibility were cited the most as effective strategies to engage individuals in their own health, the report found. A fourth means was better communication, but the ordering of these strategies shows that health leaders recognize there's a lot of education and relationship building needed to support individuals, the company stated.
PwC outlined in the report five areas where healthcare systems can customize care and engage individuals in managing their health:
- Coordinated care teams: Integrated care networks that share information, care and accountability for patient outcomes are likely to become models for the future.
- Fluent navigators: In a patient-centered health system, there will be a growing need for consumer advocates beyond friends and family. This role of healthcare-fluent navigators will be played by pharmacists, community workers and possibly the emergence of a new professional field.
- Patient-experience benchmarks: In a patient-centered health system, more attention will be paid to understanding and meeting consumer expectations. Many health systems already are tracking and publicly reporting on patient-centric metrics of care, such as cleanliness, wait times and physician satisfaction, allowing patients to make more informed decisions.
- Care-anywhere networks: The definition of access is being redefined by telehealth, wireless mobile devices, remote monitoring and new care delivery models that move care from hospitals, nursing homes and physicians' offices and into patients' homes, which increasingly are wired with networked devices.
- Medical proving grounds: Through collaboration and investment, some regions and other countries are positioning themselves to be medical proving grounds, or centers of excellence in medical innovation and care as a way to attract patients, researchers and providers looking for the shortest path to access and innovation.