While the US healthcare industry has historically been a business-to-business system of silos wherein patients paid a more passive role, that won’t fly in today’s consumer-directed economy, says a new study by Pricewaterhouse Cooper’s Health Research Institute.
Instead, the study authors say, healthcare is increasingly emerging as a “modular ecosystem that operates similarly to retail, technology and hospitality.” This system, which puts the consumers in the driver’s seat in choosing care according to their wants and budget, is comprised of five multi-sector markets of care delivery; diagnostics and therapeutics; financing and payment, platforms and support; and wellness and health management. Right now, the $5 trillion US health industry is dominated by care delivery, but that is expected to shift as wellness, patient platforms and consumer support grow.
“This ecosystem is more dynamic, responsive to consumers and fertile for innovation,” the authors write.
PwC identified five forces reshaping the industry, with the bulk of them – the rise of the consumer, decentralization and technological advances – already evident at transforming other industries. The last two, which include a drive by federal government to pay for value versus volume, and a surging interest in wellness and health management, are specific to healthcare.
Care delivery, the authors say, will experience a reduction in growth as traditional providers find themselves enduring “deaths by 1,000 cuts,” thanks to innovations and trends such as telehealth and patient messaging services that siphon services away from them. The focus on value-based care will require providers to find more advanced ways to integrate data with EHRs and use patient data, the study said, as well as seek web-based tools to coordinate care and monitor patients.
American consumers are finding themselves in the middle of all this; dealing with higher deductibles and navigating through increasingly narrow provider networks, shopping for care online and looking at reviews while also educating themselves through apps and web-based resources. This has led to the surge in wellness and health management platforms, the study authors said.
“Many micro trends around wellness are converging, including the hiring of dieticians and nutritionists by grocery store chains and retailers, the popularity of wearable fitness trackers, a detectable shift in the American diet and a flurry of wellness-oriented incentives provided by employers, insurers and others,” the study authors write.
The study posited that a decentralization of care will also encourage consumers to obtain care anytime, anywhere, thanks to the ever-increasing availability of virtual care and remote patient monitoring. This will, in turn, increase the use of “clinician extenders,” such as messaging services and care coordination platforms, and seamless sharing of data among stakeholders via connected medical devices like Medtronic’s continuous glucose monitor and connected app.
Quoting Andrew Thompson, president and CEO of Proteus Digital Health, which makes ingestible biosensors and a connected platform, the study says the advances will be intertwined with others. But it's not enough to have good technology.
"Digital enables the ability to shift the model from volume to value," Thompson said. "It will take a decade to make this shift the industry norm. [But] you need to have a product that fits beautifully into the patient's life flow."