PWC Hri Top Healthcare Issues 2017 Chartpack

Money
Top healthmatters:
industry issues of 2017:
A yearand
Billing of payment
uncertainty andHealth
for a New opportunity
Economy
Chart pack
The seeds of many of 2017s issues were sown in 2007
Top health industry issues of 2007 Top health industry issues of 2017
Obesity is the new smoking, with employer incentives Diet-related health issues, including obesity, are addressed by
considered to push employees to lose weight. health organizations and employers focusing on nutrition.
Industry embarks on digitalization with slow electronic Nearly 90% of hospitals have basic EHRs. The question now is
health record (EHR) uptake. Less than 9% of hospitals how to use emerging technologies such as blockchain, drones
have a basic EHR system. and artificial intelligence.
Volume to value is in early days, as CMS begins its Volume to value is in full swing. CMS and private plans are
push to tie payments to quality and drive the industry nudging providers to take on more downside risk.
toward greater transparency.
Consumer-directed health plans start to grow. Just three Millions of Americans are in high-deductible health plans,
million Americans have consumer-directed plans. leading providers to modernize their payments systems
to handle the surge in consumer credit card charges.
Retail clinics are in their infancy. In 2006, 90 are in operation More than 3,000 retail clinics are in operation. One in three consumers
and about one in 10 consumers have been to one. have visited one. This drift to new venues is part of the trend
prompting medical schools to rethink how they train young doctors.
Drug prices draw scrutiny as 42 blockbuster products lose Drug prices again are facing public and political attention.
their patents in 2007, representing $82 billion in sales. Industry moves to regulate itself in response to pressure.
Source: Top health industry issues of 2007, Top health industry issues of 2017, Surviving seismic change: Winning a piece of
the $5 trillion US health ecosystem, Healthcare's new entrants: Who will be the industry's Amazon.com?
2016 PwC. All rights reserved. PwC refers to the US member firm or one of its subsidiaries or affiliates, and may sometimes refer to the PwC network.
Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details.
Under any healthcare reform, consumers care most
about their premiums
Consumers pointed to the cost of their monthly premium, coverage of services and
medications, and provider network as their most important considerations when choosing
a plan from a health insurance company.
100%
90%
80%
Percentage of consumers who said
69%
66%
70%
factor was important
56%
60%
49%
50%
40%
30% 23%
15% 14%
20%
7%
10%
0%
iu y
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on
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y
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in
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on
or
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ov
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ct
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In
Source: PwC Health Research Institute Consumer Survey, 2016

Many consumers with chronic health conditions are
willing to share data with drug companies
Percentage of consumers who said Percentage of consumers who said they

they would share data with drug would share data with drug companies
companies about how well their about their daily symptoms and their
treatments are working best and worst days
100%
90%
80% 79% 78%
70% 66% 66% 62%
60% 58%
50%
40%
30%
20%
10%
0%
as h
as h
er y
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se it
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ni er
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ro um
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Many organizations may be more prepared for
downside risk than they realize
An HRI analysis of 2015 CMS data shows that many Medicare Shared Savings Program
(MSSP) accountable care organizations (ACOs) would have earned bigger bonuses had
they taken on downside risk.
Actual performance in 2015 2015 performance had all MSSPs

shifted to two-sided risk models
ACOs receiving shared ACOs receiving shared

savings bonus: 119 savings bonus: 143
Average shared Average shared

savings bonus: $5.4M savings bonus: $5.65M
Program cost Program prot

for CMS: $216M for CMS: $58M
Source: PwC Health Research Institute analysis of CMS MSSP ACO performance year 2015 results
Phishing, email compromise and ransomware top list
of healthcare security issues
Percentages of payers and providers reporting each type of security incident
31%
Phishing
22%
Business email
compromise
16%
Ransomware
Source: PwC The Global State of Information Security Survey 2017

Eight technologies with great potential to disrupt the US
health industry over the next decade
1 Artificial intelligence (AI) 2 Augmented reality (AR) 3 Blockchain 4 Drones

Software algorithms able to perform tasks Virtual additions to the physical world to Distributed electronic ledger that can record Pilot-free vehicles and devices
normally requiring human intelligence change the user experience and confirm transactions securely
Digitized supply chain, delivery
Digitized supply chain, efficient Fitness and wellness gaming Consumer identity management, of healthcare goods to
billing, accelerated R&D apps, guided tours of grocery Medicare and Medicaid fraud consumers, emergency and
aisles, surgical guidance prevention, personal health data disaster response
protection
5 Internet of Things (IoT) 6 Robots 7 Virtual reality (VR) 8 3D printing

A connected network of objects that Machines or virtual agents that automate, Interactive simulation of a 3-D image Additive manufacturing techniques
collect and exchange data augment or assist human activities or complete environment used to create three-dimensional
objects based on digital models by
Inventory control, care Digital supply chain, remote Patient distraction, stress relief, layering or printing successive layers
coordination, remote patient patient patient monitoring and medical school education tools, of materials
monitoring, digital supply chain, care, digital behavioral health consumer and clinician training,
digitized operations services scenario planning Customized implants,
prosthetics and transplants,
distributed supply chain,
on-demand inventory
Sample use cases
Source: PwC Tech breakthroughs megatrend: How to prepare for its impact, PwC Health Research Institute analysis
Public and private sectors are working to boost the
antibiotics pipeline
Antibiotics in development Most common indications among

by clinical phase antibiotics in clinical development
11 8
Phase 1 Acute bacterial skin and
skin structure infections
13 6
Phase 2 Complicated urinary
tract infections
6
13 Bacterial infections
Phase 3
Source: HRI analysis of Pew Charitable Trusts data, May 2016

Consumers want more nutritional advice, especially
from their healthcare resources
Consumers were asked whether they would take advantage of free advice for weight
management or help with diet-related medical conditions from a nutritionist or dietitian
from each of these entities. Percentage of respondents answering yes:
Doctor Pharmacy Gym
79% 59% 41%
Employer Grocery Store Big Box Store
38% 28% 17%

Average out-of-pocket spending on drugs is shrinking for
privately insured consumers
Average out-of-pocket prescription drug costs

among privately insured individuals, 2005-2014
$1,600
$1,400
$1,200
$1,000
$800
$600
$400
$200
$0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Mean out-of-pocket
Mean total spending
spending on
on prescriptions
prescription drugs
Source: PwC Health Research Institute analysis of the US Department of Health and Human Services Medical Expenditure Panel Survey data
Most consumers dont have strong feelings about
healthcare mergers
Consumers were asked whether consumers benet, lose, or neither benet nor lose when one
healthcare organization mergers with another. They also were given the option of answering
that they were unsure. Percentage of respondents for each option:
56%
50%
40%
30% 27%
20% 17%
10%
0%
Consumers Consumers lose Consumers
neither benefit with mergers benefit from
nor lose, or mergers
respondent was
unsure of impact
Source: PwC Health Research Institute Consumer Insights Survey, fall 2016
Clinicians: Primary care docs will spend more time
analyzing data, triaging
HRI asked clinicians whether they believe primary care physicians will spend more or
less time on the following activities
Percentage of clinicians who believe that in 10 years primary care physicians will spend...
More time on the Less time on the

following activities following activity
100%
90% 85%
80%
70% 67% 65%

60% 55%
50%
40%
30%
20%
10%
0%
Using data from Triaging Managing Conducting

apps and patients medically- in-person care
wearabies complex
patients
Source: PwC Health Research Institute Workforce Survey, 2015

For more information, please visit:
www.pwc.com
www.pwc.com/us/healthindustries
www.pwc.com/hri
twitter.com/PwCHealth
Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details. 257672-2017

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Money

Source: PwC Health Research Institute Consumer Survey, 2016

Percentage of consumers who said Percentage of consumers who said they

Source: PwC Health Research Institute Consumer Survey, 2016

Actual performance in 2015 2015 performance had all MSSPs

ACOs receiving shared ACOs receiving shared

Average shared Average shared

Program cost Program prot

Source: PwC The Global State of Information Security Survey 2017

1 Artificial intelligence (AI) 2 Augmented reality (AR) 3 Blockchain 4 Drones

5 Internet of Things (IoT) 6 Robots 7 Virtual reality (VR) 8 3D printing

Sample use cases

Antibiotics in development Most common indications among

Source: HRI analysis of Pew Charitable Trusts data, May 2016

Doctor Pharmacy Gym

79% 59% 41%

Employer Grocery Store Big Box Store

38% 28% 17%

Source: PwC Health Research Institute Consumer Survey, 2016

Average out-of-pocket prescription drug costs

More time on the Less time on the

70% 67% 65%

Using data from Triaging Managing Conducting

Source: PwC Health Research Institute Workforce Survey, 2015

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