The healthcare industry is on target to meet requests made by American consumers. That’s what PwC Health Research Institute uncovered in its annual report highlighting 2019’s top health industry issues. American consumers have been asking for “more convenient, digitally enabled and affordable care” since 2013. Specific requests include:

  • 78 percent of consumers want to pick and choose care from a menu of options offered by multiple providers.
  • 78 percent of hospital patients say they could have had virtual instead of in-person care for recent out-of-hospital visits.
  • 54 percent would prefer at-home hospital care if it cost less.
  • 54 percent of consumers would likely use an FDA-approved app or online tool for medical treatment.
  • 47 percent would welcome health services from tech giants such as Google or Microsoft.
Healthcare is now operating the way other industries conduct business: it’s offering retail-like options that mirror how consumers interact in other areas of their lives.

The change is so evident, PwC says the New Health Economy has finally arrived. New and innovative business partnerships reflect healthcare’s transformation. These partnerships pour in money by the millions to help make healthcare more affordable and more digitally accessible. Consider the numbers:

$6.9 billion — The amount of venture capital funding for digital health startups in 2018.

84 percent — The number of Fortune 50 companies involved in healthcare including tech and telecommunications companies, financial firms and traditional healthcare organizations.

487 — The number of healthcare deals closed in the first three quarters of 2018 by private equity firms, more than double the number of deals just 10 years ago.

What’s more, health-dominated partnerships made headlines in 2018. PwC predicts they will also play a role in healthcare’s transformation this year. They include:

  • CVS and Aetna
  • Amazon, Berkshire Hathaway and JPMorgan Chase & Co.
  • United Health Group and DaVita Medical Group
  • Smaller partnerships that will impact local markets

New value lines to offer low prices for high-quality care
Traditionally, the health industry has shied away from offering service lines with low transparent costs, virtual interactions and staff members who target the consumer. But that’s changing in 2019. New, profitable models are emerging in which, for example, providers offer services to patients primarily on Medicaid. PwC makes these additional recommendations to healthcare providers:

Offer value to consumers in need
Develop value lines for patients with high-deductible health plans, those on Medicaid and the uninsured. Serve a diverse population and target the elderly, individuals with chronic conditions and mental health patients.

Partner with employers of low-wage workers
Make care easy and affordable to all employees and manage their ongoing care to bypass emergency room visits. For instance, Redirect Health based in Scottsdale, Ariz., works with companies around the country, offering unlimited primary care visits paid for by the employer. Pharmaceutical companies also need to step up and offer value lines that go above and beyond generic drugs and prescription discount cards.

Lawmakers to continue reshaping ACA
Republicans and the Trump administration have made changes to the Affordable Care Act (ACA) over the past two years. Their actions will lead to positive and negative outcomes in 2019.

Those on the winning end include: healthy individuals, small businesses seeking cheaper premiums, payers selling short-term insurance plans, new companies specializing in the underinsured and uninsured, financial services firms, makers of nonretail medical devises and employers who offer high-cost insurance plans.

Those who may feel negative impacts include: middle-class consumers seeking comprehensive coverage from ACA exchanges, and providers and payers who are dependent on Medicaid patients in conservative states.

The report states “Of all the actions that the Trump administration and Republican lawmakers took to affect the ACA, the one that will most strongly affect the health industry in 2019 is the reduction of the ACA individual mandate penalty to $0 on Jan. 1, a change included in the Tax Cuts and Jobs Act of 2017.”

PwC predicts Democrats will have more influence over health policy, thanks to political changes in the nation’s capital. Still, fundamental issues will remain such as how to curb rising costs, deliver improved consumer experiences and implement new technologies.

Stay tuned to the BioIQ blog for updates on these key healthcare issues throughout the year.

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