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You get what you pay for
As the pressure to control health spending increases, payers, governments, and providers are compelled to scrutinize the quality and amount of care they'll be able to deliver in the future. Health leaders around the world see the health payment system as one of the best tools in managing this challenge and achieving sustainability. However, with less than 40% of those same leaders ranking their existing payment system as good, every country has room to improve and can benefit from shared best practices. See
You get what you pay for.
Behind the numbers: Medical cost trends for 2009
From one year to the next, healthcare costs for employers and their workers always go up. Yet, for the past five years there's been some positive news. The growth rate has been dropping. However, that trend will level off in 2009, according to employers and health plans. The new Health Research Institute (HRI) report, "Behind the numbers: Medical cost trends for 2009", addresses the cyclical nature of the healthcare industry and provides insights into the conflicting factors that are contributing to both cost increases and savings. See
"Behind the numbers: Medical cost trends for 2009".
The Price of Excess: Identifying Waste in Healthcare Spending
More than half of the $2.2 trillion spent annually on healthcare in the U.S. could be considered wasteful, according to an analysis published by PricewaterhouseCoopers’ Health Research Institute. Defensive medicine, such as redundant, inappropriate or unnecessary tests and procedures, was identified as the biggest area of excess, followed by inefficient healthcare administration and the cost of care necessitated by conditions such as obesity, which can be considered preventable by lifestyle changes.
Straight Talk: Looking at Health System Disaster Preparedness
When — not if — a large-scale disaster hits, Americans expect a carefully orchestrated and sequenced response from hospitals, emergency workers and public health officials. In their greatest time of need, the system may fail them unless disaster preparedness becomes a greater priority. In this StraightTalk roundtable, health industry leaders discuss the steps health executives should take to ensure an effective response to a disaster.
Working towards wellness: The business rationale
Written in collaboration with the World Economic Forum PricewaterhouseCoopers outlines how chronic diseases risk the economic sustainability of an interdependent global economy. Through examples, we demonstrate how effective workplace wellness efforts can lead to solid returns on organizational investments and can be used to attract, retain and motivate employees.
Top eight health industry issues in 2008
Health organizations face a pivotal year in 2008 as they anticipate the wildcard outcome of the presidential election. Meanwhile, they must prepare for impending changes — pharmaceutical and life sciences companies are adapting to a new safety agenda from the FDA including the agency's expanded authority over post-market drug safety.
Beyond the Sound Bite: November 2007 Review of Presidential Candidates' Proposals for Health Reform
Healthcare is one of the top domestic concerns in the upcoming presidential election. The current health care system is not built to last, and the 2008 presidential election is poised to see a significant push for major health reform. The direction it goes depends largely on the next President.
Closing the seams: Developing an integrated approach to health system disaster preparedness
A disaster occurs every week in the US, and the numbers are increasing. Yet despite increased federal and state funding since 2001 and lessons learned following 9/11 and natural disasters like large-scale hurricanes and floods, disaster planning in the healthcare arena remains sporadic, disconnected and under-funded. PricewaterhouseCoopers Health Research Institute's (HRI's) "Closing the Seams" analyzes preparedness throughout every key element of our healthcare system, identifies gaps, and highlights emerging solutions and innovative best practices that can be leveraged to make the most of our resources and help those in the emergency response and healthcare communities deliver the best healthcare possible in the face of unknown disasters.
Creating a climate of innovation: the health industry's most challenging paradox
Innovation is one paradox of healthcare - tremendous strides forward within a system that overall doesn't work well. Can innovation transform healthcare? The annoyingly complex answer is that it does and it doesn't. Effective incremental, sector and local innovations are everywhere, but the breakthroughs that would make the entire health system workable remain elusive
What works: Healing the healthcare staffing shortage
The federal government predicts that by 2020, nurse and physician retirements will contribute to a shortage of approximately 24,000 doctors and nearly 1 million nurses. Health industry leaders are faced with the challenge of orchestrating care in an increasingly complex and converging healthcare labor market. Seeking solutions means understanding that while the challenges confronting nurse and physician shortages are very different, their roles and futures are starting to converge.
Behind the numbers* Healthcare cost trends for 2008
The nation's employers can expect a return to single-digit increases in health benefit expenses in the year ahead. Unlike health plan premium forecasts, medical cost trends reflect the underlying numbers for actual medical costs by plan design. They are used by private insurers and employers to compare health plan costs year over year, ultimately to set premium levels and design the benefit packages that will be offered to employees in the fall.
Pharmacy Benefit Management Savings In Medicare and the Commercial Marketplace
The Pharmaceutical Care Management Association (PCMA) retained PwC to estimate the value of pharmacy benefit management as well as the potential impact of enactment of proposed legislation that would restrict pharmacy benefit management (PBM) activities for consumers, private employers, health plans, unions, and state and federal governments> download report.
Tailoring the approach: Employer attitudes and healthcare strategies address distinct issues
Employers are still debating how to stave off future healthcare cost increases and incent employees to take on more responsibility for their health. In describing emerging employer attitudes and healthcare strategies, a tailoring of approaches can be observed, in which distinct issues, such as chronically ill employees, are being addressed through specific tools, incentives and disease management programs. The newest results released by the Health Research Institute of PricewaterhouseCoopers and Management Barometer demonstrate the evolution of employer attitudes on benefit design, consumers and quality.
A Sustainable Framework for Achieving Transparency in the Health Industries
Transparency is having a transformative effect on the health industry. The following report: Seeing is Believing* A Sustainable Framework for Achieving Transparency in the Health Industries, looks at transparency from three separate viewpoints: the health industry, government and non-health sectors, such as transportation and financial services. Understanding the power of transparency from these different viewpoints will be important as organizations traverse the future.
The quality conundrum: Practical approaches for enhancing patient care
More than a year in development, "The Quality Conundrum" is a compilation of essays by PwC subject matter experts, discussions with selected clients and insights from our interviews with health industry leaders in the United States and around the world. It explores the barriers that have made healthcare quality improvements difficult to achieve, and outlines a clear path to progress. It includes a discussion of quality from the patient's perspective, in the journey across the health care system.
New Federal Leadership on Healthcare Transparency: What Will It Mean for Patients, Payers and Providers
On August 22, 2006, President Bush signed an executive order mandating that four federal agencies that administer or sponsor several of the largest federal healthcare programs compile information about the quality and price of the healthcare services they pay for and communicate that information to their consumers and each other. The executive order builds on previous administration efforts to expand the transparency of pricing in support of consumer-directed healthcare, an innovative approach to controlling healthcare costs by empowering patients as the consumers of healthcare. This PricewaterhouseCoopers report reviews the president’s executive order and its implications for patients, payers and providers.
Healthy choices: The changing role of the health insurer
Health insurance is pivotal to healthcare financing. In most parts of the world, governments are looking to enlarge, or at least to encourage, the contribution of private sources of healthcare funding.
Rethinking postretirement benefits
The FASB’s proposal, its impact on companies and capital markets, and the changing pact with the American worker
The Trends and Benefits of Providing Healthcare Quality Data
In this latest HealthBrief, PwC discusses the results of a recent survey of top executives at large U.S.-based multinational companies. The focus of the HealthBrief is on healthcare quality data that firms provide to their employees as a way to influence the utilization of healthcare through better education of their employees on cost and quality issues and improvement of their own health behaviors.
Assessing Quality-Based Benefit Design
Quality-based benefit packages take traditional benefit design one step further by emphasizing coordination of health care, support services, and the importance of providing useful information to consumers. But are they effective? And do they really improve the quality of care and boost the value of benefit dollars? This report was prepared by PricewaterhouseCoopers for the Pacific Business Group on Health and the California HealthCare Foundation.
HealthCast 2020: Creating a Sustainable Future
In this groundbreaking report, HealthCast 2020, PricewaterhouseCoopers looks at solutions and responses from around the world to the globalization and industrywide convergence of healthcare. What insights, best practices and policy lessons can be learned from experiences in various countries to create a globally sustainable health system? Who, or what, is driving the solutions?
Employers Embrace Consumerism to Control Healthcare Costs: New PwC White Paper
With double digit health insurance cost increases affecting the business bottom line, employers are turning to consumerism and consumer directed healthcare to provide a solution. HRI's latest research gets behind this trend to find out how employers are coping with rising healthcare costs and the promise that consumerism may bring.
President Bush's Second Term: Prescribing Private Solutions for the Nation's Healthcare Problems
PwC's Health Research Institute (HRI) developed a comprehensive 360 degree view of President Bush's health plan, the challenges and opportunities for industry, and an analysis on the likelihood of implementation.
2004 Cost-Of-Living Adjustments Announced
PwC's Tax professionals discuss the recently released 2004 cost-of-living adjustments affecting Social Security tax, employee benefits, and individual income tax.
Identifying Savings from Pharmacy Management
A new study from PricewaterhouseCoopers finds that pharmacy management techniques are expected to save $1.3 trillion in drug cost over the coming decade.
HealthCast Tactics: A Blueprint for the Future
This report suggests tactics for the healthcare industry to employ over the next three to five years. According to HealthCast Tactics, there are significant gaps between what healthcare executives, policy makers and employers rate as important and what is being implemented performance-based reimbursement, privacy, and clinical excellence. The report draws on a survey of more than 650 top executives of hospital systems, payors, governments, medical supply vendors, physician groups and employers.
An Employer's Guide to Consumer-Directed Health Benefits
This comprehensive report explores the legal, regulatory, financial and actuarial issues that employers must consider when empowering their employees to make more decisions about their healthcare and healthcare benefits. The report comes from the Wye River Group, an informal policy consortium that includes PricewaterhouseCoopers.Download an Employer's Guide to Consumer-Directed Health Benefits (3020K).
HealthCast 2010: Smaller World, Bigger Expectations
Our survey group included a mix of policy makers, health system executives, employers, physicians, insurers and medical supply vendors. In addition, PwC practice leaders interviewed more than 50 thought leaders from seven countries at length about future trends and their implications for the industry's stakeholders.
Managing the Privacy of Employee Health Information
The privacy of employee information has joined the privacy of consumer data as a focus of privacy programs for companies both in the US and abroad. In the US, that issue is being driven for health information primarily by HIPAA's privacy rules.
