Employees shouldering more of the cost and individual consumers are powerful and growing forces in the health ecosystem. To succeed, healthcare organizations should fashion strategies around new demands for value: greater transparency, better management, and competitive costs.
According to PwC’s 2014 Touchstone survey, 26% of employers have a high-deductible health plan as their highest enrolled medical plan in 2014 – the highest percentage ever. Another way to control costs might be participation in private exchanges. Watch carefully the arrival of expensive new specialty drugs and consider how to tailor your pharmacy benefits to control drug spending. At the same time, provide education and greater transparency to ensure a healthy workforce.
Newly consolidated health systems looking to standardize and streamline should be mindful of the consumer: offer price transparency and avoid cutting human touch points that comfort the patient. Be prepared to invest in the latest technology to share patient data across the organization; embrace innovative care strategies.
After a challenging year in 2014 with so much change in the market, insurers must remain on guard. Be prepared to manage more high-cost therapies and to get acquainted with millions of new members who arrived due to a new mandate in the ACA. Experiment with ways to steer patients to lower-cost providers through education and partnerships.
Specialty therapies that deliver high impact to specific populations at high costs have given way to purchaser angst. Now the industry has to prove the ultimate value of the new products to public and private purchasers. Understand the impact on consumers, who may forgo the treatment if required to pay the price. Consider risk-based relationships with providers and partnerships with disease associations.