Top health industry issues of 2013

States on the frontlines of ACA implementation
In 2013 the spotlight shifts to the states. Over the next year, state officials will decide whether to expand Medicaid coverage, who will operate their insurance exchange and what type of market regulation is needed. Delay is not an option—the federal government will step in where necessary. The race to 2014 is on.

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Caring for the nation’s most vulnerable: dual eligibles
With the Affordable Care Act (ACA) set to add 16 million people to the Medicaid rolls by 2019, the number of "duals" is certain to increase. Cash-strapped states are increasingly turning to the expertise of managed care companies to tackle skyrocketing dual eligible costs.

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Bigger than benefits: employers rethink their role in healthcare
Healthcare and employers: inseparable? Maybe not. With the Supreme Court ruling to uphold the ACA and the president’s re-election, employers have never had a better opportunity to re-examine their long-term role in providing healthcare coverage. The year 2013 will likely be the turning point for how healthcare benefits evolve over the next decade.

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Consumer revolution in health coverage
Consumers’ rising voice in how they spend their healthcare dollars, coupled with state insurance exchanges, is prompting the industry to compete differently. Healthcare consumers can expect to see a shift in the marketplace as insurers borrow three key practices from the retail industry.

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Customer ratings hit the pocketbooks of healthcare companies
Paying for performance takes on new meaning as consumer reviews generate penalties and bonuses for hospitals and insurers. This could mean a bonus payout of more than $3 billion for insurers and a hold-back of $850 million for providers in 2013. Healthcare companies will need to invest in consumer research and education in order to take full advantage of the new payments.

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Goodbye cost reduction, hello transformation
With the impending fiscal cliff and reimbursement resetting under the ACA, providers are scrambling to reduce costs. Labor productivity and supply cost reductions were the first phase; now, organizations are embarking on full-scale transformations of their care delivery models.

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The building blocks of population health management
Medicare’s accountable care organization (ACO) and patient-centered medical home initiatives have laid a foundation for improving population health, but other collaborations are fueling growth in population health management.

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Bring your own device: convenience at a cost
Hospitals must balance the desires of nurses and doctors to bring their own mobile devices to work with creating an environment secure enough to protect sensitive patient data. Many are behind. Only 46% have a security strategy regulating the use of mobile devices.

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Meeting the new expectations of pharma value
Pharmaceuticals and medical devices play a pivotal role in health outcomes. But the path from lab to bedside is often long, arduous, and expensive. And now the final hurdle is not regulatory approval; it’s reimbursement.

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Medtech industry braces for excise tax impact
Effective January 1, 2013, the 2.3% excise tax on medical devices could prompt consolidation in a $380 billion global industry consisting mainly of small start-up companies with lean product portfolios and fewer than 50 employees.

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It is almost a cliché to observe that healthcare in America is changing rapidly. Yet the pace of the transformation is certain to quicken in 2013 with the effects of technology, consumerism, budgetary pressures and the Affordable Care Act (ACA) converging on a sector that represents nearly one-fifth of the economy. An industry that had grown accustomed to uncertainty now has a clearer picture of its future and how to better serve consumers, who are demanding the speed, convenience, transparency and results they get in other service industries.

For this year’s Top Health Industry Issues, HRI polled 1,000 consumers about a range of healthcare topics.

Obstacles to improving the US healthcare system

Contacts

Kelly Barnes: Partner
Health Industries Leader; Tel: +1 (214) 754 5172
Michael Galper: Partner
Healthcare Payer Leader; Tel: +1 (213) 217 3301
Robert Valletta: Partner
Healthcare Provider Leader; Tel: +1 (617) 530 4053

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Top health industry issues of 2013

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