"Before rolling out any technology training program, healthcare organizations should develop incentives and performance metrics for employees who align with the digitally fit culture they seek to develop," PwC said. The resources below provide information about CDC offices and programs that focus on policy-related matters and on various laws, regulations, and policies that have public health implications. First, healthcare organizations should recognize that the market is ripe for divestitures. "Private equity's acquisitions and investments in the health sector have become increasingly diversified and frequent; they include such things as new entrants in technology and convenient care delivery, contract research organizations, and ophthalmology and dermatology practices," PwC noted. ", Tax reform has only just begun for healthcare companies. First, life sciences organizations should focus on outcomes, not just end-points. As a result, everyone—patients, businesses, taxpayers, hospitals, doctors, pharmacists—pays more. "Before tax reform enactment, healthcare companies in the S&P 500 held an estimated $186 billion in cash overseas at the end of 2016, according to a Credit Suisse analysis, and they may now begin repatriating those funds at favorable rates.". "The arrival of digital therapeutics – an emerging health discipline that uses technology to augment or even replace active drugs in disease treatment – is reshaping the landscape for new medicines, product reimbursement and regulatory oversight," PwC said. Prescription drug policy issues have remained front and center, with a strong -- though not complete -- focus on the question of prescription drug pricing. "They also should revisit their recruitment and retention strategies to compete for a gig workforce that is attracted to a virtual work environment.". "Many companies lack in-house training capabilities – either expertise in training or the learning management system required to train a national workforce – and will have to partner with external organizations to deliver advanced training.". All Rights Reserved. Latest from “Health Policy” in The Wall Street Journal. "Healthy individuals and small businesses seeking cheaper premiums will benefit in 2019, as will payers selling short-term, limited duration insurance and supporting association health plans," PwC said. Private equity's purchases of healthcare divestitures are expected to continue in 2019 as the sector looks to invest the cash it has raised, a reported $624 billion ready for investment across industries as of July 2018, the report stated. We can expect to see an intensification of the push for universal health coverage (UHC), culminating with a first-ever high-level United Nations meeting, and a shift away from disease-specific interventions towards more integrated approaches. Mental Health America takes a unique approach to policy. Many other connected devices designed to treat diabetes, central nervous system disorders and other conditions – in concert with an active drug, or not – are expected to enter the market in 2019, the report said. AI and process automation are expected to eliminate 1.8 million jobs while creating 2.3 million new ones reliant on a more skilled workforce, PwC reported. Also, nearly 30 million Americans remain uninsured, and Medicaid covers more than 60 million people, the report added. Please Second, healthcare organizations should consider partnerships to deliver lower-cost, high-quality care. "In all states, payers will be able to sell more products in the individual and group markets, but regulations of those products will differ. "But it likely is fueling the efforts already in place.". In 2019, new entrants and biopharmaceutical and medical device companies will bring to market new digital therapies and connected health services that can help patients make behavioral changes, give providers real-time therapeutic insights and give insurers and employers new tools to more effectively manage beneficiaries health. "We need to be paying attention to innovation in technology. "The Trump administration had previously delayed the provision. "Organizations must come to terms with a simple fact: The old way of doing business may no longer be the most effective or efficient way under the new code," PwC stated. This gives companies time to fully understand and analyze their business, partners and supply chains.". Many payers and providers don't have foreign operations, so they won't benefit from the repatriation provision, or they may not have positive taxable income to realize these benefits, the report said. Some employees, such as a hospital system's IT team, will soon need strong abilities in a given subject area, such as developing a technology, the report said. And third, insurance regulations are falling to states, creating a patchwork. Unlike traditional Medicare, Medicare Advantage allows adults 65+ to get vision, dental, hearing, and wellness care without worrying about additional costs. See where voters are polling on the most popular Healthcare issues of 2020. Organizations can spend their tax savings in different ways, including reinvestment, acquisitions and stock buybacks, the report said. "And the base erosion and anti-abuse tax (BEAT) provisions impose an additional corporate tax liability on domestic and foreign companies operating in the United States that make certain deductible payments to foreign-related parties.". President Donald Trump's main healthcare policy initiative has been working to fulfill his campaign promise to repeal and replace the Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare. Seventy-three percent of Americans surveyed by Health Research Institute said they want the government to do more to control the cost of prescription drugs. Health care is always on the minds of the public, usually ranking among the top 3 concerns. This first wave of automation in healthcare has affected finance functions the most. Scottsdale, Ariz.-based Redirect Health is working with employers nationwide to make it easy and affordable to provide healthcare to even low-wage employees, the report noted. For instance, Innovation Health, an insurance provider created jointly by Virginia-based Inova Health System and Aetna, is testing digital therapeutics and financial models to better understand these new products' effectiveness. "Evaluate workflow processes for new data streams, including integration in electronic medical health records.". A private equity sector bursting with cash and searching for deals means more of that money has flowed into the healthcare system over the past decade, the report noted. ], Twitter: @SiwickiHealthIT "To succeed in the digital therapeutics era, pharmaceutical and life sciences companies must venture more deeply into care delivery," PwC said. Diet and alcohol. In 2019, healthcare companies new and old will identify which employees – from the back office to the front lines and all the way up to the C-suite – have to be upskilled or reskilled to get the most out of new and impending investments in technologies such as artificial intelligence and robotic process automation, the report predicted. Private equity firms bring capital and experience from other industries that can contribute to the healthcare industry's efforts to rein in costs and achieve better outcomes, the report said. "On the losing end of these policies and decisions are middle-class consumers seeking comprehensive coverage on the ACA exchanges, and providers and payers dependent on patients covered by Medicaid or ACA plans living in conservative-leaning states that are more skeptical of the law," PwC said. Recognizing the connection between health and lifestyle, MA health plans go beyond traditional medical care to help their members live active and healthy lives. For-profit companies generally are benefiting from tax reform because of lower tax rates on earnings, reduced from 35 percent to 21 percent beginning in 2018, and the ability to repatriate foreign cash at a favorable rate, 15.5 percent for cash holdings as of Dec. 31, 2017, and zero U.S. federal income tax for new foreign earnings starting in 2018," PwC explained. "For both tax reform and trade-related issues, many organizations now are in a holding pattern, awaiting guidance and action by government regulators before responding," PwC said. Some healthcare organizations – in particular academic medical centers – already are aligned with educational institutions and may be able to advance more quickly, PwC added. Financial services companies, makers of non-retail medical devices and employers offering high-cost insurance plans all will enjoy modest gains, too, the report added. And third, organizations should go beyond the prescription coupon. What remains constant is that Medicaid provides financial security and quality health care to 74 million hardworking Americans who depend on it. Medicare Advantage invests in new, innovative programs and works hard to improve how care is delivered, lower the costs of care, and lead to healthy outcomes for patients. saved. In 2019, these actions will create new winners and losers. The Healthcare Policy Outlook for 2019 ... One thing remains—health care and health insurance are still top of mind for lawmakers, regulators and their constituents. So for PwC Health Research Institute's latest report, rather than focusing on issues only U.S. health organizations face, it for the first time is examining how healthcare is adapting to factors common to all industries: deals, business and tax strategy, risk and regulatory issues, workforce trends and digital transformation. Learn on-demand, earn credit, find products and solutions. "In response to these pressures, some companies are starting to build new, lower-cost delivery models to capture this market, bucking the trend by reducing fixed costs, rethinking which clinicians deliver care and addressing the social determinants of health," PwC said. First, healthcare organizations should recognize their consumer segments that need value. The law will create both new possibilities for organizations looking to turn their tax savings into competitive advantages and novel challenges for organizations facing new taxes, the report said. Speaking before at a House Rules Committee hearing on the Medicare for All Act of 2019, Commonwealth Fund Vice President Sara R. Collins assessed how recent Congressional health reform bills might address the rates of uninsured and underinsured, and the overall rate of growth in U.S. health … They also were more likely to say they would stick with an employer if the training was offered.". There is nothing more important than allowing everyone, and those they care about, the chance to live the life they want with meaningful … While upskilling an employee may take time, companies that invest in making employees digitally fit should be ready for the technological challenges of tomorrow and beyond, the report advised. Two years into the Trump administration, the Affordable Care Act remains law, but Republican lawmakers and the administration have reshaped parts of it through legislative, regulatory, budgetary and legal actions, the report noted. Notwithstanding the general concerns about … [UPDATE: For a look back at this story from year's end, click here for a follow-up article from December 16, 2019. CiteScore values are based on citation counts in a range of four years (e.g. As digital therapeutics and connected devices have transitioned from concept to reality, investors have poured $12.5 billion into digital health ventures in 2017 and 2018, PwC reported. Adults were more than 4x more likely, and children were 2x-3x times more likely, to receive certain preventive care services than people with no health insurance. Practical. Healthcare organizations should consider selling noncore business units to private equity firms that have money to invest and may be more apt than a corporate buyer to purchase a single business unit, the report advised. Operational agility will permit companies to act quickly when necessary, but that will require planning and creativity, the report said. "These investments could create two types of competitive advantages: A better skilled workforce, and a workforce that is less likely to leave," PwC predicted. "Fifty-one percent of employees whom Health Research Institute surveyed said they felt that training in AI, robotic process automation and analytics would help them do their jobs better. States that don't ban new products outright could still place greater restrictions on their use than federal regulations allow for.". These skills should be developed in tandem with strategic goals to ensure a company is ready to act on its strategy. "These companies offer premier customer experiences at low, transparent costs, balancing in-person and virtual interactions with employees who are laser-focused on the consumer," PwC said. Current Public Policy Papers. PwC says that despite the U.S. healthcare industry's high costs and mammoth size, it is lacking a "value line" of products or services, its own version of a Southwest Airlines that eases the cost of travel, a Costco Wholesale that sells its products and services at a known markup, or an Uber that transports people with a click of a button. Showing 1 - 10 of 113. One of the primary ways we achieve this is by advocating on behalf of registered nurses at the top levels of government as policies are conceived, debated, and implemented. Second, life sciences organizations should evaluate the impact of digital therapeutics and connected care solutions on providers' practices. Harkness Fellowships in Health Care Policy and Practice ... Sign up to get future issues of Headlines in Health Policy delivered to your inbox. Companies could choose to hire external talent, but that strategy presents significant challenges: Thirty-five percent of the skills workers will need will change by 2020, and the required skills will continue to evolve, according to the World Economic Forum. First, care delivery must move beyond the office and to a broader team. The healthcare industry will begin to feel substantial effects of the 2017 Tax Cuts and Jobs Act in 2019, the report predicted. "This means that new data sharing processes and payment models will be established to integrate these products into the broader treatment arsenal and regulatory structure for drug and device approvals.". "Some ACA revenue-raising provisions have been delayed or eliminated, exacerbating their situation.". "Subscription pricing for digital therapeutics or connected device solutions, for example, could make pharmacy spending more predictable and efficient. Opioids are a type of drug that includes fentanyl, heroin and prescription painkillers … PwC identified three implications of the need for new, upskilled healthcare workers. America's Health Insurance Plans. Out of provider executives the PwC Health Research Institute surveyed on the subject, 45 percent say their workforce's capabilities are a significant barrier to organizational change. Fifty-two percent of consumers with a high-deductible health plan say it would be hard to afford the deductible, the report said. "As they did then, organizations won't have to train every employee immediately and they won't have to train each employee at the same level.". Recovery is founded on the principle that people can take on meaningful roles in the community despite mental health challenges, when they receive the support they need. Opioid epidemic. Some of the policy priorities facing health insurance providers as they work to improve access and affordability include: When it comes to prescription drugs, the problem is the price. try again. The Most Popular Healthcare Issues of 2020. A lower-cost value line is an important growth strategy in a healthcare ecosystem in which average deductibles have tripled over the last decade and are now almost $1,300 for an individual with employer-based insurance, making healthcare costs a difficult financial decision even for the insured, the report said. The new report identifies six overarching issues facing healthcare in 2019: Digital therapeutics and connected care reshape the life sciences industry. In 2019, health care issues remain on top of the to-do list for the White House and lawmakers. "It could build on existing patient support programs to tackle social and lifestyle barriers to patient adherence.". Drug pricing. [See what PwC said last year would be the 12 issues that define healthcare in 2018]. Please try again. October 15, 2019 Current debates in health care policy: A brief overview. Six in 10 pharmaceutical executives surveyed by Health Research Institute said their workforce has the skills needed for an evolving digital economy. Summit: Digital Health Innovation—Reimagining Healthcare On January 26, join Alberta Innovates to discuss key digital health themes that include the social and legislative aspects of digital health and the governance and ethical considerations of health data.Hear directly from thought-leaders, entrepreneurs, and change-makers to explore what’s possible in digital health and how to get there. The Affordable Care Act in 2019: Still alive. See what PwC said last year would be the 12 issues that define healthcare in 2018, The move to value accelerates in 2021, spurred by lack of fee-for-service payments during pandemic, Commentary: Digital health companies should stay away from FDA in 2021, Memorial Health uses chatbots to boost patient experience, streamline workflows. ... Lastly, involvement with our state and federal regulators is necessary to create the policies and climate to improve healthcare’s current landscape. 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At the same time, states will seek ways to stabilize marketplaces through federal assistance, particularly through reinsurance programs designed to reimburse payers with high-cost beneficiaries and slow individual plans' premium increases, the report said. Something Congress continues to tackle important issues that impact all Americans, such as lowering the price of prescription drugs. More than 100 C-suite and director-level executives voted on and then ranked the top 10 critical challenges, issues, and opportunities they expect to face in the coming year, during the 2019 HCEG Annual Forum. "On trade, while some actions will have recently gone into effect, others – such as trade tensions with China – are ongoing. "Some healthcare organizations will have access to a substantial amount of capital to help them gain a competitive advantage," PwC noted. And third, healthcare organizations should figure out what operational changes the new tax law will require. The tables below provide demographic and economic statistics for the United States, since both factors significantly impact healthcare and healthcare policy. Telehealth reimbursement may be changing. America’s Health Insurance Plans601 Pennsylvania Avenue, NWSouth Building, Suite 500 Washington, DC 20004. The American Nurses Association (ANA) works to advance the nursing profession and improve health and health care for all. Join health care industry experts, policymakers, academics, and thought leaders in March to get some clarity on what’s happening now and discover strategies to stay ahead of change. "New health data streams coming in from patients' devices and mobile phones may disrupt provider practices even as they help improve care delivery," PwC said. The U.S. healthcare industry is looking less like a special case, a large segment of the U.S. economy with its own unique quirks, and is beginning to behave like other industries, according to "Top health industry issues of 2019: The New Health Economy comes of age," the 13th annual healthcare report from consulting giant PwC. For added context, these figures are compared with those in Massachusetts and Utah, the states with the highest and lowest levels of healthcare spending per capita, respectively. And third, life sciences organizations should explore partnership models focused on demonstrating results. In 2009, private equity firms completed more than 200 healthcare deals, and by 2016 this had tripled to more than 600 deals, the report said. Your subscription has been "Providers that understand the consumer segments they want to serve can design an operating model for the future – perhaps as 'integrators' serving a payer mix and consumer base that are both diverse, or as 'health managers' targeting the frail elderly, complex chronic, chronic and mental health consumer segments.". For example, 20 percent of workers are expected to rely on artificial intelligence to do their jobs by 2022, according to Gartner. AHIP Issues Statement on Repeal of McCarran-Ferguson Act Exemptions for... AHIP Issues Statement on Continued Negotiations for COVID-19 Relief, While Americans on Medicaid are more likely to have health problems, their insurance coverage. In 2019, healthcare organizations may find it necessary to restructure their businesses to accommodate new rules on unrelated business taxable income (UBTI); assess how taxes and refunds could affect their Medical Loss Ratios; determine how best to invest cash previously held outside the US; and restructure their supply chains to accommodate a new territorial tax system and emerging trade uncertainties, among other actions, the report advised. Forty-two percent of US workers surveyed by PwC said they agreed or strongly agreed that automation would put jobs at risk of elimination. Lawmakers in 2019 will be increasingly interested in how 340B entities are using the benefit and whether or not savings generated by the program are making it to consumers or padding companies' pockets.". As megadeals complete, newly consolidated entities should consider shedding noncore assets, with private equity as a potential buyer, the report said. ", Your company's new, upskilled health worker of the future is you. Sixty to 72 percent of respondents would have a positive opinion of a life sciences company, health insurer or hospital that used its tax savings to hire more staff, while 38 to 39 percent would have a negative opinion if the same company were to repurchase shares of its stock from investors. What policies are generally supported by both parties? In addition, other provisions of the law could negatively affect payers, providers and life sciences companies, the report said.