Practical answers to difficult questions are needed. With this in mind, KPMG’s Global Healthcare practice brought 40 senior executives and clinicians, representing some of the world’s largest healthcare organizations from 22 countries, together for a conference in October 2012 to share their insights, ideas and outlooks.
Despite the differences between their national systems, the delegates found striking similarities in the way that payers and providers are rethinking their strategies and developing new approaches. Overwhelmingly, participants agreed that individuals, organizations, systems and nations alike all have something to teach and something to learn.
In particular, delegates identified five major trends reshaping healthcare today:
- Payers – whether governments, public sector bodies or insurers – are becoming ‘activist payers’ by focusing on value, contracting more selectively, reshaping patient behavior and moving care upstream to focus more on prevention.
- Providers need to rethink their approach as it is becoming clear that major transformational change can no longer be delayed. Some hospitals have the opportunity to transform themselves into ‘health systems’, providing new forms of much more extensive and integrated care and taking more risk and accountability for outcomes from payers. Others need equally radical approaches to reshape their operating models.
- There is an imperative to engage patients in new ways so that they become active partners in their care, rather than passive recipients. This requires new systems and ways of working – as one physician put it, clinicians need to change their role from ‘God to guide’.
- The rise of the ‘high-growth health systems’, from rapidly developing countries in Asia, Africa and South America, is changing global outlooks. Unencumbered by traditional healthcare doctrines, they are innovating fast.
It is a global phenomenon offering extensive learning, and opportunities for all.
- Sustainable change and better value are increasingly being seen as a direct result of new approaches to integration. A survey of our delegates revealed that 90 percent of payers, providers and professionals believed integration would produce better patient outcomes, while three-quarters were confident that it would cut costs.
Our payer and provider participants (listed at the end of this publication) shared some anxieties over the long-term sustainability of their respective health systems and existing care and business models, but remained confident that these challenges could be met.
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A central paradox
The report looks at the major problems facing many health systems, as well as the scope for agile organizations to exploit new models and opportunities.
It also highlights, however, a central paradox.
While nearly all of the delegates expected ‘moderate or major business model change’ within the next five years, there was a consensus that too many systems are still behaving as though these changes only affect other people. They are focusing on minor transactional change rather than the major transformational reform required to address future challenges.
Making the first step along a different path requires an act of courage, and committed leadership. This report is a call for such a journey of leadership.
Ultimately, leaders and their organizations must learn to focus on patient value and outcomes.
In the past, many healthcare systems have been fueled and driven by supply-induced demand rather than concentrating on the outcomes – what patients really need and want. Such perverse incentives cannot provoke cultural change or the implementation of best practices.
Shifting the balance from volume to value will not be easy. Change is hard, risky and painful. Providers will need support as they bear the brunt of systems’ streamlining and integration.
Strong leadership will also be required to shift the focus from short-term goals to long-term ambitions. The best leaders, while not shying away from the biggest challenges, will reduce complexity. They will look beyond process targets and they will allow space for their organizations and staff to innovate and experiment on the way to creating new models of care.