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Healthcare’s call for radical change, shared learning and greater innovation 

22 April 2013
Health systems around the world must undergo radical reform to cope with rising costs and demands.

According to a new healthcare report published by KPMG titled ‘Something to teach, something to learn: global perspectives on healthcare’, the next decade will be critical as health systems struggle with rapidly ageing populations, technological advances and spiraling costs.

Said Mr Tan Wah Yeow, Head of Asia Pacific Healthcare Practice, KPMG in Singapore: "The challenge is straightforward – governments must find ways of providing higher quality care for their growing, aging populations at lower cost. For healthcare organisations, this also means that living in the status quo is no longer an option.”

The report comprises insights of healthcare practitioners from 22 countries including Singapore. Its key findings include:

  • The rise of the ‘activist payer’ as an agent of change, where governments and insurance companies force healthcare providers to contract for services by becoming more focused on the outcomes.

  • Shifting from volume to value will reshape how we pay for and provide healthcare. Payers for healthcare, whether governments, public sector bodies or insurers need to transform their health systems by rewarding providers for quality (the benefit to patients and overall population health improvement) instead of quantity (the number of treatments performed).

  • Hospitals need to transform themselves into integrated health systems, responsible for entire pathways of care and the health of their communities. Integration was named by 90 percent of 40 senior healthcare executives and clinicians surveyed as being able to produce better outcomes. Three-quarters of them felt that it would cut costs.

  • Patients need to become more engaged and active partners in their own care. Evidence shows that patients often make better and more cost-effective decisions about their care when empowered and fully informed of their options.

Dr Mark Britnell, KPMG’s Global Health Chairman and co-author of the report, said: “Real change is hard, risky and painful. The report uncovers a paradox. Leading practitioners acknowledge that major change is inevitable but too few are actually planning the scale of system reform to cope with it.”

Pushing care upstream

Healthcare professionals interviewed in the report agree that pushing care upstream towards prevention, self-management and home care will increase quality while reducing costs.

Put simply, the model for care must be shifted to one where the focus is on preventing medical conditions from deteriorating in the first place. Currently, health systems prefer waiting for medical conditions to become acute before caring for patients in high-cost medical centres.

For the model to shift, care must be delivered in a much more integrated and coordinated way.

Said Mr Tan: “Hospitals are just one component in a patient’s care-journey. Primary care professionals such as General Practitioners and community nurses should work together with medical specialists and patients.”

Integration in turn requires deep changes in current payment systems. Existing payment systems tend to pay for individual care activities within organisations or the attention of professionals. They should instead be rewarding efforts to integrate care across a care-path and paying for outcomes.

Emergence of new models

Some health systems have already started to respond to the changing environment by developing new ways of working.

For example, consultant neurologist Professor Bloem in the Netherlands identified all the professionals working with Parkinson’s patients in his region. He then equipped them with tools to facilitate greater communication to share best practices, patient data and enrolled patients through a web portal.

Patients were able to use the web to set their own priorities, build their own care networks, exchange information with professional and connect to other patients.

This revolutionary partnership formed by creating a network of experts linked with information technology tools succeeded in reducing hip fractures amongst the Parkinson’s patients involved in the project by 50 percent. Some US$25 million worth of savings were also achieved.

Some hospitals are also building entirely new models focusing on a specific process or procedure. Singapore’s Fortis Healthcare, for instance, recently opened a hospital purely focused on colorectal conditions.

Strong leadership to pave way for change

The report argues that while some systems are undergoing swift changes, others have been slower to appreciate the urgency of the situation.

Dr Britnell noted that the large-scale transformation required in many health systems will require strong leadership. Healthcare leaders must be ready to “take a leap of faith to succeed in shifting the focus from short-term delivery to long-term ambition.” “They should share and learn with their international peers. They will need to empower their people and allow their organisations to experiment to create new models of care,” he said.

He added: “Healthcare organisations across the world have their own market and regulatory environment but they face many common challenges. There should be no excuse for a lack of urgency and the only option not on the table is doing nothing.”

Mr Tan concluded: “Rapidly developing countries in Asia, Africa and South America are witnessing the rise of high growth health systems unencumbered by traditional healthcare doctrines. They are innovating fast and offering learning opportunities for others.

“This report presents healthcare leaders with new models and huge learning opportunities. Powerful examples of how we can provide better care at lower costs are out there – we just need to be better at sharing and learning.”


Notes to editors

About KPMG’s Global Healthcare Practice

Healthcare systems around the globe are facing more complex challenges than ever. KPMG is committed to providing long-term support to our clients as they tackle these challenges and seek to transform the way that healthcare is provided.

With deep industry experience, insight and technical support, KPMG firms are among the leaders in delivering a broad range of audit, tax and advisory services to meet the unique needs of healthcare policy-makers, providers and payers.

KPMG has more than 3,000 dedicated professionals in our healthcare team, with skills in strategy development, cost optimisation, financial management, clinical performance improvement, market development, tax planning, mergers and acquisitions, commercialisation and organisational development. We have one of the largest, best equipped and most experienced healthcare advisory teams.

For more information, please visit healthcare, or join the conversation on LinkedIn with KPMG Healthcare.

About Something to teach, something to learn: global perspectives on healthcare

KPMG brought together 40 experts from leading healthcare organisations representing 22 countries, including Singapore, in October 2012 to debate the future of healthcare systems and to share learning. The report captures the outcomes and perspectives of the participants.

For payers
  • Organisations will need to be capable of contracting for outcomes and value.

  • Finding new ways to connect with and empower patients to influence their behavior will be crucial.

  • An increased focus on the management of overall population health is needed.

  • The development of new skills and organisational abilities will be a priority.

  • Payers will need to engage with and incentivise providers in new ways to shape their behavior, and create innovation.

For providers
  • Radical new transformational approaches will be needed to create integrated health systems, specialist networks or areas of special expertise.

  • For many providers, the logic will be to take more responsibility for the whole of the patient journey.

  • Investing in leadership will be key, as will the creation of new partnerships with clinical staff.

  • Learning from other markets and better use of information to gain strategic advantage will come to the fore.

For health systems
  • Payers and providers will need to move away from traditional adversarial approaches.

  • Significant structural change will be required, yet the payback for such investment will not be immediate.

  • Payers and providers must understand what constitutes value for patients and build this into every process.

  • Health systems need to develop new channels to talk to patients and to connect them to each other.

  • The best-prepared organisations and systems are investing a significant amount in both teaching and learning as they work towards new ways of operating.