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PwC’s Health Research Institute Gives Us Five

By Clive Riddle, March 20, 2015

Many institutions are pausing to write and reflect on the ACA at this five-year anniversary mark, underneath the pall of the SCOTUS’ King vs. Burwell shadow. PwC’s Health Research Institute has just weighed in with a nice 22-page report : Healthcare reform: Five trends to watch as the Affordable Care Act turns five.

The report lays five key trends on us that they contend the ACA has fueled after five years:

  1. Risk Shift: Raising the stakes for all healthcare players. The ACA added force to new payment models that reward outcomes and penalize poor performance such as high rates of readmission and hospital-acquired conditions.
  2. Primary care: Back to basics. Experimentation in new payment models and expansion of insurance coverage are making primary care once again the critical touch point.
  3. New entrants: Innovators in the New Health Economy. New entrants are rushing into the market to meet the demand for lower-cost, consumer-oriented care options in the post-ACA era. More than 90 new companies have been created since 2010, according to HRI analysis.
  4. Health insurance: From wholesale to retail. Rapid enrollment in the ACA's public exchanges has demonstrated the potential of retail-style health insurance and spawned renewed interest in private exchanges.
  5. States: Reform's pivotal stage. States have emerged as key players in the reconfigured healthcare landscape, as the ACA gave states notable discretion in how the law could be implemented.

Ceci Connolly, managing director of PwC's Health Research Institute, tells us "the five trends have led to the creation of more than 90 new companies that have entered the sector since 2010. The ACA has opened gates for savvy investors and start-ups to take a piece of the $2.9 trillion industry."

And if that isn’t enough, they give us these five takeaways on what stakeholder should consider going forward:

  1. Revisiting strategies to emphasize saving over spending and quality over quantity, to serve more consumers effectively and demonstrate affordability.
  2. Watching closely as the reimbursement pendulum swings from fee-for-service to accountable care.
  3. Innovating to meet the demands of the new healthcare consumer.
  4. Pursuing opportunities to enhance consumer choice and engagement in selecting health benefits.
  5. Working with states as they continue to shape the future landscape.

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