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Squeezing Costs out of Healthcare Tops PricewaterhouseCoopers' List of Health Industry Issues in 2010
Date:12/17/2009

devices and pharmaceuticals. Payers will look to reduce benefit-related administrative costs. Expect employers to increase audits of employee dependents to weed out those who are no longer eligible for coverage.
  • Aftermath of health reform -- While 2009 was a year of watch and wait on health reform, healthcare organizations will be busy in 2010 absorbing the potential first waves of regulatory changes. These include major insurance market and payment reforms, dozens of new agencies and grant programs, reimbursement and pricing pressures, increased oversight, tax changes and the overall implications of increased coverage and consumer demand. PricewaterhouseCoopers expects the trend in the United States to mirror that of European countries in which major reform initiatives and their concomitant regulations will be a recurring process.
  • Government accelerates change through rewards and penalties -- 2010 will be a double-bonus year for physicians who act quickly to take advantage of government incentives to adopt electronic medical records and e-prescribing. Those who do not will face potential penalties later. This new carrot and stick model of accelerating change represents a shift in the government's role as a "passive payer" to an "active buyer" of healthcare and its move from volume-based payments to value-based purchasing.
  • Focus on fraud and mistakes -- Healthcare organizations will need to tighten internal controls and raise the bar on compliance as the government
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  • SOURCE PricewaterhouseCoopers
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