HEALTH & MEDICAL INDUSTRY PROFILE
INDUSTRY OVERVIEW:
The numbers don’t lie: Providing 13.5 million jobs and 8 out of the 20 fastest growing occupations, health care is the country’s largest industry. Compared to other industries, the health-care industry as a whole is expected to realize a relative increase in the number of career opportunities across the spectrum of its many specialties.
People are living longer and thus demand more and higher quality preventive and long-term care. The demand for health-care workers is expected to grow faster than the average rate for all occupations between 2000 and 2010. In particular, the demand for home care aides, registered nurses, physician assistants, nurse practitioners, physical therapists, nontraditional health aides, and physicians will continue to increase at a healthy pace. This trend also applies to technical and administrative jobs, as hospitals continue to focus their energies on more efficient management and profitability.
Many people are attracted to the health-care industry for its human touch and service-oriented aspects. However, the harsh reality is that the industry as a whole is all business these days. Hospitals, nursing homes, home health care, specialized clinics-and even to some extent organizations that provide alternative medical treatments-are being run increasingly like any other major for-profit organization. Simply put, health care today is all about big business-with its focus sharpening on driving profits higher.
The health-care industry provides diagnostic, healing, rehabilitation, and preventive services. The individual physician is often the consumer’s (or patient’s) primary point of contact with the system. However, it is the health-care organization itself-that is, the hospital or health management organization (HMO)-that finances much of the industry today; it represents the preponderance of the physician’s revenues. The lion’s share of these revenues, in turn, comes from employee health insurance plans, Medicare (health insurance for Americans over the age of 65), and Medicaid (health insurance for Americans on welfare). Health-care organizations (with the exception of county hospitals) are generally run for profit. This disconnect between organizations based on the profit motive and those operating as nonprofits creates tension among doctors and other health-care professionals intent on prescribing the most cost-effective treatments and conducting diagnostic tests. Health-care organizations are increasingly driven to cut costs across the board.
ALTERNATIVE MEDICINE
A growing segment of the population is turning to a wider, more diverse set of techniques and therapies to meet health-care needs. The catchall category of alternative medicine refers to any practice outside of conventional medical treatments, including homeopathy, acupuncture, massage therapy, and chiropractic. The granddaddy of the movement is Dr. Andrew Weil, who preaches the benefits of treating a patient holistically, serving the body, mind, and spirit.
Americans are increasingly turning to herbal remedies to treat ailments, spending over 4 billion dollars a year on herbs and other botanical remedies. Health-care providers and insurance companies are beginning to recognize the legitimacy of some of these alternatives and to accept some nontraditional techniques for treating chronic health issues.
HOSPITALS
Despite the increased outsourcing (not uncommon in any industry today) of medical records, housekeeping, lab testing, and clinical services (e.g., orthopedics and radiology), hospitals remain the biggest employers in the health-care industry. The huge networks such as HCA and Tenet demand a steady supply of doctors, nurses, administrators, medical technicians, therapists, and other support staff. In areas where competition from HMOs is mounting and cost-cutting is a priority, former staff may move outside the immediate confines of a hospital. However, close and important links remain-particularly for any type of surgery or specialized treatment such as chemotherapy.
HMOS AND PPOS
Health maintenance organizations (HMOs) and preferred provider organizations (PPOs) are hybrids-basically, a cross between a hospital and an insurance company. Each type of managed care plan covers primary care visits, preventive services, and copayments for prescription drugs, whereas only PPOs allow the enrollee to choose his or her physician (HMOs maintain a list of plan-approved doctors). Some of the largest organizations have their own medical staffs and facilities where they treat patients; smaller ones may simply access networks of private providers and hospitals. Competition is fierce in this arena-M&A and internal strife often destabilize the job market. Coventry Health Care, Humana, Harvard Pilgrim Health Care, and PacifiCare Health Systems (one of the leading Medicare HMOs) are a few of the better-known players.
SPECIALTY PROVIDERS
As hospitals have attempted to cut costs, they have turned to firms that can provide specialized services at rock-bottom prices. These include everything from nursing homes (Beverly Enterprises) to home infusion therapy providers (Apria Healthcare) to diabetes treatment providers (American Healthways). Clinics that focus on special treatments such as chemotherapy, MRI and other scanning techniques, and physical therapy are also proliferating. Most are small and locally run; however, Gambro and Fresenius Medical Care are two enormous service companies that focus on this type of care; others will undoubtedly emerge as their popularity increases.
HOME CARE
Advances in technology have done much to improve efficiency and reduce costs for both patients and home care staff. Today, home care nurses and aides can administer complex treatments previously available only in hospitals and clinics to the elderly and severely disabled in their own homes. And because almost all hospitals and HMOs now release patients before they are self-sufficient, home care is often the most cost-effective choice. Most jobs in this sector don’t require much training (they are closely supervised by RNs, NPs, or physicians)-just deep reserves of patience and kindness. The pay is low-often less than $10 an hour-and the work is arduous. The rewards? In addition to extremely flexible hours and plenty of personal contact with patients, there is the satisfaction of helping people when they are most in need.
The various health-care positions require varying levels of education and training. Registered nurses (RNs) are trained at the undergraduate level, whereas nurse practitioners (NPs) have received master’s degrees in their specialties. Physician assistants (PAs) are licensed to practice medicine under the supervision of a physician. Doctors of osteopathy and medical doctors both complete 4 years of postgraduate work to earn the titles of DO and MD, enabling them to prescribe medicine and perform surgery. To qualify for some positions (including doctor, nurse, tech), technical training is required-and to actually land a job, you often need a strong network in a given area and practical experience in the industry.
RNs, pharmacists, and radiological technicians are currently in very high demand and will continue to be in the decade ahead. Why? The Baby Boomer population is maturing into retirement, the elderly population in the United States is growing, and health-care spending is being cut wherever possible-which means that today, whenever a nurse can do something a doctor used to be responsible for, that’s exactly what’s going to happen. Employers are looking to attract people to these in-demand professions by offering signing bonuses, tuition reimbursement or loan repayment, flexible scheduling, and incentives for voluntary overtime shifts.
The good news doesn’t end there: Opportunities will also grow at a healthy clip for just about every other health-care function, including doctors, optometrists, occupational therapists, audiologists, medical record technologists, medical transcriptionists, and speech pathologists. The highest demand will be for physician assistants, physical therapists, lab clinicians, dental hygienists, respiratory technicians, substance abuse counselors, and especially home health-care workers.
Hospitals and HMOs offer jobs in management in addition to medicine-particularly if you have a background in information technology (IT) and data system development. As a job seeker, you should be aware that HMOs have been the catalysts for many of the efficient business practices adopted throughout the health-care industry in recent years. Technical and administrative support positions are in high demand as the industry evolves in an intensely competitive market. Health-care IT is a steadily growing sector; although the industry has been a late adopter of IT, it is catching up now. There will be lots of opportunity in this area for the tech-savvy.
As the US health care industry moves toward a financial model that is based on value rather than volume, keeping people healthy and out of the hospital will be key. In a fee-for-service (FSS) model, health systems generate more revenue when patient volume increases. But under a value-based model, a person who shows up at an emergency room or a doctor’s office becomes an expense rather than a source of revenue. Rather than seeing people as patients, health systems should treat them more like members. This shift can help strengthen customer loyalty, build brand and reputation, and even improve the health of our nation.
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Sources: https://www.wetfeet.com/articles/industry-overview-health-care
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ASSOCIATIONS & INSTITUTIONS:
LEADING COMPANIES:
An aging workforce, rising demand for health care services, and moral and well-being concerns are driving shortages of skilled health care staff. But there are a number of dimensions shaping the future of work, including automation, telehealth, and new staffing models.
Health care providers should proactively seek opportunities for augmentation in clinical workflows, which will allow clinicians and patients to benefit from an aligned financial reimbursement system, new technologies, innovative talent models, and extended locations for care delivery.
Engaging with consumers and improving the patient experience
Health care leaders need to maintain the talent continuum that offers resources for redefined roles of the health care practitioners. Providers should proactively seek opportunities for augmentation and automation in clinical workflows, which will allow clinicians and patients to benefit from an aligned financial reimbursement system, new technologies, innovative talent models, and extended locations where care is delivered.
The adage, “What goes up, must come down,” isn’t likely to apply to the global health care sector in 2019. Aging and growing populations, greater prevalence of chronic diseases, exponential advances in innovative, but costly, digital technologies—these and other developments continue to increase health care demand and expenditures. Health care stakeholders—providers, governments, payers, consumers, and other companies/organizations—struggling to manage clinical, operational, and financial challenges envision a future in which new business and care delivery models, aided by digital technologies, may help to solve today’s problems and to build a sustainable foundation for affordable, accessible, high-quality health care. This vision may have a greater probability of becoming a reality if all stakeholders actively participate in shaping the future— by way of shifting focus away from a system of sick care in which we treat patients after they fall ill, to one of health care which supports well-being, prevention, and early intervention.
As the industry continues to move toward this value-based system, here are a few trends US health care organizations should watch in 2019:
Collaboration between health systems and health plans
The shift to wellness rather than illness
How technology can help put patients at the center
Increased adoption of virtual care options
Greater focus on population health
Hear more about these trends from Deloitte’s US Health Care Leader, Steve Burrill.
Shaping tomorrow’s health care industry
The global health care industry doesn’t show any signs of slowing down in 2019. Aging and growing populations, greater prevalence of chronic diseases, and exponential advances in innovative, but costly, digital technologies continue to increase health care demand and expenditures.
Health care stakeholders struggling to manage clinical, operational, and financial challenges envision an industry in which new business and care delivery models, aided by digital technologies, may help to solve today’s problems and to build a sustainable foundation for affordable, accessible, high-quality health care. This vision may have greater probability of becoming a reality if all stakeholders actively participate in shaping the future—by shifting focus away from a system of sick care to one of health care that supports well-being, prevention, and early intervention.
Strategically moving from volume to value
As patients’ role and influence in their health care increase, providers and payers must likely shift accordingly and take advantage of emerging opportunities to establish more direct, personal relationships with the consumer. Digital technologies can improve engagement, enable convenience-driven access to care, and nurture a two-way relationship for the long term. Organizations that understand and act on how consumers would like to use digital health, telehealth, wearable monitoring and fitness devices, online resources, social media, and other technologies will likely be well-positioned to develop patient engagement strategies that help individuals make informed health care decisions.
Investing in digital innovation and transformation
Digital technologies are supporting health systems’ efforts to transition to new models of patient-centered care and helping them develop “smart health” approaches to increase access and affordability, improve quality, and lower costs.
Blockchain, artificial intelligence, and virtual reality are just some of the technologies disrupting health care. These technologies are helping with diagnosis and treatment; helping with speed, quality, and accuracy; and improving the patient experience.
Responding to health policy and complex regulations
Key takeaway
Investment in digitization can lead to better usage of health data in research supporting personalized health care. Interoperability issues and risks around connected devices, disparate systems and processes, and pilot models that need scale to facilitate system-wide adoption are some of the challenges on this road to innovation. Digital innovation is supporting and augmenting workers but not replacing them though. It is allowing highly trained resources to focus on more valuable, patient-facing activities.
Maintaining regulatory compliance and cyber security
As data becomes the new health care currency, protecting it will be key. Clinical innovations, connected medical devices, and market complexity have amplified the continued need for evolving government policies, regulatory oversight, and risk management.
And while government policies and regulations seek to strengthen health care security and safety at a micro level, health care organizations should focus on compliance, ethics, and risk, driving awareness throughout the enterprise.
Investing in exponential technologies to reduce costs, increase access, and improve care
Click the image to view the infographic
Key takeaway
While government policies and regulations seek to strengthen health care security and safety at a macro level, health care organizations should focus on compliance, ethics, and risk, and drive awareness throughout the enterprise. Organizations need to invest in crisis management capabilities that make their cyber-diligence stronger and better.
Adapting to changing consumer needs, demands, and expectations
Patients and caregivers, dissatisfied with poor service and lack of transparency around price, quality, and safety, are expecting health care solutions that are coordinated, convenient, customized, and accessible.
To help keep up with increasingly engaged consumers, providers and payers will have to shift accordingly and take advantage of emerging opportunities to establish more direct, personal relationships. Organizations that understand and act on how consumers would like to use digital health, telehealth, wearable devices, and other technologies will likely be well-positioned to develop patient engagement strategies to help individuals make more informed health care decisions.
THE UNINSURED NATION
Currently, some 43.6 million Americans have no health insurance. The number of uninsured Americans continues to grow like an epidemic. Why? Insurance premiums continue to skyrocket as health insurers consolidate their businesses through frequent mergers and acquisitions. The result of this trend is a continued decline in competition among health insurers-and higher premiums are one of the results. Indeed, employers are facing double-digit percentage increases in health premium costs each year. The upshot: More and more of the cost of health insurance is being passed on to employees, meaning many people simply can no longer afford health-care coverage-considered a necessity (indeed even a birthright, many argue) in any industrialized nation.
RUNAWAY COSTS
Doctors and hospitals have been grappling with rising costs for a long time-and each year the problem seems to get worse. Malpractice insurance premiums, soaring prescription-drug prices, and the increasing numbers of uninsured Americans are all factors leading to ever-higher costs for caregivers. At the same time, revenues for doctors and hospitals keep falling, as insurers are doing everything in their power to lower payments for claims.
Meanwhile, insurers are not feeling the squeeze nearly as much as the caregivers. The reason: They make sure that revenue from premiums rises at a higher rate than claims payments.
Creating financial sustainability in an uncertain health economy
The emergence of personalized medicine, increased use of exponential technologies, entry of disruptive and non-traditional competitors, the demand for expanded care delivery sites, and revamped payment and public funding models are all impacting the financial performance of the health care ecosystem. Between 2017-2022, global health care spending is expected to rise 5.4 percent annually to just over $10 trillion.
Health care providers are stressing rigorous financial management, efficient operational performance, outcomes-based care, and innovative solutions to help address this rise in spending. Developing public-private partnerships, investing in prevention and well-being, and learning from industries outside of health care will also be key.
Health care providers are stressing rigorous financial management, efficient operational performance, outcomes-based care, and innovative solutions development. These could result in improved care provision, reduced costs, counter declining margins, and aligned cost structure and care models with reimbursement trends and payment models. Developing public-private partnerships, investing in prevention and well-being, and learning from industries outside of health care will also be key.
Using new care delivery models to improve access and affordability
Moving from volume to value will require building an outcomes-based financial model and data infrastructure to maximize value-based care (VBC) reimbursement pathways, which will likely be fundamental to many health systems’ sustainable growth.
Clinical innovations, patient preferences, and government program payment policies are prompting hospitals to shift certain services to alternative points of care and even to virtual environments that benefit from a cost and access perspective. It will be imperative for stakeholders across the health care ecosystem to collaborate around a whole-life approach to funding and delivering sustainable care.
Creating a positive margin in an uncertain and changing health economy
It is imperative for stakeholders across the health care ecosystem to collaborate around a whole-life approach to funding and delivering sustainable health care. Collaboration should be key. Investments in technology such as virtual health and telehealth could expand services while also helping hospitals bend the cost curve. AI powered nurses interacting with patients and intelligent virtual assistants providing personalized health care coaching are innovations that are already gaining traction.
NEW YORK
EVERY NEW YORKER DESERVES TO BE HEALTHIER, BUT NOT EVERY RESIDENT HAS THAT OPPORTUNITY BECAUSE WHERE THEY LIVE WITHIN NEW YORK CITY HAS A STRONG INFLUENCE ON HEALTH.
Health outcomes can differ significantly between geographically close neighborhoods, according to the New York City Community Health Profiles. In addition, not all neighborhoods have equal access to clean air, affordable and nutritious food, or safe and well-maintained
housing and public spaces. A neighborhood’s built environment can impact how much people exercise, or even the quality of their
relationships with neighbors.
Inequities in neighborhood conditions have been shaped over decades by historical and ongoing racism. Discriminatory policies such as redlining, as well as a lack of investment in neighborhood sustainability, have historically disadvantaged many communities, particularly low- income communities of color, leaving these communities without adequate local services, housing, parks, or playgrounds, which contribute to health.
Studies show income inequality and high rates of poverty are connected to poorer health outcomes such as reduced life expectancy, and increased infant mortality, obesity, and mental illness. Life expectancy in East Harlem, where residents are predominantly black and Hispanic, and poverty is more prevalent, is 8.6 years shorter than on the Upper East Side, a predominantly white community with lower poverty just a few blocks south. Black women are eight times more likely to die from pregnancy-related causes than white women, and babies born to black mothers are three times as likely to die in their first year of life as babies born to white mothers.
By adopting a holistic approach with OneNYC, we will address a range of factors that impact our health. These include gun violence and traffic fatalities, intensive heat waves due to climate change, and air pollution that exacerbates heart and lung problems, particularly for children with asthma.
WE CANNOT ACHIEVE HEALTH EQUITY WITHOUT GUARANTEEING THE RIGHT TO QUALITY HEALTH CARE, AND ENROLLING AS MANY NEW YORKERS AS POSSIBLE IN HEALTH INSURANCE.
New York City has steadily reduced the number of uninsured residents since the Affordable Care Act was launched in 2013 — with nearly 70,000 enrolled in the past year alone — but there are still an estimated 600,000 New Yorkers without health insurance, and roughly 300,000 of them are considered “uninsurable.” We are working to ensure all New Yorkers can access high quality primary care, regardless of their immigration status, through NYC Care.
The City has also launched initiatives to protect residents from the harmful effects of tobacco use, redoubled efforts to end the AIDS epidemic, and created new air quality standards. We have started programs to expand mental health services and combat the opioid epidemic. Child exposure to lead has dropped by 90 percent since 2005.
In addition, the City has begun confronting pervasive racial and ethnic inequities in maternal morbidity and mortality, and infant mortality, launching a comprehensive strategy to improve health outcomes for mothers and babies, especially among women of color. Much of the focus has been on community health, with policies and programs informed by community members. Our Neighborhood Health Action Centers, for example, include Women’s Health Suites, and also provide services ranging from primary care and mental health care to wellness classes and are connected to neighborhood-based social services.
INDICATORS
NEW YORKERS WITH HEALTH INSURANCE – 88.2% (2017) – INCREASE
PREMATURE MORTALITY RATE – 189.4 DEATHS PER 100,000 (2016) – REDUCE BY 25% BY 2040
CITYWIDE OPIOID OVERDOSE DEATHS – 17.4 PER 100,000 (2017) – REDUCE BY 60% BY 2030
Location Specific Industry Data :
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