Leading disruption through the downturn
Health services executives find themselves at an inflection point in 2023. They face the complex mission of transforming the patient and member experience while economic forces converge to make 2023 a year of reckoning and restructuring. Many are operating with aging technology, outmoded business models and frayed infrastructure. Medical and tech innovators and start-ups are disrupting the market, and care models are being reimagined, giving rise to remote and retail care locations. COVID-19 had already laid bare the challenges of achieving health equity for everyone, while profit margins were becoming razor-thin.
The new year requires more than a recession-ready strategy. It’s imperative to build new capabilities and seize competitive advantage, and every health plan and system needs to summon the courage to change. Those organizations that hold too tightly to traditional playbooks and are complacent in challenging historical roles and views of their purpose risk falling further behind.
The stakes are high. PwC research shows we’re in the middle of a five-year, $1 trillion revenue shift away from traditional healthcare payers and providers. By 2030, we expect the sector to move into a new health ecosystem. We believe the greatest potential lies in embracing new roles as orchestrators, integrators, and platform and solutions players in the health ecosystem.
- Orchestrators focus on delivering seamless, humane experiences and outcomes to consumers. Patients benefit from greater choice, transparency and control.
- Integrators help align incentives and reduce waste and variability in healthcare by offering a simpler, more convenient experience for consumers.
- Platform and solutions players focus on creating technology and cloud infrastructure for exchanging, storing and integrating data. These higher quality insights help create a more effective marketplace.
Health services companies that follow their North Star — finding ways to develop stronger relationships with consumers and improve the patient experience, rethinking traditional workforce and business models, and continuing to invest in technology and innovation — will likely be well positioned for what’s next. No matter which role payers and providers choose to play, here are six pivotal issues that are critical to remaining competitive and leading in 2023.