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1、February 2020 home.kpmg/in Healthcare 3.0 Re-imagining healthcare in the next decade Table of Contents 2. Key future trends in Healthcare 3.0.9 Executive Summary.3 1. Forces transmuting the Indian healthcare system.5 3. Shifting gears in Healthcare 3.0.19 4. List of abbreviations.23 2020 KPMG, an In
2、dian Registered Partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. 2020 KPMG, an Indian Registered Partnership and a member firm of the KPMG network of independent m
3、ember firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Over the years India has made rapid strides in health parameters such as life expectancy, mortality rates, immunisation, among others. The Indian Healthcare system is currently at
4、a very critical juncture, where it not only needs to overcome key healthcare challenges, but also needs to progress towards path of Universal Health Coverage (UHC). The current healthcare system of the country is burdened due to the limited access to healthcare, insufficient availability of manpower
5、, sub-optimal quality of health services and high out- of-pocket (OOP) expenditure. Vital decisions around the four pillars of availability, affordability, accessibility and acceptability need to be taken to tackle these challenges. Healthcare is traditionally seen as a social sector in India, with
6、limited government focus and low budget allocation with a focus mainly on curative care. Significant progresses have been made through a number of initiatives, including the flagship National Rural Health Mission, National Urban Health Mission, Rashtriya Swasthya Bima Yojana, and most recently Ayush
7、man Bharat that covers the cost of secondary and tertiary-level hospitalisation for underprivileged population. However, with rising disposable incomes, changes in lifestyle, coupled with increasing population, the disease patterns are changing significantly from communicable to sedentary-lifestyle
8、related diseases. This needs a paradigm shift in terms of our healthcare policies as well as in establishing synergy between public and private health sectors. Considering that more than 85 per cent of tertiary care beds are in private sector, various models need to be considered to make healthcare
9、available and accessible. Prime Minister has desired for opening of 2500-3000 new hospitals in tier-II/III cities and where private sector can play pivotal role specifically around areas like patient centric infrastructure development, developing technologies, standardisation of practices, capacity
10、building and attaining economies of scale. This would lay the foundations for a wider healthcare marketplace with innovative product offerings, encourage new market entrants in the wake of possible newer investment avenues. With the consistently growing role of technology in our everyday life, there
11、 is a compelling need to make the way health is sought smarter. Patient Safety in delivery of healthcare needs greater attention. Monitoring and measuring of sentinel events and medical errors needs to become culture. Doctors need to take greater leadership role in driving quality and patient safety
12、. Quality accreditation like NABH and National Patient Safety Implementation (2018- 25) needs to be incentivized. This will further help in reducing morbidity and mortality. This report, by the Association of Healthcare Providers in India and KPMG tries to delve deeper into the imminent changes in t
13、he healthcare arena so as to become major sector driving social wellbeing. It has also huge potential in becoming economic driver by way of employment generation and even providing healthcare professionals to the world. Foreword by Association of Healthcare Providers (India) 1 Dr. Girdhar Gyani Dire
14、ctor General at Association of Healthcare Providers (India) Dr. Alexander Thomas President at Association of Healthcare Providers (India) 2020 KPMG, an Indian Registered Partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPM
15、G International”), a Swiss entity. All rights reserved. Foreword by KPMG in India Healthcare in India is being reimagined due to the various market forces in play which are transforming the pattern of consumerism, dependency on digital technologies, provider landscape, diagnosis, healthcare workforc
16、e, disease burden and regulatory regimes. The government is also taking steps to ensure delivery of accessible and affordable services through its Ayushman Bharat scheme, which in turn is laying foundation of value-based healthcare in India. Furthermore, they are aiming to equip Health and Wellness
17、centres and primary care centres proposed under Ayushman Bharat, with telemedicine tools to improve referral advice, seek clarification and undertake virtual training including case management support by specialist. New healthcare models or ecosystem of solutions are being envisioned and implemented
18、 in India which are allowing providers to save time, helping patients to take control of their health data, and forcing healthcare organisation to change their business models to include more personalised treatments. Delivery of care is also being reimagined so that the hospitals move beyond the bri
19、cks and mortar, particularly if the patients are aged or are suffering from chronic conditions. Technological advancements have made it possible for patients to receive care beyond the hospitals, which helps to save both time and money. In future, organisation will compete not only by their ability
20、to manage health data but use it to deliver experiences in real time that are matched to the patients and their needs. The report focuses on forces and lever of changes impacting the healthcare landscape. These forces are likely to demand changes healthcare providers are operating. A timely action t
21、o the changing landscape would enable providers to turn it into opportunities. The report also provides some key pointers on how they can reimagine their healthcare services in their portfolio by understanding the changing care needs of the patients/consumersand build solutions suited to various hea
22、lthcare initiatives being taken up by the government. Elias George Partner and Head Infrastructure,Government and Healthcare KPMG in India 2020 KPMG, an Indian Registered Partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KP
23、MG International”), a Swiss entity. All rights reserved. Executive summary Change is the law of nature and this law applies to businesses running in modern times. Like other industries, healthcare is also approaching towards transformation beyond recognition. Several technological, regulatory, and o
24、perational changes are set to transform the way the public health system works, patients are treated, and private providers operate. In the next decade, the healthcare industry in India is hoping to transform into Healthcare 3.0 with improved healthcare access, focus on the quality of healthcare, us
25、e of innovative diagnostics and treatment methods, improved transparency and patient centered models of healthcare delivery. The healthcare industry in the times ahead will be shaped by many forces, however the critical forces governing the emergence of Healthcare 3.0 in the next decade includes foc
26、us on Universal Health Coverage (UHC) to improve patient access and to prevent catastrophic healthcare expenditures; strengthening of the healthcare system through strategic purchasing, risk pooling and improving the overall delivery; and impetus on digital healthcare to counter the challenges of wo
27、rkforce shortage and operational inefficiencies. These forces are not the only factors demanding a change, the underlying levers of change are also playing their part in changing the landscape of the market. These key levers of change will compel the providers to deliver better health outcomes while
28、 managing changing consumer behaviour. In this paper, we explore the key levers of change and key trends likely to be witnessed in the coming decade. These include: 1. Owing to the emergence of digital disrupted business models, consumer behavior and consumer buying life cycles are rapidly changing.
29、 The same will be witnessed by the healthcare sector with patients turning into smart consumers. Patients will be more aware, participate actively in healthcare decisions, focus more on self -care, demand quick turn-around as well as transparency 2. Healthcare is also set to witness impact of techno
30、logy. Digital health driven transformation will drive plethora of changes, which includes shift to mhealth, AI-enabled care, extensive use of augmented and virtual reality (AR/VR), Use of IoT devices and connected care, advent of medical drones and utilizing technologies such as block chain to bring
31、 more transparency 3. Healthcare providers will also be seen relooking the market and will move towards leaner facilities, focusing on-demand healthcare services, virtual care and digital clinics. Changes in consumer behavior and regulatory landscape will eventually compel providers to change their
32、engagement strategy with patients. 4. The gradual shift from curative to preventive care and advent of technology will also change the way diagnosis and treatment are done. Innovations such as noninvasive and AI based diagnosis, robotic assisted surgeries, gene therapy, personalized medicine and evi
33、dence-based medicine are some of the trends which change the way care is provided 5. Lack of adequate and skilled workforce are amongst the key challenges in the current healthcare system. The newer landscape will witness a close association between healthcare workforce advances in artificial intell
34、igence cognitive computing, deep learning and machine learning. Also, the focus will be on ensuring adequate training to the existing and upcoming lot of workforce in area of handling newer technologies and soft skills 6. Increasing environmental compliance, waste management, price control, reportin
35、g of outcomes, safety and security and other regulatory compliances will remain top priorities for the government and providers. The changing regulatory environment will hugely impact the strategy of the providers to provide services. Understanding the forces changing the healthcare landscape and de
36、vising a clear strategy to act upon it will prove to be a daunting task. To plan for the forthcoming Healthcare 3.0, providers need to kick start their journey and ensure that necessary steps are taken at the right time. For this there is a need to focus on patient experience, investing smartly in r
37、elevant technologies, establishing ecosystem through collaboration, establish an agile but robust governance structure. This document highlights key action points for providers to prepare them for the transformation about to happen in the coming decade. 3 2020 KPMG, an Indian Registered Partnership
38、and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. 2020 KPMG, an Indian Registered Partnership and a member firm of the KPMG network of independent member firms affiliated with
39、KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Forces transmuting Indian healthcare system into Healthcare 3.0 Indian private healthcare sector has played major role in strengthening the Indian healthcare system in the last three decades. During this peri
40、od, it has passed through two significant eras of evolution in terms of Healthcare 1.0 and Healthcare 2.0. About three decades ago, the private sector mainly comprised of a limited number of solo medical practitioners with nursing homes and small hospitals. Availability of secondary and tertiary car
41、e was very limited and largely was served by the hospitals operated by government charitable trusts and religious foundations. This era, Healthcare 1.0, was mainly attributed to limited awareness about healthcare among people and relied mainly on the conventional methods of care. Patients played pas
42、sive role in care models and it was a totally practitioner-led care system. With ever increasing demand of hospital care, skewed geographic distribution of hospitals and dire need of adequate secondary and tertiary care healthcare facilities, several private investors saw a huge growth potential in
43、the healthcare sector. Also, advent of newer medical technology made it difficult for the smaller hospitals and nursing homes to sustain and cater to growing needs. This led to the growth of private hospitals and corporate hospitals backed by private investors. This era, Healthcare 2.0, continues ti
44、ll today and has been witnessing development of world class healthcare infrastructure, investment in advanced medical technology and upskilling of clinicians and paramedics. This era also experienced a large focus on the quality of care and accreditation with a pool of 38 JCI and 615 NABH accredited
45、 hospitals1,2 and more than 180 medical institutes. The Healthcare 2.0 phase experienced hundreds of mergers consolidate multiple intra state schemes; government funded services providers e.g. ESIS, CGHS Railways etc.; incentivisation of voluntary contribution for risk pooling schemes by the non- po
46、or population and enhancing performance as well as standardisation rules of others. 2. Strategic purchasing: Includes defining, standardizing and continuous evolution of all the key elements of engagement between insurers. For strategic purchasing it is important to define the coverage population; s
47、tandardising the contract terms and KPIs for providers; deciding prices for purchase of services for primary care OPD and IPD; independent accreditation bodies for monitoring quality; and standardisation of payment mechanism, costing templates and devising plans for implementation. 3. Health service
48、s delivery: Enhancing the performance of public and private delivery models - to be achieved by developing organisational platform for consolidating small providers, implementing care coordination models across various level of care, providing greater management autonomy to public hospitals; and focusing on incentivisation of hospitals. Recently government also announced setting up hospitals under public private partnership (PPP) mode, especially in aspirational distri