- KPMG report outlines route towards better care at lower cost
A major new report, published today by KPMG’s Global Healthcare Practice, examines the challenges facing international health systems, from the perspective of leading practitioners across 22 countries.
Called Something to teach, Something to learn: Global perspectives on healthcare, the report will be central to a debate when 3,000 of the world’s leading health experts gather at the International Forum on Quality and Safety in Healthcare in London this week*.
Shaping discussion on how to improve quality and reduce costs in an increasingly challenging environment, the report argues that the next five to ten years will be critical for health systems around the world as they look for strategies to cope with rapidly growing and ageing populations.
Dr. Mark Britnell, KPMG’s Global Health Chairman, and report co-author, says: “The report and the Forum are both focused on the central importance of sharing learning and best practice between organisations, systems and countries.
“Something to teach, Something to learn is a call to action to think about the deep-seated strategies that will enable health economies to provide better care at lower cost. Powerful examples of how it can be done are out there – we just need to be better at sharing learning.”
Despite the many differences between the various international systems examined in the report, Something to teach, Something to learn reveals a number of striking similarities in the strategies that are beginning to emerge. Key findings from the report lead to the conclusion that:
- A major shift from ‘volume to value’ is reshaping how we pay for and provide healthcare. Health systems are looking for ways to eliminate the ‘perverse incentives’ that reward providers for quantity over quality – the number of treatments carried out rather than the benefit to patients and overall population health improvement.
- The relationship between patients, clinicians, payers and providers is becoming pivotal – it is influencing the shape of services and can deliver significant benefits. Evidence shows that patients often make better (and more cost-effective) decisions about their care when empowered and fully informed of their options.
- Patients are demanding, and being given, more control over their care, putting pressure on clinicians to move their role from ‘G-d to guide’.
These drivers predict a need for transformational change leading to:
- A new breed of ‘activist payers’ (whether governments or insurance companies) reinventing themselves as agents of change by using selective and targeted contracting and demanding that providers rethink their models to come up with more innovative and integrated solutions.
- Providers taking responsibility for outcomes and health improvements. This can mean hospitals adapting by transforming themselves into ‘health systems’ responsible for pathways of care and the health of their entire communities.
- The emergence of more genuine partnerships as providers and payers start to see the quality and cost benefits that can come from effective integration and a focus on outcomes.
Professor Hilary Thomas, Partner, KPMG Management Consulting, says: “The report has uncovered a paradox at work within international healthcare. Leading practitioners acknowledge that major change is inevitable because of rising demand, but too few are actually planning the scale of system reform to cope with it.
“There is a growing consensus that doing nothing is not an option and that now is the time to act if we are to be ready for the challenges ahead. However, many organisations still think they will be able to transact their way out of trouble, by growing, merging or simply altering their focus. The learning we have brought together from around the world indicates that many of them will be wrong.”
Something to teach, Something to learn looks at current international best practice and points to a number of countries where transformational strategies are showing that measurable quality improvement and significant financial savings can go hand in hand.
For example, a revolutionary partnership involving Parkinson’s disease patients in the Netherlands, which involves web-based patient education and streamlined treatment pathways, has led to a 50 percent reduction in hip fractures and £16.3 million (US$25 million) worth of savings.
Something to teach, Something to learn urges all international health economies to ask themselves if their strategies are robust enough to meet the challenges that lie ahead.
It also urges practitioners and policy-makers to look beyond their own systems to see where lessons from other parts of the world could add value.
Maureen Bisognano, President and CEO, Institute for Healthcare Improvement, says: “It’s good to see influential practitioners from around the world taking stock of the enormous trends reshaping healthcare and reaching a consensus that leaders have everything to gain from greater collaboration and shared innovation.
“The rise of rapidly developing economies in Asia, Africa and South America are matched by new visions to improve the health of populations and to deliver high quality care using new technologies and existing resources more efficiently. This work presents healthcare leaders everywhere with new models and huge learning opportunities.”
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KPMG Press Office: +44 (0) 207 694 8773
Notes to Editors
*International Forum on Quality and Safety in Healthcare, ExCeL London Conference Centre, 16-19 April 2013.
KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and operates from 22 offices across the UK with over 11,000 partners and staff. The UK firm recorded a turnover of £1.7 billion in the year ended September 2011. KPMG is a global network of professional firms providing audit, tax and advisory services. We operate in 156 countries and have 152,000 people working in member firms around the world. The independent member firms of the KPMG network are affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. KPMG International provides no client services.
Key pull-out recommendations from Something to teach, Something to learn: Global perspectives on healthcare:
- Organisations will need to be capable of contracting for outcomes and value.
- Finding new ways to connect with and empower patients to influence their behaviour will be crucial.
- An increased focus on the management of overall population health is needed.
- The development of new skills and organisational abilities will be a priority.
- Payers will need to engage with and incentivise providers in new ways to shape their behaviour, and create innovation.
- Radical new transformational approaches will be needed to create integrated health systems, specialist networks or areas of special expertise.
- For many providers, the logic will be to take more responsibility for the whole of the patient journey.
- Investing in leadership will be key, as will the creation of new partnerships with clinical staff.
- Learning from other markets and better use of information to gain strategic advantage will come to the fore.
For health systems
- Payers and providers will need to move away from traditional adversarial approaches.
- Significant structural change will be required, yet the payback for such investment will not be immediate.
- Payers and providers must understand what constitutes value for patients and build this into every process.
- Health systems need to develop new channels to talk to patients and to connect them to each other.
- The best-prepared organisations and systems are investing a significant amount in both teaching and learning as they work towards new ways of operating.
About the report
KPMG brought together 40 experts from leading healthcare organisations, representing 22 countries, in October 2012 to debate the future of healthcare systems and to share learning. The report Something to teach, Something to learn captures the outcomes and perspectives of the participants.
Something to teach, Something to learn: Global perspectives on healthcare co-author Mark Britnell and KPMG Partner Hilary Thomas will be available for print/broadcast interviews. High resolution images are available on request. Interviews with participants from KPMG’s Global Healthcare summit will be facilitated where possible on a one-to-one basis.
Illustrations and case studies
Detailed case studies and interview opportunities are available to illustrate some of the key themes of the report. They include:
- In the Netherlands, health insurer De Friesland Zorgverzekeraar (DFZ) has worked with providers to develop a series of agreed outcome-based ‘care plan’ pathways which are already delivering marked efficiency gains and significantly reduced hospital admissions.
New provider behaviour
- India’s private hospital group Apollo has instigated a large-scale preventative healthcare programme which is improving local access to services for 27 million people, including the delivery of 6.2 million preventative health checks every year.
Patients as partners
- A revolutionary partnership approach involving Parkinson’s disease patients in the Netherlands, which involves web-based patient education and streamlined treatment pathways, has led to a 50 percent reduction in associated hip fractures and more than US$25 million worth of savings.