The top issue plaguing the healthcare industry is the economic downturn, according to a report issued by PricewaterhouseCoopers in December.
The traditionally recession-proof healthcare industry will experience increased bad debt and decreases in elective procedures, the Top Nine Health Industries Issues in 2009 report noted.
The trend of hospital systems laying off varying percentages of their workforce will continue to escalate, said Brett Hickman, national leader of PricewaterhouseCoopers Health Industries Strategy & Planning Practice.
By 2025, the healthcare system's patient volume, particularly in the ambulatory market, is projected to triple while cost remains the same, he said.
Despite the grim projections, Hickman said that evidence-based medicine, or EBM, is the "savior" that can reduce costs, as well as create capacity and access.
The American Heart Association's guidelines for stroke (through the American Stroke Association, a division of AHA), cardiac disease and heart failure are shining examples of "driving true disease management," he said.
AHA's 1,400 pilots, which have implemented its hospital-based quality improvement programs, have shown between 25 to 30 percent improved outcomes and 19 to 24 percent reduction in costs, Hickman said.
AHA is a "huge advocate" of these quality improvement programs through EBM because "it's the right and smart thing to do," he said. AHA heavily subsidizes the implementations because the cost savings can run up to a million dollars on an annual basis.
The programs are up and running, so hospitals, especially those that don't have initiatives in place, can implement them without having to reinvent the wheel.
Hospitals and physicians need to be aligned and physicians incentivized in order for standardized pathways and protocols to be designed for better outcomes, noted Hickman. "We need to build better delivery models for the different disease states," he said.
While EBM and disease management gets us to the "top of the mountain," Hickman believes wellness programs will get us "over the mountain."
Following other European countries, France banned smoking in public places last January. Hickman noted that in under a year's time the country has seen more than a 20 percent decrease in cardiac admissions and less than a 30 percent incidence of cancer.
While the United States is unlikely to institute a nationwide public policy, it can drive change through wellness initiatives.
U.S. hospitals may be challenged in a tenuous economic environment, but EBM and wellness programs can help them deliver and provide better care and access in a safe environment, Hickman said.