Cirujano Dentista

Bending the Cost Curve Emerging International Best Practices

15–16 November, 2011 Singapore Proceedings Report

The views and opinions expressed in this document are those of the roundtable participants and not necessarily of the speakers. All comments were made off-the-record.

Introduction

On 15 November, 2011, PwC, in conjunction with sponsoring organisations – Duke-NUS GraduateMedical School Singapore, McGill University and The Nuffield Trust – convened the third in a series of four symposia called Bending the Cost Curve: Emerging International Best Practices. The symposia are being held on four continents in 2011 and 2012. The objective is to bring together the world’s leading healthcare experts to explore the common challenges of containing healthcare costs, improvingaccess and quality, and disseminating emerging best practices among global healthcare leaders.

1

The story so far

Our inaugural symposium was held in February 2011 in Washington, DC, with a keynote speech by Kathleen Sebelius, Secretary of the US Department of Health and Human Services. In June 2011 the stage then moved to Amsterdam, the Netherlands, where the proceedings were introducedby The Right Honourable Alan Milburn, former Secretary of State for Health with the British Labour Party. For the November 2011 event in Singapore the audience was addressed by Mr. Gan Kim Yong, Minister for Health, Singapore. The format of each symposium has been a full-day roundtable discussion where five innovative case studies were presented that successfully met the challenge of cutting costsor increasing access. Cases were intentionally chosen from outside the host countries in an effort to expose roundtable participants to new models and spark a candid debate. Across the first two symposia a number of important themes emerged from the case studies and subsequent discussions: • Leadership: The clinical transformation necessary to meet twenty first century demands can be achievedthrough strong, agile and intelligent leadership to navigate the complex political and economic environments • Integrated care: Integrated delivery systems can bring greater value to stakeholders, but such transformation requires significant change management to modify practices and re-orient incentives

• Public-private partnerships (PPPs): New types of PPPs are now being designed to fund clinicalservices in addition to infrastructure and facility maintenance. However, in many countries this requires a leap of faith that is not yet politically viable • New business models for primary and chronic care: New, technology-dependent business models are needed to tackle chronic illness management and primary care; these models should extend beyond the medical profession • Re-thinking healthcarecompetition: Price competition alone won’t bend the cost curve without reimbursement and payment reform • Measurement: As healthcare delivery ‘industrialises’, measurement should not simply be based upon quotas but on outcomes and prevention, and health systems will need a better balance between empirical, population-based studies and more precise, personalised models • Data analytics: Ashealthcare delivery follows other industries into the digital age, it must manage and filter an overwhelming volume of data, in the process improving the ‘signal-tonoise’ ratio. This doesn’t just apply to clinicians and institutions, but to patients and their families accustomed to having information at their fingertips, who expect real-time responses

2

Bending the cost curve

In the thirdsymposium in Singapore, further themes surfaced: PPPs cannot work in isolation Examples in Valencia and Lesotho show that patients will be attracted in droves to shiny new facilities, which can quickly lead to over-demand, stretching resources and threatening the cost model. Strengthening and integrating the wider healthcare system will help balance primary, secondary and tertiary care and filter less...