The report argues that the next five to 10 years will be critical for health systems as they look for ways to cope with rapidly growing and aging populations – threatening their long-term sustainability.
Dr. Mark Britnell, KPMG's Global Health Chairman and co-author of the report, commented: "Each organization and health system will have its own market and regulatory environment to consider but many of the challenges they face are common ones. There should be no excuse for lack of urgency and the only option not on the table is doing nothing."
Key findings from the report include:
The 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 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 'God to guide'.
These drivers predict a need for transformational change leading to:
A new breed of 'activist payers' - whether governments or insurance companies - are 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 entire pathways of care and the health of their communities. The emergence of a more genuine form of partnership as providers and payers start to see the quality and cost benefits that can come from effective integration and a focus on outcomes.
"Rapid and revolutionary health system improvement is the new global reality," said Dr. John E McDonough, DPH, MPA, Professor Director, Center for Public Health Leadership, Harvard School of Public Health. "Any nation thinking that it's 'just me' misses the point "Something to Teach, Something to Learn" drives home. Compelled to change, payers, providers, patients, and health systems are abandoning the status quo for real value and true accountability. Continuous system improvement is the new normal, and those who believe it is 'just them' should read "Something to Teach" to grasp this essential truth."
Some health economies have already started to respond to the changing environment by developing new ways of working. For example, a revolutionary partnership involving Parkinson's patients in the Netherlands, which uses web-based patient education and streamlined treatment pathways has led to a 50 percent reduction in hip fractures and US$25 million worth of savings.
Others have been slower to appreciate the scale and urgency of the situation and could face uncertain futures, the report argues.
In spite of the differences between national systems, Something to teach, Something to learn identifies a number of common drivers shaping healthcare and calls for the start of an international dialogue to share lessons and best practice from around the world.
Dr. Britnell said: "The report uncovers 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."
Something to teach, Something to learn examines current international best practice and points to several countries where transformational strategies are showing that measurable quality improvement and significant financial savings can go hand in hand.
He added: "Transformation on the scale required in many health systems will not be easy, which is one of the reasons there is a continued focus on transactional approaches. Real change is hard, risky and painful. "Leaders will need to take a leap of faith to succeed in shifting the focus from short-term delivery to long-term ambition. They should share and learn with their international peers. They will need to empower their people and allow their organizations to innovate and experiment to create new models of care." Something to teach, Something to learn urges all national 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 commented: "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."
Dr. Britnell concluded: "The report is a call to action for organizations to think about the deep-seated strategies that will enable them to provide better care at lower costs. Powerful examples of how it can be done are out there – we just need to be better at sharing learning."