Part of what makes the healthcare industry massive and daunting from a business standpoint is the industry stakeholders’ being not just your typical buyer-seller-supplier combo. The several enormous healthcare industry segments include patients, providers (e.g., hospitals, labs), prescribers (e.g., physicians, clinics and pharmacy clinics), pharmacy, pharmaceutical and medical equipment manufacturers, regulators, and payers (e.g., Medicare and insurance companies). Several of these segments represent separate immense industries on their own (e.g., drug, insurance, and medical device industries). On top of this, federal and state laws and regulations impose strict requirements regarding what can be sold, how products are to be evaluated, who is going to pay for which services, who is eligible for which benefits, who can practice where, etc.
But the very same stupefying complexity and multiple maladies suffered by the industry make it a very fertile soil from which much-needed innovations can germinate. Improvements within the healthcare industry is estimated to provide revenue growth opportunities worth more than $500 billion. Achieving this will require a multi-pronged approach that targets the industry’s multiple problem areas and its many segments. In fact, the industry is already undergoing many transformations pushed by the government and various industry segments through combined approaches designed to put the industry in order.
In this report, we take a look at the issues and challenges that the US healthcare industry is facing.