Healthcare trends shape industry landscape in 2015

In the January 2015 issue, Drug Store News took a look at three issues outlined in the annual PricewaterhouseCoopers’ Health Research Institute “Top Health Industry Issues of 2015,” including the delicate dance that will take place between balancing privacy and convenient access to healthcare information; the Food and Drug Administration’s increased oversight of mobile health apps; and how DIY diagnostic tools are taking shape in today’s retail environment.



In this issue, DSN looks at another three hot spot issues identified by PwC’s HRI that will help define how health care is provided in 2015. For example, the number of newly insured patients as a result of the implementation of the Affordable Care Act will have significant implications across the healthcare landscape. PwC also takes a look at how healthcare professionals like nurse practitioners and pharmacists can serve as physician extenders to address the shrinking physician pool even as the number of patients expands considerably. Finally, while the aging of the baby boomers will continue to have an impact on how health care is administered in the United States, another generation of consumers — millennials — are coming of age and are beginning to shape the delivery of healthcare in meaningful ways.

Newly insured account for nearly 10 million

A significant number of the newly insured under the Affordable Care Act have been generated out of expanded Medicaid rolls. A recent analysis by HRI found double-digit increases in Medicaid admissions among the three largest health systems in states that expanded the program. And though the Medicaid population is expected to continue to grow in 2015 as more states expand their programs, it’s the implementation of the individual mandate penalty that may help redefine who exactly the newly insured are.



Early research suggests that the remaining uninsured are likely younger and healthier than those who have already purchased coverage. “Many of these people are accessing health insurance coverage for the first time, so they really are brand new customers that the insurance industry, as well as the provider community, are trying to learn a lot about in a relatively short period of time,” said Ceci Connolly, leader of PwC’s HRI.



Indeed, it’s the demographics of these newly insured that is beginning to garner attention. “Several very reputable counts put the number of newly insured just in the past year at about 10 million people,” Connolly said. “And that by the way does not include 6 million young adults between the ages of 19 and 34 who also have gained coverage,” she said, adding that millennials are the largest of any age group that have gained coverage through the ACA.

Retail pharmacy role to expand as physician extenders

Between the expanded role played by pharmacists in providing vaccine shots and administrating comprehensive medication therapy man-agement/disease state management programs, and the rapid expansion of retail clinics that is expected throughout 2015, retail pharmacy is set to play a significant role as physician extenders.



And America is ready for it.



“Very strikingly, many consumers, about 75%, told us that they’re very interested in getting more of their care from a group known as extenders,” said Ceci Connolly, leader PwC HRI. “These are non-physician clinicians — people such as nurse practitioners, pharmacists, physician assistants — who can do quite a bit of care delivery.”



What’s more, America’s governors are calling for it. The National Governor’s Association in mid-January issued a report calling on states to better integrate pharmacy practice into the healthcare system. “As the healthcare system undergoes a major transformation in both finance and the delivery of services, states are focusing on improved quality and health outcomes,” stated NGA executive director Dan Crippen. “Integrating pharmacists, who represent the third-largest health profession, into the healthcare delivery system is one way to meet those goals.”



According to HRI, more than half of states were weighing expanding the clinical duties of nurses, physician assistants, pharmacists and other healthcare professionals by the end of 2014. In three states — New Jersey, Pennsylvania and Michigan — bills were in play to expand the role of nurse practitioners toward the end of 2014. In 2015, another dozen states are expected to introduce or reintroduce similar legislation, HRI noted.



These efforts follow in the footsteps of such states as North Dakota, which is extending pharmacist roles into telepharmacy, as well as Indiana and Vermont, which opened their first nurse practitioner-led primary care practices in 2014, according to HRI. And in late January, bipartisan legislation had been introduced in the U.S. House of Representatives, The Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592), that would formally designate pharmacists as healthcare providers under Medicare Part B.

Millennials to redefine health care

The baby boomers may very well have redefined the breadth and scope of health care, leading retail pharmacy down the road of expanded healthcare roles in an effort to accommodate a growing population of patients with chronic conditions in the face of a shrinking provider base. But it is millennials that will redefine the face of health care, in other words, how that health care is delivered.



In 2015, the U.S. Bureau of Labor Statistics predicts millennials will be the majority in the U.S. workforce, and by 2030 they will make up 75% of it, causing employers to refocus their employee benefit strategies.



According to HRI, the children of baby boomers, the nation’s 80 million millennials who were born between the early 1980s and the early 2000s will help propel a New Health Economy that advances beyond health care to support a broader market of good health and well-being. HRI has calculated that Americans already spend more than $267 billion a year on health and wellness.



That bodes extremely well for retail pharmacy, which serves as the quintessential healthcare depot with products and services addressing everything from acute care and management of chronic conditions to the aspirational goal of better health through optimal nutrition and disease prevention.



“The new entrants will continue to be disruptors around this category because they’ll think differently,” noted Karla Anderson, partner Pharmaceutical and Life Sciences, PwC. “We’re seeing it with the adoption of wearables and monitoring across all the major disease areas and we believe we’ll continue to see this in a profound way going forward.”