Whether state-run, federally run, or state-and-federally run, healthcare exchanges fundamentally shift the way healthcare is offered. It's this reason that HRI lists State's on the frontlines of the Affordable Care Act" as its number one issue for the industry this year.
The two other issues that appear on HRI's list from 2012 are population health and the pharmaceutical industry, though the concerns are different. On last year's list, population health was seen as a core reason for systems working together, namely Highmark's investment in West Penn Allegheny Health System and Optum, which bought into a company managing 2,300 physicians.
This year, population health remains a focus because PwC predicts more collaboration between insurers and providers in 2013.
In the pharmaceutical industry, HRI's report states the industry is poised for reimbursement challenges:
"Though pharmaceutical and medical device companies play a pivotal role in health outcomes, they will have to prove it to earn it by demonstrating their value and comparative effectiveness."
Other issues to watch in 2013, according the HRI, include changing consumer behaviors, the medical device tax, and caring for the dual-eligible population. The full report may be downloaded from PwC's HRI website.
Also included in the report is a survey of 1,000 consumers on a range of healthcare topics including what 50% believe is the biggest obstacle to improving the U.S. healthcare system: politics. More than half—60% rank doctors as "the best hope" to improve the nation's system, ahead of hospitals and insurance companies.