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88 STRATEGY & INNOVATION 5 Forces Reshaping US Healthcare By Kelly Gooch T he $5 trillion U.S. health industry is in the midst of transformative change generated by what PwC de- scribes as a collision of forces. A report, published in September by PwC's Health Research Institute, outlines the five forces driving this transformative change. "Individually, not one is enough to move the entire $5 tril- lion health ecosystem. But acting together, over a decade, they can have significant impact," PwC said. Below are PwC's five forces reshaping healthcare. 1. Rise of consumerism. This in the long-term likely will help grow the market for platforms and support as well as wellness by driving consumers to options that are cheaper, more efficient and convenient, while also helping them get and stay healthier longer, PwC said. "Companies building systems that can handle and analyze these consumer data, and protect them, while offering consumers ways to shop for care and make better health decisions, likely will find fer- tile markets," the report states. 2. Shift from volume to value. This trend, driven by the federal campaign to link 90 percent of Medicare payments to quality programs, and half to alternative payment models by 2018, will likely have the most immediate impact. "This trend, which likely will send shock waves throughout the ecosystem, essentially flips the health industry's economic model on its head. Today's revenue could become tomor- row's expense for healthcare providers, especially for-profit organizations with business models that rely on high utiliza- tion," PwC said. "Organizations are finding burdens related to these quality measures are multiplying." 3. March of technological advances and digitalization. PwC describes technological advances and digitalization as "a looming tidal wave, visible on the horizon as little more than a swell." The firm projects the cumulative effect of major technological advances, such as machine learn- ing and artificial intelligence, 3D printing and the use of digital health data, likely will grow the diagnostics and therapeutics, platforms and support, and wellness mar- kets in the long term. 4. Decentralization of care. This will help encourage con- sumers to obtain care anytime, anywhere, thanks to the spread of virtual care and remote patient monitoring, the embrace of alternate venues for care, the increased use of clinician extenders and the seamless sharing of data among stakeholders, PwC said. The shift remains slow-moving, though evidence of it already can be found throughout the health industry. 5. Surge in interest in wellness. A renewed focuson well- ness and health management could ultimately siphon rev- enues out of the health industry by reducing utilization of treatments and services intended for sicker individuals, PwC said. The firm cites various micro trends around well- ness that are converging, including the hiring of dietitians and nutritionists by grocery store chains and retailers, the popularity of wearable fitness trackers, a detectable shift in the American diet and a flurry of wellness-oriented incen- tives provided by employers, insurers and others. n Hospital & Health System Executive Moves Skiff Medical Center in Newton, Iowa, an- nounced the departure of its President and CEO Brett Altman. Coquille (Ore.) Valley Hospital appointed David Ameen interim CEO. Sarasota (Fla.) Memorial Health Care System named Connie Andersen CNO. Tacoma, Wash.-based CHI Franciscan Health appointed Michael H. Anderson, MD, a re- tired rear admiral, as CMO. Warrenton, Va.-based Fauquier Health President and CEO Roger H. Baker plans to retire in 2017. Lebanon, N.H.-based Dartmouth-Hitchcock's Executive Vice President for Integrated Deliv- ery Systems and Chief Academic Officer John D. Birkmeyer, MD, tendered his resignation. John Buffington, COO of San Juan Regional Medical Center in Farmington, N.M., will re- tire this month. In a move to cut costs, Providence Health & Services in Renton, Wash., eliminated the CEO position at Providence St. Mary Medical Center in Walla Walla, Wash., forcing Steve Burdick to vacate the position. Glasgow, Ky.-based T.J. Regional Health ap- pointed Mei Deng CFO. Poinciana Medical Center in Kissimmee, Fla., tapped Tom Eisel to serve as CFO and Sharon Dillard as CNO. Grand Rapids, Mich.-based Spectrum Health named Darryl Elmouchi, MD, CMO of its hospital group. Gibson Area Hospital & Health Services in Gib- son City, Ill., appointed Matthew Ertel CFO. Mattoon, Ill.-based Sarah Bush Lincoln Health System appointed Jerry Esker president and CEO. Missoula, Mont.-based Providence St. Patrick Hospital CEO Jeff Fee is stepping down from the role at the end of 2016. Appleton, Wis.-based edaCare President and CEO Dean Gruner, MD, plans to retire, ending his 40-year career in healthcare. Concord (N.H.) Hospital tapped Amy Guil- foil-Dumont to serve as CNO. Dallas-based Baylor Scott & White Health ap- pointed James H. Hinton president and CEO, effective Jan. 16, 2017.