Managed Care - August 2012 - (Page 32)

Health Care Reform in England – Commercial Opportunity Or Another False Dawn? While the United States has been in turmoil over how to tame its excessive health care bill, the Brits have their own problems — different, but in some ways the same B By Robert Royce, PhD ack in 2000 I wrote an article for Managed Care (“Health Care Reform in the U.K.: Managed Care by Another Name”) charting the health reforms then taking place in the United Kingdom. That article (Royce 2001) considered whether there were going to be any opportunities for cross-Atlantic learning and whether those reforms might generate commercial opportunities for U.S. companies. Some 12 years have passed, and during that time both countries have undergone more than their fair share of attempted health reform, but perhaps unsurprisingly the problems that were uppermost on people’s minds 12 years ago remain largely unresolved. In the U.K. this is despite a reform process that might be neatly summarized as “rolling restructuring” (some might consider such upheaval forms part of the problem rather than helping to bring about a solution). This article does not attempt to capture the U.S. health reform process; I leave that to braver correspondents. A perennial feature of health reform in the U.K. is that any change of substance is necessarily politically driven. The National Health Service (NHS) remains inextricably bound up with national and local politics, and market signals are largely mediated through a political lens. In 12 years the percentage of NHS services provided by the private sector has increased; for example, NHS patients using private facilities now account for a quarter of private hospital income compared to 14 percent in 2005, and the independent acute sector is estimated to have treated around 425,000 NHS patients in 2010 (Hospital Episode Statistics 2010–2011). However this must be set in the context of NHS activity in the same year, which exceeded Asking the question Instead I have taken the opportunity to revisit some of the issues from the 2000 review, consider the latest U.K. health reforms, and once again ask, “Is this managed care by another name and will these reforms generate commercial opportunities for U.S. companies?” The author has worked extensively in both the National Health Service and the U.K. private health care sectors. Currently he is director of strategy at Barking Havering and Redbridge University NHS Trust. He has a research PhD on the dynamics of the U.K. private health care industry. 32 MANAGED CARE / AUGUST 2012

Table of Contents for the Digital Edition of Managed Care - August 2012

Managed Care - August 2012
Editor’s Memo
Legislation & Regulation
News & Commentary
Medication Management
Evidence Review
Compensation Monitor
Private Exchanges: Practice Makes Perfect
Hospitals and Providers Ganging Up on Plans?
Q&A: Kaiser Permanente’s Sharon Levine, MD
God Save the Health Care System!
Future Points to Greater PBM/Plan Cooperation
Formulary Files
Plan Watch
Tomorrow’s Medicine

Managed Care - August 2012