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What Reform Means for "Client X"--and You

Some critics of health care reform are skeptical that it will force the health care industry to change its behavior. But at least one informed source is saying otherwise.

The source is the world's most famous consulting firm, McKinsey and Company. As I report in this week's print edition, over the summer McKinsey prepared an internal document assesing the impact of reform on different sectors in the health care industry.  The document is a powerpoint presentation, addressed to "Client X," and appears to be a template that the firm's consultants can customize for different clients. (A McKinsey spokesperson would say only that "Client X" is not a real client--that the document was for internal guidance.)

Although the presentation is dated August, a time when health care reform's very survival was in doubt, it predicts that reform will pass and that it will look a lot like what's since come out of the Senate Finance Committee--two predictions that look awfully good right now. It also predicts that reforms will force changes in the health care industry, often in ways that reward innovation and quality.

We've uploaded three of the slides: 

One with an overview...

one sketching out the impact on hospitals...

and one predicting the impact on the drug and device industry. 

(You can see full-size versions here, here, and here.)

The drug industry slide is of particular interest, since it suggests the drug industry could take a serious hit--something the drug industry itself has been claiming for a while.

Skeptics (including me) have disagreed. And there's still reason to think we are right, at least in part.

For one thing, if you look at the bottom of the slide, you'll notice that the prediction is based in part on then-current projections from IMS Health. But, as I reported recently, IMS Health recently revised its own assessment. Where once it predicted (mildly) negative growth for the drug industry, it's now predicting positive growth.

In addition, it's in McKinsey's self-interest to hype changes to the marketplace because it's in the business of selling advice on how to cope iwth marketplace changes.

Still, companies pay McKinsey because they've learned to trust its judgments. And, broadly speaking, the predictions that reform could force at least modest changes to the business of health care are consistent with what plenty of outside experts think.

Of course, McKinsey's assessment also suggests that the entire health care industry--including the drug makers--will survive these changes and, in many cases, do quite well. That suggests there's room to push even harder in the direction of higher quality and better prices, if only the political will could be found.

Update: Sorry for the broken links. I've fixed them. I think.