Prof. Liu gives an overview and insight into the healthcare system of China.
3 periods, 1949-1978, 1978 - 2008 and 2009 till now. They spend 17x less then the USA and have the same life expectancy. What can we expect in terms of innovation? A thorough view..
Sales & Marketing Alignment: How to Synergize for Success
China & asia health systems Prof. Dr. Chang liu
1. Our vision is that all people, no matter where they
live, have a right to access high quality, affordable
healthcare and to lead healthy and productive lives.
Chang Liu
Beijing 2018.11
Health Systems in
China and Asia
Pacific
Delivery System Reform, New
Financing Models, and Digital
Revolutions
2. As a “Global Health Innovation Partner” ,
ACCESS Health International focuses on building
networks and generating knowledge for health
and aging innovation.
OUR VISION
WHO WE ARE
All people, no matter where they live, no matter what their age, have
a right to access high quality and affordable healthcare.
LOCATIONS
Mainland China
Hong Kong (China)
Singapore
United States
Sweden
Netherland
India
Philippines
3.
4. • Health systems in China and Asia Pacific:
Rapid aging, Stressed systems, Funding gaps
• Trend 1 System transformation: towards more patient centered/ integrated care
• Trend 2 Disruptions with new technologies and digital solutions
• Trend 3 Innovative financing models through partnerships
6. Demographic Challenges
• The number and
proportion of highly
disabled elderlies are
rising.
0
5.000
10.000
15.000
20.000
25.000
30.000
35.000
40.000
45.000
50.000
2010 2015 2020 2025 2030
Persons
Year
5-7 ADL limitations
3-4 ADL limitations
Source: Ansah JP, Matchar DB, Love SR, et al. 2013.
1-2 ADL limitations
7. Demographic Challenges
• The number and
proportion of highly
disabled elderlies are
rising.
• Family are getting smaller
Source: Ansah JP, Matchar DB, Love SR, et al. 2013.
1-2 ADL limitations
1
2
3
4
5
6
7
2011 2014 2017 2020 2023 2026 2029
Children
Year
Age 60 Age 70 Age 80
8. Demographic Challenges
• The number and
proportion of highly
disabled elderlies are
rising.
• Family are getting smaller
• More caregivers will have
significant depression
attributable to caregiving
Source: Malhotra C, Malhotra R, Østbye T,,et al. 2012.
1-2 ADL limitations
0
2000
4000
6000
8000
10000
12000
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030
Individuals with depression
attributable to caregiving
Individuals with depression
irrespective of caregiving
9.
10. The Regional Challenges in
Health Systems
Rapid aging
Stressed systems
Funding gap
04
6AM at a public hospital
11. Achievements before 1980
During the period between 1950 to 1978, China had many achievements in health field to
be proud of:
• Achieved rapid and large reductions in mortality rate, despite China’s low income per
capita at the time
• Created a low cost, wide coverage primary health care model
12. Unsatisfied development after 1980
After 30 years of economic reform, China’s healthcare system has not improved as well
as the economy has. Instead, it has deteriorated in many aspects:
• Medical costs are escalating rapidly
• The relationship between patients and doctors are deteriorating
13. The GHE decreased since the late 1980s and
has returned to increase since the early 2000s
( SARS in 2003).
Source: Chinese Health Statistics Yearbook 2011
Market reform in health sector: 1985 SARS, New reform (NCMS): 2003
Healthcare expenditure and reforms
13
14. Chinese Healthcare Reform Phase I
• Speed up the establishment of a universal health insurance system
• Set up an essential drug system
• Improve the primary health service network
• Provide equal access to public health care for urban and rural
residents
• Public hospital reform
14
16. The Regional Challenges in
Health Systems
Rapid aging
Stressed systems
Funding gap
Source: New funding models for cancer treatment in Asia report by ACCESS Health International
19. • Health systems in China and Asia Pacific:
Rapid aging, Stressed systems, Funding gaps
• Trend 1 System transformation: towards more patient centered/ integrated care
• Trend 2 Disruptions with new technologies and digital solutions
• Trend 3 Innovative financing models through partnerships
20. Health Systems Transformation
Keywords:
Connected & integrated
People-centered
High quality
Value-based
Affordable
Sustainable
Trend 1 System transformation: towards more patient centered/ integrated care
21. Health Systems Transformation
Keywords:
Connected & integrated
People-centered
High quality
Value-based
Affordable
Sustainable
Polyclinic
Specialty
Outpatient
Clinic
Acute
Hospital
Community
services
General
Practitioner
Service
integration
Transitional
care
Community
Services
General
Practitioner
Polyclinic
Specialty
Outpatient
Clinic
Acute
Hospital
Enhanced
Community
services
Self-care
Family
Medical
Clinic/
Community
Health
Center
Population health and disease prevention
Post acute care and disease management
The Singapore Model
Trend 1 System transformation: towards more patient centered/ integrated care
22. Pilot programs and national reforms for integrating hospital care, primary care and post-
acute care
Linkage
Coordination
Integration
National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases
and Stroke
• To enhance referral and communication between hospital and primary care systems
• No structural change of existing organizational units
India
Philippines Kalusugan Pangkalahatan (a universal healthcare scheme)
• To improve care coordination among various parts of the health system
• Adoption of common technology standards and provision
Singapore Regional Healthcare System model
• To better integrate primary, intermediate and long-term care services
• Agency for Integrated Care established in 2009
• Transformation office in MOH
China Medical Consortium model
• To coordinate public tertiary hospitals, secondary hospitals and community healthcare centers
• Through clinical information sharing and transition management
Intensity
Source: Integrated Care study in Asia by ACCESS Health International supported by WHO
Trend 1 System transformation: towards more patient centered/ integrated care
23. China: “Healthy China 2030”
中国 《健康中国2030》
Singapore: Action Plan for Successful Ageing
新加坡 《成功老龄化行动方案》
China: promote “Hierarchical Medical System”
《国务院办公厅关于推进分级诊疗制度建设的指导意见》
Source: Integrated Care study in Asia by ACCESS Health International supported by WHO
Trend 1 System transformation: towards more patient centered/ integrated care
24. Hong Kong 2030+
香港 《香港2030+》
Other regional policies
Source: Integrated Care study in Asia by ACCESS Health International supported by WHO
Trend 1 System transformation: towards more patient centered/ integrated care
25. • Health systems in China and Asia Pacific:
Rapid aging, Stressed systems, Funding gaps
• Trend 1 System transformation: towards more patient centered/ integrated care
• Trend 2 Disruptions with new technologies and digital solutions
• Trend 3 Innovative financing models through partnerships
27. Life style and wellness
Safety and access
Finance
Rehab/Care
Health Management
Medical care
Demand side
Categorization
Supply side
Categorization
Services
Products
Channels
Training
ACCESS Health International
Trend 2 Disruptions with new technologies and digital solutions
28. Source: Goldman Sachs Global Investment Research
Trend 2 Disruptions with new technologies and digital solutions
29. Digital Health and Health Tech
Booming in China and ASEAN
More Players
Categories Examples
Tech MNCs
IBM Watson, Microsoft
Intel, Google, Apple
Asian Leading Tech
Companies
Tencent, Alibaba, Baidu
Grab, Didi
Insurance and Fintech
Pingan Insurance, Metlife, Mercer
Zhongan Technology, Ant Finance
Telecom China Mobil, Singtel
Distributors Shanghai Pharma
Startups
Chunyu, Almond doctor, Linkdoc, Medilink
Practo, Mydoc, Allied World Healthcare, Possible
Health, ThinkMD
Selected Digital Health Players in China and ASEAN
Trend 2 Disruptions with new technologies and digital solutions
30. Digital Health and Health Tech
Booming in China and ASEAN
More Players
More enablers/
More collaborators
Categories Examples
Health data companies
China Electronics, China Mobil,
Shenzhou Data, YiduCloud
Technology platforms
Xiaomi, Cisco, Qualcomm
Apple, Intel, Microsoft, Huawei
Insurance companies
Taikang, Pingan, Zhongan Insurance
SwissRe, Metlife, Mercer
Pharma
Pfizer, Novartis, Lily, Sanofi
MSD, Bayer
Distributors China Pharma, Zuellig Pharma
Service provider groups
Regional health systems in Singapore, Medical
consortiums in China, Private hospital groups
Selected Enablers and Collaborators for Health Tech Solutions
in China and ASEAN
Trend 2 Disruptions with new technologies and digital solutions
31. Digital Health and Health Tech
Booming in China and ASEAN
More Players
More enablers/
More collaborators
More supportive
Policies
More business (models)
Selected Policies on “Internet+ Healthcare” in China
Trend 2 Disruptions with new technologies and digital solutions
32. Health and Wellness
Wearable
Disease Management
Registration
Cloud Hospital
Telemedicine
Physician
Communications
Information
Education
Genetic Screening
Health Screening
Online Pharmacy
E-Insurance
E-Payment
Imaging
AI
Software
Big Data
…
33. Possible Health is a non-governmental
organization that delivers healthcare through
public-private partnership agreements with
the Government of Nepal.
17
New technologies and digital solutions to support delivery model reform
34. • Health systems in China and Asia Pacific:
Rapid aging, Stressed systems, Funding gaps
• Trend 1 System transformation: towards more patient centered/ integrated care
• Trend 2 Disruptions with new technologies and digital solutions
• Trend 3 Innovative financing models through partnerships
35. • “Strategic”
• payment systems that create deliberate
incentives
• selective contracting
• quality improvement and rewards
• price and quality maker
Strategic
Trend 3 Innovative financing models through partnerships
Public payers: moving from passive to strategic purchasing
• To align incentives
• To optimize limited resources
• “Passive”
• resource allocation using norms
• little/no selectivity of providers
• little/no quality monitoring price and
quality taker)
Passive
36. Country Agencies and Initiatives
China Gates foundation, NICE
China HTA Center
China Health Insurance Bureau
Singapore Agency for Care Effectiveness;
CoRE at Duke NUS
Thailand Health Interventions and Technology Assessment Programme (HITAP)
Philippines Department of Health – HTA Taskforce
Regional initiatives Asia-Pacific Regional Capacity Building for HTA (ARCH) Initiative
HTAsiaLink (Thailand, Taiwan, Korea)
Trend 3 Innovative financing models through partnerships
Public payers: moving from passive to strategic purchasing
Private payers: more players from diversified background
• Insurers / Reinsurers / Digital Insurers
• Brokers / Insurer Tech Companies
• Technology Companies / Health Data Companies / Distributors / Health Services Providers
37. “Our research reveals that out of the 38 innovative models identified, 74% are partnerships.” —— ACCESS Health Study on
innovative cancer financing models
Partnership Examples
Public private partnerships “My Child Matters” program, Sanofi and the government of Philippines
(the Philippines)
Cross industry partnerships Between Pharmaceutical or health diagnostic companies and private
insurers (China)
Nonprofit-Private partnerships Dr. Reddy’s “Sparsh “program (India)
“Ating Didbin” program (the Philippines)
Government-International
organization partnerships
the HPV initiative (Vietnam)
the “Vajpayee Arogyashree scheme” (India)
Source: New funding models for cancer treatment in Asia report by ACCESS Health International
Trend 3 Innovative financing models through partnerships
38. Health systems in Asia Pacific: the regional challenges
Rapid aging, Funding gaps, Stressed systems
Trend 1 System transformation: towards more patient centered/ integrated care
Trend 2 Disruptions with new technologies and digital solutions
Trend 3 Innovative financing models through partnerships
Opportunities:
Develop more holistic and people centered service packages
Embrace digital health and innovative health technologies
Prepare for payment reforms and explore new partnerships
39. Health Futures Innovation Platform
bringing together partners from across
sectors to envision healthcare of the
future, one that is connected, people
centered, value based, affordable, and
accessible.
Health Futures
Innovation Platform
40. Our vision is that all people, no matter where they
live, have a right to access high quality, affordable
healthcare and to lead healthy and productive lives.
Chang Liu
Beijing 2018.11
Health Systems in
China and Asia
Pacific
Delivery System Reform, New
Financing Models, and Digital
Revolutions