Private Health in Emerging Markets: 2030 Forecasts

The role played by the private sector in strengthening health systems will be further cemented this decade as governments look to it more for support in implementing public policy goals. Until now the private sector has tended to fixate on certain types of health service provision but in the future it will need to take a broader perspective, developing different business models that align to evolving market dynamics and with improved reach to broader population groups.

The following are specific areas where I expect to see an enhanced role for the private sector:

Health Systems—less silo thinking, more robust partnerships between the public and private sectors. The worldwide push for universal health coverage (UHC) will have a knock-on effect—and many potential benefits—for the private sector. The path to UHC must be approached from the perspective of the overarching health system rather than, as often happened before, a scattered and poorly-integrated series of programs.

Social Health Insurance—drawing on innovative private sector business models. Some countries will be implementing comprehensive National or Social Health Insurance programs (watch Egypt and South Africa), while others will be tweaking theirs for improvement (watch Georgia and Indonesia). Most will need to address funding shortfalls and reform how benefits are designed with a view to providing better value for money. The private sector has developed models that can inform and inspire this process.

Private Health Insurance—greater penetration, more emphasis on active population management. The next decade will see a major uptick in government-run health insurance programs. While it will vary from country to country, in general, the role of private and corporate health insurance will also increase. Currently, this is a relatively immature segment in most emerging markets, with little active management of care or coordination of services to align with patient needs. Expect this to change, with big data a major factor.

Payment Models—the slow (and welcome) death of fee-for-service. There will be a significant rise in the use of payment models that are based on patient volumes and a sharing of risk. Private sector operators will need to adapt their businesses to work better with low-cost, high-volume models, with a sharper focus on measuring quality and outcomes. In some markets, the era of health care providers dictating the choice of care purchase will end. Robust data analytics will facilitate a better quality of care.

Quality and Outcomes—a broader embrace of health service quality. Both the purchasers and providers of health services will appreciate more the importance of quality in health care. There are many, many holes to be plugged in this area. The goal is for patients to have access to a system where all elements are underpinned by quality, including the clinical experience, administration, facility management, and staff training.   

Public-Private Partnerships (PPPs)—reimagining what they can be. PPPs have received some negative press over the years and at times understandable. In part, this stems from an overly-narrow conceptualization of what a PPP can be. It can mean so much more than a large-scale infrastructure project. Expect the space to transcend the traditional, procurement-based PPP and delve into the realm of what may more accurately be described as Public-Private Collaborations encompassing service provision, supply chain management, and operational delivery of social health insurance. 

Health Services– the expanded use of out-of-hospital settings. Countries are rightly focusing on bolstering their primary care segment. At the same time, due to underinvestment and poor planning, many hospital systems are failing to meet the soaring demand created by a surge in noncommunicable diseases. The right path forward is greater use of out-of-hospital services where appropriate, harnessing telemedicine to expand primary care, and overhauling the diagnostics space to improve access and speed up response times. Coordinated service planning is key to achieving these reforms.

Big Data—greater use, more integration, more regulation. The potential of artificial intelligence-powered health data analytics gets hyped a lot. Yes, it is essential and does offer significant benefits. But you must make sure to collect the right data, and those collecting the data must clearly know why they are doing so! Another challenge will be preventing the proliferation of data silos, where data is not shared because it can potentially mean a loss of financial benefit to those that hold it.

Digital Health—benefiting the many, not the few. Digital solutions will be more readily embraced and understood by all health professionals. Care processes will be rewritten, when relevant, to tap digital health solutions more. In this process, it will be useful to give ourselves a clearer understanding of what we mean when discussing digital health. Is it just consumer-facing products, or does it also encompass cutting-edge technologies being built into restructured clinical care procedures to create more effective clinical decision making?

Staffing–greater focus on expanded training of health professionals and operational managers. Estimates vary but we have perhaps a shortfall of eight million health professionals in emerging markets. If this problem is not addressed urgently, it will significantly undermine efforts to strengthen systems and improve service delivery. We need to see the broader use of the private sector to develop and provide necessary training. In addition, there will be greater use of digital solutions to support service provision and offset human shortages where appropriate.

Two trends not in the forecast deserving of ‘honorable mentions’ are the rise of a more informed and demanding patient and their family, especially in the middle-income segment, and an impending tidal wave of requirements for senior care as populations age. More on the latter in a separate article!

So, there you have it. My series of forecasts for the next decade. Hopefully, we will realize many of them. From IFC’s perspective, we will work to advise and invest in many of these areas to positively contribute to an ever-growing need for improved access to affordable, timely-coordinated care.

Keep up with the latest on private health care in emerging markets by following the IFC Health LinkedIn showcase page.