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Reforming
Healthcare
PAUL YOUNG CPA CGA
JULY 28, 2020
Paul Young - Bio
• CPA, CGA
• Financial Solutions
• SME – Risk Management
• SME – Close, Consolidate and Reporting
• SME – Public Policy
• SME – Financial Solutions
• SME – Supply Chain Management
• SME – Business Strategy and Restructuring
Contact information:
Paul_Young_CGA@Hotmail.com
Agenda
 Global Healthcare spending
 Efficient Healthcare Countries
 OECD and Healthcare
 USA – Healthcare Waste
 Canada and Healthcare Waste
 Automation / Healthcare
 Performance Audits
 Forecasting / Solution
Introduction
 Healthcare is key area for government as it is
large government expenditures
 Too many people do not grasp there are issues
with healthcare delivery
Global
Healthcare
Spending
SOURCE - DELOITTE
Efficient Healthcare Country Ranking
Source - http://worldpopulationreview.com/countries/best-healthcare-in-the-world/
OECD and
Healthcare
Funding
SOURCE – FRASER INSTITUTE
USA Waste and Healthcare
Source -
https://www.cfo.com/health-
benefits/2019/10/annual-waste-in-
u-s-healthcare-system-nears-1-
trillion/?utm_campaign=CFODailyAl
ert&utm_nooverride=1&utm_source
=CFO-
email&utm_medium=email&utm_co
ntent=CFODailyAlert_Tuesday_2019-
10-22&utm_term=health-benefits
Canada and Healthcare
Source - https://www.cihi.ca/en/canadas-drug-spending-growth-outpaces-that-for-hospitals-and-doctors or
https://www.cbc.ca/news/canada/london/ontario-hallway-healthcare-1.4923954 or https://theconversation.com/how-healthy-is-the-
canadian-health-care-system-82674 or https://www.conferenceboard.ca/CASHC/research/2012/inconvenient_truths.aspx
• Canada needs to review its drug programs. Drug
Costs continues to rise - In 2018, $14.4 billion
(42.7%) of prescribed drug spending is expected to
be financed by the public sector, while the
remainder will be financed by private insurance and
individuals paying out of pocket. Drug spending is
just part of the expected $253.5 billion in total
health spending in Canada this year.
• Hospitals (28.3%), drugs (15.7%) and physician
services (15.1%) are expected to continue to
account for the largest shares of health dollars
(close to 60% of total health spending). The
remaining 41% will be spent on other health care
goods and services, including long-term care
facilities and allied health professionals.
• Fraud or about 12B per year
https://www.claimsecure.com/en/whats-new-
blog/2019/march/11/fighting-fraud-waste-and-
abuse-for-a-healthy-business/
• Miss management and waste – Let’s say about 5% to
10% is waste (est.) then the value could be $11B to
25B per year. Could you imagine how dollars could
be stretched?
Global Delivery of Healthcare
Source - https://globalnews.ca/news/3599458/canadas-health-care-system-lower-performing-compared-to-its-peers-study/ or
https://www.theguardian.com/commentisfree/2018/feb/05/americans-uk-health-system-trump-nhs or
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2017
• United Kingdom has many programs that are used to
reign in costs of healthcare, i.e. prescriptions drug
caps - https://theconversation.com/why-the-us-has-
higher-drug-prices-than-other-countries-111256
• Australia has one of the most efficient
healthcare system -
https://theconversation.com/australias-health-
system-is-enviable-but-theres-room-for-
improvement-81332
RPA and other Automation- Healthcare
 RPA spending could grow to $5B by 2020 -
https://health.economictimes.indiatimes.com/news/health-it/advancements-for-rpa-in-
healthcare/70358766
 AI and Analytics – 15 applications - https://research.aimultiple.com/healthcare-ai/
 AI revolutionizing healthcare - https://healthcareweekly.com/artificial-intelligence-in-healthcare/
 191 startup companies in AI Healthcare - https://www.medicalstartups.org/top/ai/
 AI and Medicine - https://www.ibm.com/watson-health/learn/artificial-intelligence-medicine
Performance
Audits
 All levels of government along with the private
sector need to look at expanding the role of
internal audit. The role of internal audit can be
streamlined using analytics -
https://www.slideshare.net/paulyoungcga/the-
role-of-operational-and-performancebased-
auditing-on-government-and-the-private-sector
 IBM Internal Audit Solutions -
https://www.ibm.com/ca-
en/marketplace/openpages-internal-audit-
management
Forecasting
Solution

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Reforming| Healthcare

  • 2. Paul Young - Bio • CPA, CGA • Financial Solutions • SME – Risk Management • SME – Close, Consolidate and Reporting • SME – Public Policy • SME – Financial Solutions • SME – Supply Chain Management • SME – Business Strategy and Restructuring Contact information: Paul_Young_CGA@Hotmail.com
  • 3. Agenda  Global Healthcare spending  Efficient Healthcare Countries  OECD and Healthcare  USA – Healthcare Waste  Canada and Healthcare Waste  Automation / Healthcare  Performance Audits  Forecasting / Solution
  • 4. Introduction  Healthcare is key area for government as it is large government expenditures  Too many people do not grasp there are issues with healthcare delivery
  • 6. Efficient Healthcare Country Ranking Source - http://worldpopulationreview.com/countries/best-healthcare-in-the-world/
  • 8. USA Waste and Healthcare Source - https://www.cfo.com/health- benefits/2019/10/annual-waste-in- u-s-healthcare-system-nears-1- trillion/?utm_campaign=CFODailyAl ert&utm_nooverride=1&utm_source =CFO- email&utm_medium=email&utm_co ntent=CFODailyAlert_Tuesday_2019- 10-22&utm_term=health-benefits
  • 9. Canada and Healthcare Source - https://www.cihi.ca/en/canadas-drug-spending-growth-outpaces-that-for-hospitals-and-doctors or https://www.cbc.ca/news/canada/london/ontario-hallway-healthcare-1.4923954 or https://theconversation.com/how-healthy-is-the- canadian-health-care-system-82674 or https://www.conferenceboard.ca/CASHC/research/2012/inconvenient_truths.aspx • Canada needs to review its drug programs. Drug Costs continues to rise - In 2018, $14.4 billion (42.7%) of prescribed drug spending is expected to be financed by the public sector, while the remainder will be financed by private insurance and individuals paying out of pocket. Drug spending is just part of the expected $253.5 billion in total health spending in Canada this year. • Hospitals (28.3%), drugs (15.7%) and physician services (15.1%) are expected to continue to account for the largest shares of health dollars (close to 60% of total health spending). The remaining 41% will be spent on other health care goods and services, including long-term care facilities and allied health professionals. • Fraud or about 12B per year https://www.claimsecure.com/en/whats-new- blog/2019/march/11/fighting-fraud-waste-and- abuse-for-a-healthy-business/ • Miss management and waste – Let’s say about 5% to 10% is waste (est.) then the value could be $11B to 25B per year. Could you imagine how dollars could be stretched?
  • 10. Global Delivery of Healthcare Source - https://globalnews.ca/news/3599458/canadas-health-care-system-lower-performing-compared-to-its-peers-study/ or https://www.theguardian.com/commentisfree/2018/feb/05/americans-uk-health-system-trump-nhs or https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2017 • United Kingdom has many programs that are used to reign in costs of healthcare, i.e. prescriptions drug caps - https://theconversation.com/why-the-us-has- higher-drug-prices-than-other-countries-111256 • Australia has one of the most efficient healthcare system - https://theconversation.com/australias-health- system-is-enviable-but-theres-room-for- improvement-81332
  • 11. RPA and other Automation- Healthcare  RPA spending could grow to $5B by 2020 - https://health.economictimes.indiatimes.com/news/health-it/advancements-for-rpa-in- healthcare/70358766  AI and Analytics – 15 applications - https://research.aimultiple.com/healthcare-ai/  AI revolutionizing healthcare - https://healthcareweekly.com/artificial-intelligence-in-healthcare/  191 startup companies in AI Healthcare - https://www.medicalstartups.org/top/ai/  AI and Medicine - https://www.ibm.com/watson-health/learn/artificial-intelligence-medicine
  • 12. Performance Audits  All levels of government along with the private sector need to look at expanding the role of internal audit. The role of internal audit can be streamlined using analytics - https://www.slideshare.net/paulyoungcga/the- role-of-operational-and-performancebased- auditing-on-government-and-the-private-sector  IBM Internal Audit Solutions - https://www.ibm.com/ca- en/marketplace/openpages-internal-audit- management