The over-arching challenge facing health care in the U.S. for 2010 is managing costs, according to PricewaterhouseCoopers‘ forecast, titled appropriately, Squeezing the Juice Out of Healthcare.

PwC says that health stakeholder organizations will have to redefine their roles given the ‘squeeze’ on incoming revenues, forcing focused management of operational costs.

“Flat is the new growth for many industries outside of healthcare,” PwC asserts. Businesses in health will have to get used to that economic reality in 2010. 2009 saw big increases in costs which could result in pricing pressures in 2010.

Value-based purchasing is taking hold in both the public and private sectors. This will involve greater scrutiny of vendor pricing and attention to detail in finely honing health benefit designs for employees.

One of the top 10 issues PwC cites is a shift in care beyond the doctor’s office and the hospital institution. The chart illustrates data from PwC’s Consumer Access Survey 2009.

Note that 50% of consumers say they’re likely to use the Internet, computers and the telephone to access health care. Furthermore, over 1 in 3 Americans say they’d likely use a worksite or retail clinic to get healthcare.

And a pioneering 1 in 5 Americans say they’d use a mobile device to receive health messages via text.

Health Populi’s Hot Points: The ability to bend the health cost curve, which PwC says is Job 1 for health stakeholders in 2010, will in turn depend on health citizen-patients engaging with the health system in new ways. While PwC recommends that health plans, hospitals, pharma, and other players in the healthcare value chain “redefine” themselves, patients-themselves must re-imagine their role in health care and costs.

Being willing to try out new methods for care will be part of that reengineering of patient health-flow. PwC points out that telecommunications will be more integrated into health delivery (Top Issue #5). It’s important to connect the dots between this issue and many of the others cited by PwC. Technology infrastructure for health will enable providers and patients to more effectively collaborate in co-creating health. Furthermore, by delivering care in clinically appropriate, alternative (read: lower cost settings), overall health costs can be better managed. And, patients can be more engaged in care when they know their numbers and data. Mobile telecomm technology can enable that, too, by helping health consumer manage what they measure (e.g., blood glucose, blood pressure, calories consumed, etc.).

Managing health costs isn’t just attending to operational workflow in institutions, plans, and life science companies. It has a great deal to do with managing patient expectations and educating people on what works in health care, and what doesn’t. The more patients are armed with this information and easy/fun-to-use tools, the greater the engagement and commitment to whole health will be.