2015 healthcare-outlook-report

Key HeadlinesA Promising 2015, According to Those in the Healthcare Sector

M&A Expected to Keep Rising— and That’s “a Good Thing”

The Burden of Healthcare Now Too Large for Consumers to Bear

Tepid Acceptance for Government’s Role and Current Regulations

Modest Support for Affordable Care Act: Tangible Response Already Felt within Industry

Entreaty to Consumer: Get More Involved

Technology Provides Improvements to Quality, Convenience and Cost — but Scalability Is a Concern

Future Not an Echo of the Present

Measuring Outcomes: Little Consensus on Alignment to Outcomes with Expected Focus on Profit in Long Term

Access and Convenience Biggest Benefits in Latest Care Trends

ealthcare executives appear optimistic about revenue and growth in 2015 and express a desire to make additional

investments and seek financing in the coming year. They expect trends around M&A to continue to rise and acknowledge its benefits for the industry. When considering adoption of new technology and non-traditional methods of care, they cite both benefits and drawbacks of each. These executives recognize that healthcare costs are becoming too great for consumers and encourage consumers to take a more active role in managing their healthcare costs.

In order to understand current trends, challenges and outlook for the healthcare industry, Harris Poll on behalf of CIT, a leader in financing and advisory services to the healthcare sector, conducted research online from February 25 to March 10 among 155 U.S. healthcare executives representing a broad cross-section of the industry.

Healthcare Outlook2015

Middle Market Healthcare Executives Optimistic for 2015

H

2015 Healthcare Report

2

Most healthcare executives are fairly optimistic about the major financial metrics for 2015—including revenue, price growth and volume growth, believing all three are likely to increase relative to the previous year. Very few expect a decrease.

That said, a substantially smaller percentage (4 in 10) anticipate an increase in capital spending in 2015. And a similar proportion (44%) envision that their company will be at least somewhat likely to seek financing this coming year. Both projections—the potential increase in capital investments and the potential demand for financing—are built around the same fundamental needs for: new hires, information technology, and construction or renovation.

Some specific reasons for projected increases include:

Percentage of self-pay continues to increase in our area; no affects seen in revenue relative to Healthcare reform.

We have diversified and have more revenue outlets.

The general population is aging, and more of the elderly are requiring skilled care, which in turn, equates to more revenue generated for our facility.

Because we’re implementing better technology.

(two-thirds) believe volume growth will increase in fiscal year 2015 (relative to 2014)

(nearly 6 in 10) believe price growth will increase in fiscal year 2015 (relative to 2014).

71%

58%

66%

of healthcare executives believe revenues will increase in fiscal year 2015 (relative to 2014)ONLY 7% SAY DECREASE

ONLY 7% SAY DECREASE

ONLY 6% SAY DECREASE

Financial OutlookA Promising 2015, According to Those in the Healthcare Sector

Many healthcare executives (46%) believe capital spending will remain the same in fiscal year 2015 (relative to 2014) followed by 4 in 10 (40%) who say it will increase. Among those who anticipate an increase, the top investments include:

42% IT35% New hires 34% New goods/services 32% Renovation

More than 4 in 10 (44%) say it is at least somewhat likely that their company will seek financing in the next year, based on a wide variety of considerations including:

26% New hires 22% New construction22% IT


3

Philosophically, about 3 in 4 healthcare executives believe that mergers and acquisitions within the sector are generally a good thing for all key stakeholders: the company, the industry as a whole, the general public and the shareholders. Most recognize a wide variety of benefits including: keeping up with revenue, removing competition, allowing for efficiencies to be realized and placing a greater focus on care. However, according to the majority of executives, the benefits exist largely on the side of the company, not the consumer.

Many think mergers and acquisitions within the healthcare industry are generally a good thing for:

79% shareholders78% their company73% the healthcare industry72% the general public

Mergers & AcquisitionsM&A Expected to Keep Rising—and That’s “a Good Thing”

In general, most healthcare executives believe that mergers & acquisitions…

…help to keep revenue up for companies in the healthcare industry

83%

… allow healthcare companies to focus on providing care rather than aspects of running a business

67%

…are removing competition83%

… typically benefit a company, but not consumers

65%

… allow for efficiencies to be realized76%

Copyright ©2014 The Nielsen Company. ConfidenDal and proprietary.

6

28%

27%

22%

21%

72%

73%

78%

79%

The General Public

The Healthcare Industry

Your Company

Shareholders

A bad thing A good thing

M&A BENEFIT ALL, CONSUMERS INCLUDED Most execuDves feel M&A are a good thing rather than a bad thing for shareholders, their company, the healthcare industry and the general public.

BASE: ALL QUALIFIED RESPONDENTS (Total n= 155) Q5 When thinking about M&A and each of the following groups, are they…?

M&A: a Good Thing or Bad Thing for… Mergers & Acquisitions:

A Good Thing or A Bad Thing For…


4

MORE THAN HALF (55%) OF HEALTHCARE EXECUTIVES HAVE BEEN PART OF A MERGER OR ACQUISITION IN THE PAST 2 YEARSAmong those who have been on the purchasing side, an overwhelming 91% say the experience was at least somewhat positive; 39% say it was extremely positive

� More than half (56%) expect M&A activity within the healthcare industry to increase in the next twelve months. Practically no one (1%) says decrease

� Healthcare executives are more likely to believe that M&A activity within the healthcare industry is driven by strategy (61%) rather than by purchase price multiples/valuation (39%)

� When companies in the healthcare industry prepare for M&A, more than half (55%) say the companies are valued just right

¡ 28% think companies are valued too high, and 17% say too low

ATTITUDES TOWARD MERGERS & ACQUISITIONS VARY BY EXPERIENCE� Those whose company has been

purchased or has not yet been part of a M&A are more likely to agree that their company tries to avoid M&A at all costs (52% and 57%, respectively) versus those who have been doing the purchasing (45%)

� Those whose company has done the purchasing are more likely to agree that their company seeks out M&A whenever possible (86%) compared to those whose company was being purchased or not yet involved (57% and 46%, respectively)

A VARIETY OF M&A STRATEGIES CITED BY HEALTHCARE EXECUTIVESVertical Merger 29%a customer and company or a supplier and company Horizontal Merger 24%two companies that are in direct competition and share the same product lines and marketsMarket extension merger 22%two companies that sell the same products in different marketsProduct extension merger 16%two companies selling different but related products in the same market

Mergers & AcquisitionsM&A Expected to Keep Rising—and That’s “a Good Thing” continued

In real terms, just over half say they have been part of a merger or acquisition in the past two years, and nearly all feel M&A will likely increase or remain static, over the coming year. The main impetus appears to be driven by strategy, much more so than multiples/valuation- companies are generally viewed as being valued just right. Experience appears to influence attitudes toward M&A with those who have been a part of the company doing the purchasing agreeing that their company seeks out M&A whenever possible. Whereas those whose company has been purchased or has yet to be part of an M&A say their company avoids M&A at all costs. Thinking about their own strategy for M&A, there also appears to be no clear consensus between looking for vertical, horizontal, market extension or product extension mergers.

2015 Healthcare ReportCopyright ©2014 The Nielsen Company. ConfidenDal and proprietary.

10

36%

32%

11%

64%

68%

89%

Quality of care will suffer if cost of healthcare declines

The lower growth rate of healthcare spending is not sustainable

Consumers can’t endure any higher costs to healthcare than they are facing now

Somewhat/strongly disagree Somewhat/strongly agree

EXECUTIVES SAY CONSUMERS CANNOT ENDURE ANY HIGHER HEALTHCARE COSTS, BUT MAY COME AT DETRIMENT TO QUALITY Nearly all execuDves say that consumers cannot endure any higher costs to healthcare than they are already facing now, but if healthcare costs were to decline, more than 6 in 10 feel quality of care will suffer.

BASE: ALL QUALIFIED RESPONDENTS (Total n= 155) Q13C How strongly do you agree or disagree with the following statements?

5

Nearly 7 in 10 healthcare executives recognize that healthcare costs are currently too high for consumers and present at least a minor, if not a major, problem. In fact, the vast majority say consumers cannot endure any higher costs than they already face right now.

Most executives believe that insurance companies and healthcare providers should bear primary responsibility for bringing healthcare costs down. However, more than 4 in 10 place the onus on the federal government and pharma companies; and nearly 1 in 5 say consumers themselves are responsible. That said, if the cost of healthcare declines, more than 6 in 10 executives caution that there may be some threat to the quality of the care provided.

Currently for consumers, most (69%) think healthcare costs are too high. Very few (3%) say too low. Nearly 9 in 10 healthcare executives (89%) feel that consumers can’t endure any higher costs to healthcare than they are already facing now.

Healthcare CostsThe Burden of Healthcare Now Too Large for Consumers to Bear

Today, 7 in 10 (70%) healthcare executives believe healthcare costs in their healthcare sector are a somewhat (56%) or very big (14%) problem

Some solutions that executives have explored to take costs out of the healthcare system include:

We try to reduce costs every day, in every aspect of the company. Paperless billing, fighting with insurance companies, and pay reductions are all ways we reduce costs.

43%PHARMACEUTICAL COMPANIES

51%HEALTHCARE PROVIDERS

44%FEDERAL GOVERNMENT

INSURANCE COMPANIES

59%

Healthcare executives believe that the following have primary responsibility for bringing healthcare costs down:

quality of care will suffer

IF THE COST OF HEALTHCARE DECLINES

BELIEVE THAT...

According to a recent survey by Nielsen’s Strategic Health Perspectives, more than a third of US consumers (36%) experience the cost of medical care as a major or

moderate burden…43% health insurance premiums39% deductibles38% hospital bills37% doctor bills

64%

We’ve considered moving locations, changing the quality of products.


6

Executives express a modest, though not overwhelming, amount of support for the government’s role in regulating the healthcare industry. More than 6 in 10 support the government having at least some authority over the industry as a whole.

When reflecting on the regulations in place right now, more than half of healthcare executives feel the regulations in their sector are “just right” and recognize the positive impact these regulations have had on both revenue and growth (though not as encouragingly on costs). That said, among healthcare executives who are uncomfortable with the current level of regulations, “too little” is not the key complaint. In fact, they are more than twice as likely to say too much as too little.

Many feel that regulations have had a positive impact on their company’s revenue (59%) and growth (59%) but are split on the impact to their costs (47% positive/53% negative):

Industry RegulationsTepid Acceptance for Government’s Role and Current Regulations

Most believe that the government should have at least a "moderate amount" of authority over the healthcare industry (score of 6-10 on a 10 point scale).

� When thinking about the regulations on their healthcare sector specifically, over half (52%) feel the regulations are just right

¡ One-third (33%) say too much and 15% say too little

62%

As an example of the government’s involvement, a recent survey by Nielsen’s

Strategic Health Perspectives found that US employers are very conflicted around high cost innovative therapies, both feeling that they owe it to their employees to find new ways to ensure these medications are available (79%) but also clearly feeling that government will have to play a role in ensuring these medications are affordable (86%).

How Much Authority Should Government Have Over The Healthcare Industry?

Impact of Regulations on Company


13

6% 7% 5% 7% 13% 16% 18% 19% 6% 3%

1 – None 2 3 4 5 6 7 8 9 10 -‐ A lot

MODERATE GOVERNMENT INVOLVEMENT IN HEALTHCARE INDUSTRY SUPPORTED BY MOST More than 6 in 10 healthcare execuDves feel the government should have at least a moderate amount of authority over the healthcare industry, while 1 in 10 think the government should have a lot.

BASE: ALL QUALIFIED RESPONDENTS (Total n= 155) Q15 How much authority should government have over the healthcare industry? Please use a scale from 1 to 10 where 1 is none and 10 is a lot.

How Much Authority Should Government Have over the Healthcare Industry 62%

8%


Many believe the ACA is having a positive impact on:

7

Most executives express support for some modifications to the Affordable Care Act (ACA), while keeping the basic framework intact. Many recognize the positive impact it could have on access to healthcare. But the impact on quality of care and their company’s revenue is less certain. Approximately 1 in 3 believe the ACA will be repealed, and of those, most expect the process to be fairly quick (i.e., within two years' time).

Regardless of their perspective, most executives envision both positive and negative, short- and long-term, changes will be experienced within their company in response to the ACA, most commonly: changes in business strategy, increased operating costs, decreased revenue and new innovations/solutions. In fact, when reflecting on the ACA since its implementation, more than 8 in 10 say their business strategy has already changed, largely to become more cautious.

When asked in an unaided way, ACA tops the list of regulations that executives are most concerned with. Other concerns include:“ Medicare and Medicaid

ever-changing regulations.”

“Cost regulations.”

“ Joint Commission on Accreditation of Healthcare.”

“Regulations for patient care.”

Affordable Care ActModest Support for ACA; Tangible Response Already Felt Within Industry

Only 1 in 4 (27%) support full repeal. And among those, the majority (58%) think it will be repealed quickly, within the next 2 years.

Most healthcare executives expect both positive and negative changes will be made by their company, due to the ACA. The most common short- and long-term changes that healthcare executives expect for their company, due to the ACA are:

• change in business strategy (43% next 5 years; 44% beyond 5 years)• increased operating costs (36% next 5 years; 36% beyond 5 years)• decreased revenue (34% next 5 years; 29% beyond 5 years)• new innovations/solutions (31% next 5 years; 36% beyond 5 years)

Thinking about the ACA since its implementation, 85% say their business strategy has changed, either by becoming more aggressive (19%), or more likely, by becoming more cautious (66%).

But are less certain about the impact on:THEIR COMPANY’S REVENUE

52% say positive

48% say negativeHEALTHCARE QUALITY

55% say positive

45% say negative

INSURANCE EXPANSION/ REDUCTION OF UNINSURED69%

ACCESS TO HEALTHCARE73%BELIEVE THE ACA WILL BE REPEALED

35% Healthcare Execs

BUT SUPPORT SOME MODIFICATIONS

WANT TO KEEP THE BASIC FRAMEWORK OF THE ACA59%

OVER 1 IN 3


8

The vast majority of executives feel that consumers need to take more ownership over their healthcare decisions and do a better job of managing their healthcare costs. However, despite advocating for a more proactive role for consumers, more than 8 in 10 executives criticize the widespread availability of healthcare information in the public domain, suggesting that the proliferation of information may be creating problems that wouldn’t otherwise exist for the industry.

When making decisions about healthcare, executives are most likely to feel that consumers are driven by affordability, followed by quality, convenience and access. (However, it’s perhaps not surprising that cost is the overriding concern, trumping even quality of care, given the negative perception of the current cost burden placed on consumers.)

Role of ConsumerEntreaty to Consumer: Get More Involved

AFFORDABILITY86% most/all51% all

HIGH QUALITY CARE80% most/all38% all

CONVENIENCE80% most/all21% all

ACCESS78% most/all30% all

In relation to

HEALTHCARE DECISIONSthe majority of healthcare executives believe that most, if not all, consumers are driven by:

say consumers should take more responsibility for managing their healthcare costs88%

say consumers should be more involved in their healthcare decisions94%

FEEL THAT THE PROLIFERATION OF

available to consumers is creating issues for the healthcare industry

Healthcare Information 81%

Consistently, and increasingly, consumers indicate that affordability is their biggest health care concern (48% in 2010 to 54% in 2014), over access, quality or security.

(Source: Nielsen’s Strategic Health Perspectives)


9

The benefits of technology are clear, according to most healthcare executives. The vast majority say technology improves both the quality and the convenience of care. Moreover (given the current stress around costs), about 3 in 4 recognize the positive impact technology can have—for the industry as a whole and their sector specifically—to bring costs down for the consumer.

However, a majority feels the stakes are higher for the healthcare industry with respect to technology, and they struggle to figure out which technological advances will be most relevant. More than 8 in 10 executives also worry that scalability is a genuine concern and that technology in the healthcare industry is such a large undertaking.

With respect to technology, the majority of healthcare executives see the benefits. For example:

TechnologyTechnology Provides Improvements to Quality, Convenience and Cost; But Scalability Is a Concern

� More than 9 in 10 (91%) feel that new technology is making healthcare more convenient for consumers.

� About 3 in 4 say technological advances in the healthcare industry (72%) and in their sector (73%) are helping to bring costs down for consumers.

A large majority say technology is helping to provide better quality care93%

The majority says the stakes are much higher for technology in the healthcare industry (85%) and that it is difficult to figure out which technological advances are the most relevant (72%).

84%

feel that scalability is a real concern for technology use in the healthcare industry

BENEFITS & CHALLENGESBIG DATA BRINGS WITH IT BOTH

SAY

Specific challenges include:

Keeping the information secure seems to be a key challenge.

I see the biggest challenge being that many traditional data processors are inadequate in comparison. It’s too big, too fast, and requires too much capacity for traditional software to handle it.

The more information it is able to bring us sometimes makes it take longer to get general information.

Primary challenges being safety/securityFollowed by manageability & scalability

84%


10

The majority of healthcare executives do not believe that the future leaders in the industry will necessarily mirror those seen today. Most give low marks to the industry as a whole, saying that only a few companies are ahead of the curve in preparing for the new healthcare marketplace; but that their company (in this case) is the exception, not the rule.

An overwhelming majority critique healthcare companies as changing because they have to, not because they want to—and feel that the most successful companies strive to understand what consumers need. According to most executives, some keys to future success will include an emphasis on: good customer service, alternative payment models and wellness/prevention (over treating acute illnesses).

SuccessFuture Not an Echo of Present

the businesses who lead in healthcare today will not be the same ones who lead into the future

68%

few companies are ahead of the curve in preparing for the new healthcare marketplace

80%

successful healthcare companies understand what today’s healthcare consumers need

83%

good customer service will be a key to success for healthcare companies in the future

there is tremendous opportunity for healthcare companies to be out ahead of the curve on alternative payment models

81%

believe their company is ahead of the curve80%

healthcare companies are changing because they have to, not because they want to

90%

HEALTHCARE EXECUTIVESBELIEVE THAT...

Most believe the healthcare industry should focus more on...

OF HEALTHCARE EXECUTIVES BELIEVE THAT…

24%TREATING ACUTE ILLNESSES

76%WELLNESS & PREVENTION

90%


11

More than 8 in 10 healthcare executives believe that their sector is on track with the rest of the industry in determining how to best measure outcomes. That said, despite feeling they are in lockstep with the industry as a whole, there is not widespread agreement (and perhaps some lack of clarity) on the desire to align healthcare payment to specific outcomes. Many are unclear or neutral in their opinion, but among those who feel one way or the other, more feel positive toward the approach than negative.

However executives anticipate a slight shift in terms of what qualifies as the primary measure(s) of success. In the short term, about 1 in 3 executives identify “satisfaction” as a key measure now and in the next 3 years, followed by profits and clinical outcomes. In the longer term, emphasis continues to shift off clinical outcomes and moves toward profit.

Impression of approach to align healthcare payments to specific outcomes is somewhat more positive than negative:

MeasurementMeasuring Outcomes: Little Consensus on Alignment to Outcomes with Expected Focus on Profit in Long Term

Healthcare executives see a shifting focus on how to measure success in the future compared to today.

� Now the focus skews toward satisfaction (35%), followed by profit (23%) and clinical outcomes (22%)

� In the next three years, profits appear to rise a bit with a continued focus on satisfaction (satisfaction 30%, profit 25%, clinical outcomes 18%)

� More than 5 years from now, measurement of success will skew more toward profit (satisfaction 30%, profit 33%, clinical outcomes 14%)

Some specific actions executives are taking to align payment to outcomes include:

“ Follow-ups, more customer-provider interaction, etc.”

“ Researching best options for consumers and the business itself.”

“Increasing quality initiatives.”

• but among those who are off track, more say they are behind the curve (11%) than ahead (6%)

believe their sector is ON TRACK with the rest of the healthcare industry83%

in terms of determining how best to measure outcomes


27

5%

19%

39%

31%

6%

Total

Very posiDve

Somewhat posiDve

Neither negaDve nor posiDve

Somewhat negaDve

Very negaDve

ALIGNMENT OF HEALTHCARE PAYMENTS TO OUTCOMES SEEN AS NEITHER POSITIVE NOR NEGATIVE Although more are more posiDve than negaDve, nearly as many healthcare execuDves see the approach to align healthcare payments to specific outcomes as neither posiDve nor negaDve.

BASE: ALL QUALIFIED RESPONDENTS (Total n=155) Q42 As you are aware, there is a current desire to align healthcare payment to specific outcomes. What is your impression of this approach?

Impression of Desire to Align Healthcare Payment to Outcomes

37%

24%


26

11%

83%

6%

Total

Ahead

On track

Behind

HEALTHCARE SECTORS ON TRACK IN DETERMINING HOW TO MEASURE OUTCOMES The vast majority of healthcare execuDves say their sector is on track in terms of determining how best to measure outcomes. Among those who are off track, more are behind (11%) than ahead (6%).

BASE: ALL QUALIFIED RESPONDENTS (Total n=155) Q44 Where is your sector compared to the total healthcare industry in terms of determining how best to measure outcomes?

Status of Sector in Determining How to Measure Outcomes


26

11%

83%

6%

Total

Ahead

On track

Behind

HEALTHCARE SECTORS ON TRACK IN DETERMINING HOW TO MEASURE OUTCOMES The vast majority of healthcare execuDves say their sector is on track in terms of determining how best to measure outcomes. Among those who are off track, more are behind (11%) than ahead (6%).

BASE: ALL QUALIFIED RESPONDENTS (Total n=155) Q44 Where is your sector compared to the total healthcare industry in terms of determining how best to measure outcomes?

Status of Sector in Determining How to Measure Outcomes


12

Non-Traditional Methods of CareAccess and Convenience Biggest Benefits in Latest Care Trends

When reflecting on non-traditional methods of care, executives see both pros and cons to several of the latest trends. The benefits are clear, focused around key consumer motivations like: quality, efficiency and access. The drawbacks also center on quality, but introduce other issues of cost, privacy and security.

Most Common Benefits Cited Most Common Challenges Cited

RETAIL MEDICINE( urgent care, walk-in clinics, free standing ERs, etc.)

61% More choice for consumers

57% Convenience for consumers

56% Routine care can be taken care of quickly

51% Privacy

50% Care from less qualified HCPs

45% Decentralized medical records

CONCIERGE CARE( relationship between patient and HCP in which patient pays an annual fee/retainer for improved access or services)

49% Convenience for consumers

47% More focused care

42% Low overhead costs

42% Consumers not wanting to pay cash/not use insurance

40% Care not covered under fees

37% Consumers don't want to pay fees

TELEMEDICINE( diagnosis and treatment of patients in remote areas using medical info transmitted over long distances sometimes via satellite)

47% Improved access to medical services

40% Care provided in remote locations

38% Reduces cost of medical care

45% Increased risk of data being compromised by cybersecurity

44% Decrease in human interaction between patient and HCP

38% Requires technical training from medical personnel


13

MethodologyThis study was commissioned by CIT and conducted online by Harris Poll within the United States between February 25 and March 10, 2015, among 155 executives within the healthcare industry. Key demographics are:

� Executive title: Board member (4%), CEO (21%), COO (5%), CFO/Treasurer (11%), Other C-level executive (7%), SVP/VP/Director (16%), Head of business unit (10%), Head of department (26%)

� Company revenue: $25 million to $99 million (66%), $100 million to $249 million (19%), $250 million to $499 million (10%), $500 million to $749 million (4%), $750 million to $1 billion (2%)

� Industry: Those represented include skilled nursing (9%), biotech (2%), pharmaceuticals (5%), hospitals/medical centers (44%), other inpatient hospitals (2%) physician services (7%), private practice (2%), healthcare technology (11%), medical devices/supplies (6%), home health and hospice (5%), dialysis (1%), and other healthcare-focused (5%).

To ensure that the data are balanced and that they accurately reflect the population of interest for this study, the sample was weighted to ensure that it accurately represents the U.S. “Healthcare” industry. Figures for industry and revenue were weighted, where necessary, to bring them into line with the population of U.S.-based healthcare-related companies with annual revenue of $25 million to $1 billion, based on information obtained from D&B database sources.

All sample surveys and polls, whether or not they use probability sampling, are subject to multiple sources of error which are most often not possible to quantify or estimate, including sampling error, coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey weighting and adjustments. Therefore, the Harris Poll avoids the words “margin of error” as they are misleading. All that can be calculated are different possible sampling errors with different probabilities for pure, unweighted, random samples with 100% response rates. These are only theoretical because no published polls come close to this ideal.

About the Harris Poll Over the last 5 decades, Harris Polls have become media staples. With comprehensive experience and precise technique in public opinion polling, along with a proven track record of uncovering consumers’ motivations and behaviors, the Harris Poll has gained strong brand recognition around the world. The Harris Poll offers a diverse portfolio of proprietary client solutions to transform relevant insights into actionable foresight for a wide range of industries including healthcare, technology, public affairs, energy, telecommunications, financial services, insurance, media, retail, restaurant and consumer packaged goods. Contact us for more information: [email protected].

ABOUT CITFounded in 1908, CIT (NYSE: CIT) is a financial holding company with more than $35 billion in financing and leasing assets. It provides financing, leasing and advisory services to its clients and their customers across more than 30 industries. CIT maintains leadership positions in middle market lending, factoring, retail and equipment finance, as well as aerospace, equipment and rail leasing. CIT’s U.S. bank subsidiary CIT Bank (Member FDIC), BankOnCIT.com, offers a variety of savings options designed to help customers achieve their financial goals. www.cit.com

www.cit.com/viewfromthemiddleTo subscribe to the CIT View from the Middle newsletter, please send an email to: [email protected].

FOR PRESS INQUIRIES PLEASE CONTACTCurt RitterSenior Vice President, Corporate [email protected]

Matt KleinVice President, Media [email protected]

FOR BUSINESS INQUIRIES PLEASE CONTACTDan InfantiSenior Vice President, Marketing and [email protected]

Debbie HaeringerDirector, Content [email protected]

2015 healthcare-outlook-report

Business

healthcare industry

healthcare costs

healthcare reform

healthcare sectorma

revenue relative

fiscal year

coming year

volume growth