PwC's research found common trends around the world in how governments are juggling priorities:

(bullet) Meeting demand by caring for an increasingly aging population was rated the most difficult challenge facing health systems around the world.

(bullet) Cost control was ranked as the most important factor in developing payment systems in the future. It ranked more important than quality, efficiency or demand.

(bullet) "Better informed patients" or consumerism ranked highest as a way to better manage demand. Increasing out-of-pocket payments ranked lowest.

(bullet) Approximately eight in 10 global health executives said that better coordination of care would do the most to improve quality in their countries. Bonuses for care coordination to physicians and hospitals were among the top five methods needed to improve quality and efficiency.

(bullet) To better reward quality, quality information must be gathered, measured, and acted on. Data is becoming increasingly available to compare quality measures, but PwC found that patients and gatekeepers aren't acting on the data because patient choice is still largely driven by subjective perceptions of quality versus quantifiable medical or technical data. Payers are still reluctant to base reimbursement on quality alone.