A year ago, as the nation was entrenched in the greatest financial downturn since the Great Depression, health care organizations were forced to cut costs and find ways of increasing revenue as the rates of uninsured and bad debt took a dramatic leap.

In 2010, health care organizations will still be cutting costs. But it won't be for reasons of survival. It will be because of the government's involvement and investment in the industry, according to an annual report issued by PricewaterhouseCoopers.

About half of the predictions in PricewaterhouseCoopers' annual health industry predictions report, "Top 10 health industry issues in 2010: Squeezing the juice out of healthcare," were driven by the American Recovery and Reinvestment Act, which pumped more than $147 billion dollars into the health care system, and the promise of health system reform, expected to cost the federal government close to $1 trillion.

"Since 2009 ... the role of government, particularly in terms of how much money is being put into health care, has changed radically," said David Chin, MD, principal of the health care advisory practice group of PricewaterhouseCoopers, who helped draft the report.

"It's totally understandable ... that when the government puts more money into an industry, it expects more accountability," he said.

Due to this increased government scrutiny, the addition of more agencies and grant programs, as well as reimbursement and pricing changes, topped the report's list of predictions. Increased efforts to catch and prevent Medicare fraud and abuse also are expected in 2010.

But cost controls won't be the only lasting impact of health reform, the report said. Methods of care delivery also are expected to evolve.

Because the reform debate has centered mostly around insurance coverage for more Americans, researchers expect access to become an issue. They predict that patients will seek alternative care delivery models such as on-site employer clinics, retail clinics and telehealth solutions.

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