Healthcare Trends to Watch for in 2014
While most of my blog posts have covered some of the more recognized effects of the Affordable Care Act, it isn’t just about insurance coverage. The legislation is also about transforming the way health care is provided. As caregivers and insurance companies have wrestled with the new rules and regulations, a new era of competition has been ushered in. Services and business practices are in turn generating substantial industry shifts that affect all links along health care’s value chain. In this blog post, I will shed some light on what are anticipated to be the top trends this coming year.
1. Evolution of Pioneer ACOs: Many providers are moving quickly to implement accountable care organizations (ACOs). As providers work to improve their way to shared savings payments, there should be a more intensive focus on the biggest health care consumer: those with multiple chronic conditions. As part of the approach to managing these patients, providers will need to develop care pathways for better managing chronic conditions and behavioral health needs, with an eye toward lowering hospital utilization, including inpatient bed days, length of stay, admissions, readmissions, and ED visits.
2. Impact of ICD-10 transition: Overall, providers have been slow to move forward with the conversion of ICD-9 to ICD-10, but the October 1st deadline is fast approaching and there is no indication that CMS will further delay the implementation date. One study suggests that 74 percent of providers haven’t made plans for end-to-end testing with external entities. These providers could be subject to a potential cost of $1 million to more than $15 million.
3. Turnover of hospital CEOs: Latest statistics show that healthcare experiences higher CEO turnover than any other industry. Please read my prior blogs, “Battling Hospital CEO Turnover…Parts 1 & 2” for more information regarding this trend.
4. More hospitals become insurers: Population health management and Medicaid expansion have pushed some providers to expand their healthcare services and start offering insurance plans. Many non-profit community health centers have entered the market as more people become eligible for Medicaid and states move enrollees into managed care plans.
5. Health Coaches: Health coaches function like a personal trainer in a gym; they’re there to motivate, challenge, inspire, and listen. They complement medical professionals providing care; they get to know the patient one-on-one and keep clinical staff apprised of issues that wouldn’t come up in a doctor’s appointment, including financial struggles, problems with housing, family concerns, or any other obstacle that could stand in the way of someone following a prescribed care plan. And because the position does not necessarily require a medical degree, health coaches can be drawn from a diversity of settings.
6. Increase in Telemedicine: Research firms estimate that telemedicine applications will double from $11.6 billion in 2011 to over $27 billion in 2016. Driving the growth is the need to make care more convenient, so patients can be monitored and coached to health anytime, anywhere.
7. Health Incentives: This trend is being driven by two forces, both spurred by the ACA: the ability for employers to increase the dollar value of wellness incentives from 20 to 30 percent of total coverage, and increased private insurance costs.
Further elaboration on these trends as well as some additional trends can be found here.