Anticipating top healthcare industry issues for the coming year is always interesting and a new U.S. president and administration make it even more so. If we have learned anything from past predictions, it is that change is constant but slow. So, while it can feel like there has been a seismic shift that will lead to a major overhaul of regulations, little has been decided. I expect that many of the trends we have seen in recent years will continue, with a little more uncertainty thrown into the mix:
- Uncertainty over future of ACA – This may be stating the obvious, especially now that it looks like any substantive changes will take longer than originally anticipated. On the one hand, 2017 is looking more like business as usual. On the other hand, the suspense over what to expect continues, which makes long-term planning and investment difficult.
- Greater demand for value with MACRA – MACRA is still on track for 2019 implementation using 2017 as the performance year used to determine 2019 payment adjustments. MACRA is a cost-savings program with strong bipartisan support and not likely to be among the provisions of ACA that will be repealed or significantly revised.
- Continued alignment with hospitals and providers – We continue to see more employed physicians and merging of physician group practices and hospitals/health systems. These alignments solve some problems, while creating others, but this is a trend likely to continue during the year ahead.
- Increasing dyads and triad leadership teams –To successfully align formerly independent entities requires collaboration and shared responsibilities. So, we will see more dyads and triads consisting of key administrative and clinical stakeholders who partner to drive change.
- Additional new players /disruptors/innovators – Last year we saw a lot of speculation about the “Uberization” of healthcare and what shape it would take. Of course, no one thing emerged and, given the complexities of the healthcare industry, it is unlikely there will be a single major disruptor. But we are sure continue seeing disruption across many fronts from artificial intelligence (like IBM Watson) and gene editing, guiding diagnostics and treatment, to price transparency apps and retail clinics, informing choice and increasing competition.
- Expanding telehealth – Albeit gradually, remote office visits, monitoring vital signs, managing chronic conditions, diagnosing skin conditions, and other technology-enabled medical services are catching on and show promise for increasing efficiency and reducing costs.
- Rising consumerism – Although our third-party payment system generally prevents a direct buyer-seller relationship between patients and providers, Americans are becoming more informed about their healthcare options and have many more tools at their disposal to compare and contrast treatments, costs, outcomes, reputations and more. The days of blindly following the doctor’s orders are over.
- Higher risk of stress and burnout – The amount and pace of change for healthcare has taken its toll and it is likely to get worse before it gets better. Bound as we are to political decisions in general and the fate of the Affordable Care Act in particular, enduring uncertainty and additional change surely lies ahead. We can hope that it will ultimately be for the best. In the meantime, physicians, nurses, and others will be under pressure and healthcare organization leaders must be vigilant about safeguarding against severe stress and burnout.
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