A new year is coming along with political and social changes. People in healthcare management and leadership need to understand the forces that could shape their opportunities and responsibilities.
Affordable Care Act
Now that Trump has won, what will happen with the ACA is murky. Many Republicans want to can the whole package and Trump had talked that way during the campaign. But now he’s talked of some aspects that he wants to keep, such as the inability of insurers to exclude pre-existing conditions and the ability for people to keep children on family plans until they reach 26 years.
There is concern among hospitals that a repeal could cost $165 billion by the middle of next year. Plus, while some significant changes could be made to the ACA legislation without Democratic approval, a filibuster could bring attempts to complete gut the law to a quick halt. Furthermore, the industry has invested heavily in meeting the law’s requirements, so there will be considerable pushback.
Expect value-based payment strategies to keep moving forward. No one can afford a pay-for-procedure approach in the long run and people want better results. Value-based compensation will become more popular, which means providers and care organization will need to better learn how to provide results while still protecting themselves from lawsuits. This becomes only more crucial as many insurance plan premiums see price spikes.
This will also cause expansion of population health management as a technique to help providers identify chronic patients and find more economic ways to treat conditions. Expect improved Healthcare Effectiveness Data and Information Set, or HEDIS, scores to become more important as part of measuring value-based payment success.
New technologies will become hot as the industry looks for help to contain costs and improve outcomes. According to Healthcare IT News, there are close to two dozen technologies that hospitals have said they are considering. They include advanced laboratory systems, 3D imaging in radiology, molecular diagnostics, systems to check insurance companies for medical necessity before undertaking procedures, anesthesia monitoring systems, and much more.
Employers have long used health benefits as a way to attract and retain workers. Voluntary benefits are going to have an additional impact next year. High-deductible health plans are pushing people, particularly millennials, to drive down costs. That includes a growing demand for telemedicine services and healthcare for part-time employees.
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