We have no special powers. We are not clairvoyant. Rather, we have lived
within the healthcare management world for nearly 100 years, combined.
We all recall the days docs made house calls. Being entrenched in the
ever changing health care scene, the three of us made many predictions.
Some of which, people may have thought were ludicrous. But, today, they
are all a part of health care reality.
Following are visions we see in our crystal ball. These trends will become
more visible in 2016 and beyond.
will accelerate as insurance companies merge and opt out of the exchanges. Make no mistake
about it, insurance companies are not benign payers in the healthcare
marketplace. They are much more important to healthcare delivery than
is the government. As they consolidate, they drive and control the providers’
business. The higher premiums paid by every insured person affects care
because it forces people to choose a higher deductible plan in order to
hold down monthly premium cost. And, the higher deductible plans drive
providers crazy because they, in turn, are forced to collect more from
a patient who is already angry at having to choose a less desirable plan”
2. Most healthcare consumers are currently in the dark.
The onus will be on the patient, and the market will provide tools to educate them on their health care
choices. Entrepreneurs will take advantage of this growing trend and create
apps for mobile devices that enable consumers to be more informed. Outcomes
by physicians and providers will become more accessible. Providers will
boost their marketing efforts, based on transparency, to attract patients
similar to bariatric and laser eye surgery services have been doing for
years. Likewise, prices will become more visible and promoted.
Healthcare services will evolve like the airlines, to a few players on
an enormous field. Local/Regional providers will venture out of their home state and serve
the entire country. As they accelerate, and intensify their focus on the
consumer, access and high value will be drivers of organizational change.
Regional providers will grow larger in order to become stronger, but they
will soon realize that size alone will not ensure success. All providers,
regional and national, will become more sustainable only through reorganizing
themselves to insure ease of access and high value (translation: efficient
and high quality) services.
Doc in the Box
will be the norm. Retailers such as Walgreens, Target, CVS and Walmart will expand services
and attract more regular health care customers. Other companies that offer
clinical services, such as Cancer Centers of America, will become more
expert at marketing and we should expect more patient travel out of their
home area as a result.They have only five locations in the country, but
they advertise everywhere. They promise same day or next day appointments,
the latest in cancer treatment, and by all reports they provide excellent
customer service. Even though this is a clinical operation, their strength
is marketing. They do not offer free care. It seems to be working; and
with only five locations, patients must travel.
5. Rising drug costs will cause more intensive government review and involvement.
may be considered. Other countries put a cap on the price of drugs. Congress attempted to
get the same price for Medicare patients that the VA was able to get by
buying in bulk. The idea is that if one agency of the government can get
cheaper prices all agencies should get it. But, Medicare is not a provider
like the VA, it is only a payer and the pharma lobby got this provision
squelched. There was also a legislative proposal to allow Medicare patients
to buy drugs in Canada; but this was also squelched by the lobby.
We will see rural health deserts. State budgets are being pummeled, and health care is being hit hard.
These shortfalls result in lower Medicaid payments, and reduced access
for many in rural areas. Providers in urban centers have also refused
Medicaid. But the urban Medicaid eligible patient usually can access a
service of some kind and thus get care. This is not true in rural areas
where care options are extremely limited, distance is sometimes great
and even though a provider may offer care to a Medicaid patient, that
provider will soon be out of business because of such low payments with
no way of supplementing revenue from philanthropy or tax payments.
Employers will feel the pinch. Accelerating healthcare inflation will result in aggressive responses
by employers. Employee premiums and deductibles will rise. Another potential
scenario is forcing employees to shift to a voucher approach leaving the
employee totally responsible for securing their own coverage.
Hospitals will be lean and mean. Productivity will be the goal. “Assembly line/manual labor-focused”
improvement efforts will result in declines in healthcare staff engagement,
loss in service delivery and more clinical personnel seeking non-hospital
working environments which will in turn accelerate increasing costs creating
a downward financial spiral.
The Affordable Care Act (ACA) is here to stay. Anecdotal stories abound, some proclaiming success and others screaming
for a dismantling of the program. If nothing else, the ACA has significantly
raised awareness of the many healthcare issues. The genie is out of the
bottle, and turbulence is bubbling in the industry. A repeal is unlikely
to happen. However, amendments may be forthcoming if expected outcomes
are not achieved by deadlines set in the original legislation or due to
some political expediency.
Information Technology sophistication will be a silent driver of profound change. Major IT systems are becoming dominant. As more corporate consolidations
occur, more alignment on IT platforms occurs. The result is standardization
of processes, and, in turn, required behavior change by providers. IT
will move from programmable computers to cognitive systems and there will
be more reliance on machines and less on clinical expertise.