Working through first quarter of 2018, we observe healthcare organizations doing their best to hang in there and ride out the wave during this period of uncertainty. As they hunker down waiting for the storm to pass, hospitals have an increased focus on reducing cost and enhancing hospital revenue cycle management – all while improving performance.
Will 2018 see more erosion of the Affordable Care Act (ACA) or will the legislation gain strength? What is in store for value-based healthcare? We examine these questions as we look at 2018 healthcare trends on the horizon.
Other hospitals, in particular, those more willing to take on the financial risk as they move forward with value-based payment contracts, press on towards transformation goals. California Healthcare News reports that opportunities exist for these hospitals while they improve their performance under Medicare opportunities and value-based contracts – such as Next Generation, Bundled Payment for Care Improvement Advanced (BPCI Advanced) or Medicare Shared Savings Program (MSSP) ACOs.
Will these value-based care initiatives be successful after the 2017 shift away from incentive programs?
In order for these programs to work, substantial reforms to the delivery system must take place. For instance, there needs to be structured local provider and Community Based Organization (CBO) networks – that work hand in hand to deliver access to the appropriate level of care to the right patients at the right times with proper social services support. In addition, healthcare providers must also improve internal care management processes and the utilization review capabilities – all while applying best evidence-based clinical practices and making effective use of data analytics.
How the Progressive Dismantling of the Affordable Care Act will Shape Healthcare
Day Health Strategies reports that due to the erosion of certain aspects of the ACA, 2018 could see significant market destabilization and more state involvement. According to the article:
“This erosion included ending cost sharing reduction payments to insurers, shortening the open enrollment period, cutting navigator funding, eliminating the individual mandate, and introducing a number of administrative proposals. It appears the efforts to erode the ACA will continue in 2018, especially through administrative action.”
The following are things to watch for in 2018 that could result from the efforts to erode the ACA according to the piece in Day Health Strategies:
- Individual market destabilization and higher insurance rates
- Cuts to state funding
- Increased involvement from the state
In terms of value-based care in 2018, the same article predicts the year will see more initiatives, including:
- Emphasis placed on value over volume
- Virtual care
- Increase in partnerships and joint ventures
- Smart electronic health records (EHRs)
It’s going to be another interesting year in healthcare with notable changes already on the horizon. As summarized in a Health Affairs article:
“2018 will be a year of a renewed focus by CMS on paying for value, particularly with the continued ramp up of the Medicare Access and CHIP Reauthorization Act of 2015 that incents clinicians to take risk, and new APMs that create attractive alternatives for fence sitting providers.”
- See also:
2018 Tips & Trends for Hospital Revenue Cycle Management
The Future of Healthcare: New Obstacles and Ongoing Challenges
We will follow this topic and continue to report on the progression and transition of the current healthcare delivery model and legislation that gives it shape.