New healthcare trends in 2016 and in years down the road will affect value-based care and population health management. The healthcare industry continues to evolve, and comes with both good and bad news regarding healthcare costs. A reminder, healthcare costs as a percent of Gross Domestic Product have hovered around 17.5 percent for the last few years. The bad news: costs as a percentage of GDP are projected to increase and reach 19.6 percent by 2024. Conversely, the good news is that the growth in healthcare costs are not due to simple inflationary pricing; instead the increase is in large part due to the combined effects of the Affordable Care Act's (ACA) coverage expansions, stronger expected economic growth and population aging. Despite this increase, the projected growth rate is still lower than the growth experienced over the last three decades prior to the most recent recession1.
Beyond costs, there are many other considerations and factors to note in the coming year. We have surveyed the landscape, for those interested in population health and value-based care these are five of the top healthcare trends to watch in 2016.
1. Personalized Medicine
The ability to use an individual's unique DNA and biology to customize drugs is gaining popularity, due to a better understanding of the role and value of molecular biology in the medical community. While once a reality only available to the super rich or well-connected few, the promised benefits of personalized medicine are more precise and more effective treatments for chronic disease and serious health ailments, with fewer unintended effects. As one clinician offered, the ultimate patient centered care is personalized medicine.
2. Patient Information Security
Healthcare companies are concerned about the security of protecting the digital records and identities of their patients (aka members), more than ever. According to Reuters, a medical record is worth more to digital thieves than a credit card. The price of a patient record on the black market ranges from $25 to over $40 per record compared to a dollar or less for a stolen credit card. It becomes very clear as to why healthcare companies are becoming victims to cybercriminal activities at an unprecedented rate. If a breach occurs, the average cost of a healthcare record ranks the highest at a whopping $359—both direct and indirect costs. According to SC Magazine, this cost is very alarming for well-established security professionals. Due to medical records being compromised and the cost related to recover from these events happening, it is clear why security is a critical healthcare trend for 2016 and beyond. Healthcare companies need to invest in the necessary resources to protect their digital assets such as electronic Protected Health Information (ePHI).
3. Healthcare Analytics
Another new healthcare trend to notice is the shift in the use of analytics. Healthcare analytics are moving away from a reactive to a more proactive approach—this is the shift from historical data analysis to both predictive and prescriptive data modeling to identify at-risk populations, reduce unnecessary costs and improve overall outcomes. Clinical, operational and financial data should be readily accessible on a self-service business intelligence platform. Healthcare executives can then use the data to make timely business decisions to reduce unnecessary costs and impact overall care, because they’re using real-time information as opposed to historical data.
4. Chronic Care Management
Chronic Care Management (CCM) will play a critical role in new healthcare trends for the future. In January, the Centers for Medicare & Medicaid Services released a new ruling for Chronic Care Management (CCM) recognizing care management as a critical component of primary care contributing to better health and reduced spending. The revision now includes Rural Health Clinics and Federally Qualified Health Centers as providers who are able to bill for CCM services. At this time, CMS does not require RHCs and FQHCs to use certified EHR technology for some services involving the care plan and clinical summaries, however there are some electronic technology requirements. Refer to the CMS website for updates.
5. Population Health Initiatives Attract Expanded List of Healthcare Entities
Historically, health information exchange, clinical interoperability, and care coordination were deemed necessary for IDNs, large IPAs, and ACOs. As the quest for true population health expands, additional organizations including specialty hospitals, dialysis centers and home health agencies are looking for business intelligence, data, and analytical tools to stratify patients more accurately based on care needs. With that data, they'll be able to track, report and share information across the entire continuum of care. This year, look for even more organizations to jump on the population health / data exchange bandwagon.
The link between all of these healthcare trends is the vision for a better healthcare system. However, we know that higher quality care, lower costs, and better health will not be realized by technological advancements alone. In the words of eQHealth Solutions' CMO, "the silver bullet that makes the promise of healthcare's triple aim come to life is both high-tech and high-touch.” Said another way, “it is coordinated care that marries technological innovation and advancements to local community-based, hands-on, coordinated caregivers that deliver individualized, real-time patient care."
eQHealth Solutions provides a technology platform that can improve the effectiveness of your value-based care delivery and provide a local, community-based coordinated care team in your area. For more information, click here.
Centers for Medicare & Medicaid Services - National Health Expenditure Projections 2014-2024, https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/proj2014.pdf