Archive for the ‘Consumer-Driven Healthcare’ Category

ACA Afterlife: Unwinding Obamacare Under the Trump Administration

November 14th, 2016 by Patricia Donovan

The people have spoken: the future of the ACA is healthcare's most pressing concern for 2017.

The people have spoken: the future of the Affordable Care Act is healthcare's most consuming concern for 2017.

If U.S. President-elect Donald J. Trump delivers on his campaign promises, the 'repeal and replacement' of the Affordable Care Act (ACA) should be an early priority for the nation's chief executive-in-waiting.

That prospect sent shock waves through the healthcare industry, as evidenced by a snapshot of post-election responses to the ongoing Healthcare Trends in 2017 survey sponsored by the Healthcare Intelligence Network.

"The change or replacement of Obamacare might affect us significantly, including changing our USA market priority over other markets," contributed one respondent.

"We don't know what ACA repeal implications will mean for us," offered another.

Other respondents identified "changes to our government structure and the unknown impact" as well as "lack of clarity post-election" as their most pressing concerns for the year ahead.

Take the Healthcare Trends 2017 survey and receive an executive summary of the results.

Given Trump's ambitious healthcare agenda, much is at stake for industry stakeholders. But is it possible for the incoming administration to unravel the ACA, when the public already has been exposed to many of its provisions? And if repeal is possible, how long might the process take?

Greg Mertz, managing director for Physician Strategies Group, LLC, advises healthcare organizations not to panic about the ACA's demise. "A '“repeal and replace' means that Trump admits Obamacare can't go away. Nothing will happen quickly, and whatever happens will be less dramatic than many expect," predicts Mertz, who points to Trump's lack of specifics as to what might replace Obamacare as further evidence.

"House Speaker Paul Ryan, R-Wisconsin, has already put forward his plan for healthcare reform, so I would think his ideas will be a pivotal part of what eventually gets passed," continues Mertz. "However, Congress still decides what happens, so whatever Trump proposes will be mired in hearings, staff work, and debate for at least the next year. This means that we limp along with a broken program as we argue what is better."

Also based on Ryan's healthcare proposals, Travis Ansel, senior manager of strategic services for Healthcare Strategy Group, is advising providers to brace for more Health Savings Account (HSA)-related payment woes. "Ryan's plans for Medicare, which have loomed over the industry for five years, bring with them increased patient payment obligations," Ansel explains. "Expect more and more employer-based coverages to shift to HSAs as well. We can expect payors to raise insurance premiums across the board as the Republican-led Congress unwinds the ACA."

Ansel pointed out that major payors were forced to shift their business models and infrastructure to compete in an ACA-focused market. "The quick shift back will be a reality these payors are not prepared for and not prepared to succeed under," he concludes.

As payor margins suffer, adds Mertz, pressure will be placed on commercial insurers to raise reimbursement to offset the gap. "Employers will howl and the feds will be pressured to control costs, especially big pharma."

Where Mertz does expect activity is within the Health Insurance Exchanges created by the ACA. "The insurance exchanges are in trouble already, so we would expect that providers that were seeing significant numbers of exchange-insured individuals would have likely seen a drop in those numbers regardless. I think the number of uninsured will increase in the short-term, as many will decide that paying the penalty is better than paying the premium."

As to what healthcare might look like under the Trump administration, Mertz thinks the industry will see tax credits or vouchers. "However, I seriously doubt we'll see a government-sponsored alternative, which I think we would have seen with (the Democratic presidential nominee) former U.S. Secretary of State Hillary Clinton."

On the provider side, Mertz expects that while physicians will see little impact, hospitals will see a rise in charity care, and no major increase in income.

For a post-election roadmap to the challenges and opportunities facing healthcare in the year ahead under GOP leadership, don't miss Trends Shaping the Healthcare Industry in 2017: A Strategic Planning Session, a live webcast on Thursday, November 17 at 1:30 Eastern.

Take the Healthcare Trends 2017 survey and receive an executive summary of the results.

Infographic: Patient and Provider Healthcare Perceptions

September 5th, 2016 by Melanie Matthews

Fifty percent of healthcare consumers say they take complete responsibility for their health; only 6 percent of healthcare professionals believe this to be true, according to a new infographic by Xerox.

The infographic looks at the different perspectives for consumers and providers on healthcare responsibility and finding treatment options and how consumer generational differences impact these perspectives.

Intermountain Healthcare's strategic six-point patient engagement framework not only has transformed patient care delivered by the Salt Lake City-based organization but also has fostered an attitude of shared accountability throughout the not-for-profit health system.

Framework for Patient Engagement: 6 Stages to Success in a Value-Based Health System details Intermountain's multilayered approach and how it supports its corporate mission: Helping people live the healthiest lives possible.

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Infographic: Patient Empowerment in Healthcare

July 13th, 2016 by Melanie Matthews

Patient empowerment has the potential to revolutionize healthcare, and it's happening at a time when patients have more information at hand than ever before. Emerging as a new paradigm, patient empowerment promises to help improve medical outcomes while also lowering healthcare costs, according to a new infographic by LabFinder.

The infographic outlines steps for taking patient empowerment from concept to practice.

Transformational patient-centered models emerging post-ACA are designed to succeed with a core of engaged, activated patients, yet enlistment of individuals in chronic care management, telehealth and other health enhancement interventions continues to challenge the healthcare industry.

2015 Healthcare Benchmarks: Patient Engagement documents strategies, program components, successes and challenges of engaging patients and health plan members in self-care from 133 organizations responding to the 2015 Patient Engagement survey by the Healthcare Intelligence Network.

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Infographic: Shattering the Sick-Care Marketplace

May 11th, 2016 by Melanie Matthews

The emergence of an entirely new healthcare business design that ignores the boundaries and economic framework of the existing healthcare system is occurring in response to healthcare consumerism trends and is resulting in new consumer health, wellness, and better-living products and services.

A new infographic by Oliver Wyman describes the circumstances driving this transformation, the expected market of these products and services and essential product and service elements.

Population Health Framework: 27 Strategies to Drive Engagement, Access & Risk StratificationFaith-based integrated delivery system Adventist Health is on a mission to improve population health status with a wellness-based approach it estimates will eventually net $49 million in savings.

Population Health Framework: 27 Strategies to Drive Engagement, Access & Risk Stratification walks through the elements of Adventist's population health management program that engages individuals to modify behaviors and prevent illness in the future.

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Infographic: Trends in Employer-Sponsored Health Insurance

January 15th, 2016 by Melanie Matthews

Between 1999 and 2015, employer-sponsored health insurance premiums increased by 203 percent, outpacing both inflation and workers' earnings. However, growth of premiums for family coverage slowed toward the end of that time period, from an average of 11 percent a year between 1999 and 2005, to 5 percent between 2005 and 2015, according to a new Visualizing Health Policy infographic by the Henry J. Kaiser Family Foundation.

The infographic also looks at the average annual premium for family coverage and how employers are responding to high-cost health plans.

Healthcare Trends & Forecasts in 2016: Performance Expectations for the Healthcare IndustryFrom cost pressures, consumerism and consolidation to a proliferation of patient-centered, value-based delivery and payment models, the state of healthcare continues to challenge organizations in the industry.

Healthcare Trends & Forecasts in 2016: Performance Expectations for the Healthcare Industry, HIN's 12th annual business forecast, pins down the trends destined to impact the industry in the year to come and proposes tactics C-suite executives can employ to distinguish their operations in a dynamic marketplace.

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Infographic: The Three C’s of Digital Health

January 13th, 2016 by Melanie Matthews

An overwhelming majority, 73 percent, of health insurance executives are planning major, technology-driven transformation at their organizations, according to a new survey by HealthEdge.

The infographic looks at how the three C's of digital health—consumerism, cost reduction and care coordination—are driving this trend.

Despite reimbursement challenges, the healthcare industry is charged up about remote patient monitoring to manage chronic illness: two-thirds of respondents to HIN's 2015 Telehealth and Telemedicine survey monitor high-risk patients in this fashion. Encouraged by early success in coaching 23 patients to wellness at home via remote monitoring, CHRISTUS Health expanded its remote patient monitoring (RPM) enrollment to 170 high-risk, high-cost patients. At that scaling-up juncture, the challenge for CHRISTUS shifted to balancing its mission of keeping patients healthy and in their homes with maintaining revenue streams sufficient to keep its doors open in a largely fee-for-service environment.

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System chronicles the evolution of the CHRISTUS RPM pilot, which is framed around a Bluetooth®-enabled monitoring kit sent home with patients at hospital discharge.

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Infographic: Patient-Driven Healthcare Through Mobile Technology

November 30th, 2015 by Melanie Matthews

The traditional healthcare environment is changing to one where information is handled more efficiently and consumers are taking more control of healthcare decisions.

A new infographic by Samsung examines how the use of mobile devices is changing healthcare consumer and provider behaviors and the benefits of mobile health.

From home sensors that track daily motion and sleep abnormalities to video visits via teleconferencing, Humana's nine pilots of remote patient monitoring test technologies to keep the frail elderly at home as long as possible. When integrated with telephonic care management, remote monitoring has helped to avert medical emergencies and preventable hospitalizations among individuals with serious medical and functional challenges.

In Remote Patient Monitoring for Enhanced Care Coordination: Technology to Manage an Aging Population, Gail Miller, vice president of telephonic clinical operations in Humana's care management organization, Humana Cares/SeniorBridge, reviews Humana's expanded continuum of care aimed at improving health outcomes, increasing satisfaction and reducing overall healthcare costs with a more holistic approach.

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Healthcare Drivers for 2016: Cost Management, Consolidation, Consumerism

November 19th, 2015 by Patricia Donovan
Healthcare Trends 2016

Healthcare data, both system-generated and consumer-reported, will continue to transform the industry in the year ahead, according to HIN's twelfth annual strategic planning session.

As healthcare heads into a presidential election year, cost management remains a key focus, with infomediation—the growing practice of mining healthcare data about cost, quality, and services—a major tactic against price pressure.

These were just a few predictions by thought leaders during an annual industry strategic planning session sponsored by the Healthcare Intelligence Network.

"The North Star now for healthcare, for all players in the system, is sustainable cost," said Paul Keckley, managing director of Navigant, during Trends Shaping the Healthcare Industry in 2016: A Strategic Planning Session, now available for replay. Multiple forecasts indicate U.S. health costs will increase between 5.6 and 6 percent a year over the next decade, he noted, with the nation's economy only recovering to about a 3 percent growth rate.

"Not to be missed is the pressure on price and therefore, the pressure on reducing operating costs and reducing the cost per episode of care," agreed Laura Jacobs, executive vice president of GE Healthcare Camden Group. "Where you're going to be in that cost value equation is a key strategic question and should be part of your board discussions about where you want to be on that spectrum."

To become leaner and more efficient, healthcare organizations are closing ranks in increasing numbers. Ms. Jacobs predicted that this "dance of consolidation" would continue among all stakeholders in healthcare, with intense scrutiny by the FTC of those collaborations.

Some payors already are well ahead of hospitals, doctors and service providers in the degree of consolidation, added Mr. Keckley. "These super regional systems of care are evolving as a result of this transition of volume to value."

At the moment, health plans are better positioned to profit from healthcare's pay for value formulas and the proliferation of shared risk arrangements, he continued, largely because of the huge data repositories they have constructed. "A very strong meta-analysis of [health plan] data becomes the anchor for shared risk arrangements," Keckley said, referring to the phenomenon known as infomediation. "The strongest asset health plans have is their data." Manipulation of this data to influence population health trends is fast becoming central to health plan operations, he said.

Another type of data the healthcare industry should be cognizant of is consumer-generated healthcare data, in the form of provider reviews on social media or within apps. "Consumer reporting on their experience with providers is not something that providers love," Ms. Jacobs said. "But just as we've experienced with other parts of consumerism, the impact of these kinds of venues will continue."

The panelists also shared thoughts on opportunities in the Medicare Advantage market, the blurring of lines between payor and provider, early returns from provider-sponsored health plans, and the anticipated evolution of primary care as the "epicenter" of healthcare.

Click here to listen to more predictions from Laura Jacobs.

Infographic: Meet Today’s Healthcare Consumer

October 30th, 2015 by Melanie Matthews

Consumer engagement is increasing in three important areas—provider partnerships, online health information searches and technology use, according to findings from Deloitte's 2015 Survey of U.S. Health Care Consumers.

A new infographic by Deloitte looks at how these trends are impacting today's healthcare consumer.

Meet Today's Healthcare Consumer

Skyrocketing private exchange participation rates—industry estimates predict more than 40 million people may be enrolled in private insurance exchanges within three years—carry implications for health insurers in terms of how the various market segments are succeeding or failing to attract business.

Private Insurance Exchanges: Adapting Insurer Strategies to the New Marketplaces details the radical transformation underway in how employers and consumers offer and shop for coverage. It discusses the current status of private exchanges, reviews the inventory in existence today, and shares thoughts from market consultants and insurance executives on how new business strategies will be influenced by new entrants to the private exchange space and the participation of insurers and brokers.

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Infographic: Patient Demands Drive Health IT Transformation

October 21st, 2015 by Melanie Matthews

Today's healthcare consumer demands are driving IT transformation, according to a new infographic by CDW Healthcare.

The infographic examines how patients want to communicate with their physician and new routes of patient education and access to care.

Patient Demands Drive Health IT Transformation

As the healthcare industry's understanding of the importance of an empowered, engaged patient has increased, Intermountain Healthcare changed its mission statement to reflect the critical role of patients in a value-based healthcare system. "Helping people live the healthiest lives possible" embodies the new environment of shared accountability between patients and providers that is fostered at Intermountain Healthcare.

During A Patient Engagement Framework: Intermountain Healthcare's Approach for a Value-Based System, a 45-minute webinar, on October 28th at 1:30 p.m., Tammy Richards, corporate director of patient and clinical engagement at Intermountain Healthcare, will share the key tenets of Intermountain's patient engagement strategy.

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