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.