Whether concerned with healthcare delivery or reimbursement for services rendered, providers and payors alike will need to be nimble in the coming year to survive and thrive in a sharply shifting, value-based marketplace, advises Steven Valentine, vice president, Advisory Consulting Services, Premier Inc.
"Be aware: the competitors you've had in the past are changing, and you're seeing more competition with various Internet providers, CVS, Apple, Watson. It's all going to change," said Valentine during Trends Shaping the Healthcare Industry in 2017: A Strategic Planning Session, a November 2016 webinar now available for replay.
But what healthcare shouldn't panic about, at least for the immediate future, is the demise of the Affordable Care Act (ACA).
"[The ACA] is not going to be canceled any time soon," Valentine emphasized during the thirteenth annual planning session sponsored by the Healthcare Intelligence Network. "We would expect it would take two years, at least, to begin to put in some kind of a replacement program."
Assuring participants that within all this industry flux are opportunities, Valentine suggested they follow the lead of retail pharmacy CVS. "CVS envisions itself as a full service healthcare organization with a goal of 'patient stickiness.' In other words, CVS is saying, 'I need patients to rely on me as their source of getting started for healthcare.'"
Later in the program, he offered participants a four-point plan for improving patient stickiness.
As for care management sophistication, Valentine pointed to the pairing of hospitals with a case manager, with incentives for care managers and hospitalists to manage down length of stay, or manage resource consumption.
"We're probably gravitating more toward care management models that are outside the four walls of the hospitals...which will give us better economies, better outcomes, people more specialized in the areas they're in that could really help provide better quality at a lower cost."
And while the healthcare thought leader believes Medicare will remain essentially untouched by the incoming presidential administration, he did identify nearly a dozen areas where President-Elect Donald Trump's 'Better Way' might eventually make its mark on healthcare, including more price transparency and the sale of insurance across state lines.
Moving on to sector-specific forecasts, Valentine outlined four expectations for health plans, including a push for more access points like telehealth and urgent care centers and added pressure to reduce chronic care costs.
Healthcare providers should focus on population health and immerse themselves in data analytics to better prepare for MACRA and the narrow, quality-based provider networks that will result.
Both sectors should expect more consumer demand for accountability, Valentine said, since patients and health plan members are fed up with rising costs and armed with more transparency information and health awareness.
Valentine concluded his presentation with eight guiding principles for 2017 success, including collaboration between health plans and physicians.
And in the Q&A that followed, Valentine offered guidance on a number of issues, including how providers can grow their population bases; identifying and addressing social health determinants; succeeding in value-based healthcare, and offering efficient, integrated behavioral healthcare services.
Click here to listen to advice from Steven Valentine on employing technology for patient engagement.