Healthcare Forecast 2012: 10 Trends to Watch in the Year Ahead

Wednesday, November 9th, 2011
This post was written by Cheryl Miller

ACOs and bundled payments will have major impacts on the healthcare industry in 2012, said Steve Valentine, president of The Camden Group, in a recent webinar, Healthcare Trends 2012, a Strategic Industry Forecast, during which he provided a first look analysis at the key trends and opportunities for healthcare organizations in the coming year.

In 2012 and beyond, physicians will be the real “movers and shakers” in terms of changing the delivery system and curbing costs, Valentine continued. They will be especially key in the post-acute care continuum, if they can successfully move patients into lower cost sites through changed care models.

Given this changing landscape, healthcare leaders will need to identify their geographical area’s healthcare needs and available resources, articulate their goals, and structure their network of care around these elements. Valentine cited the CalPERS pilot program in 2010 (the consolidation of Blue Shield of California, Hill Physician and Catholic Healthcare West in Northern California) as a prime example. The group generated savings by reducing 30-day readmission rates and reducing patients’ length of stay, and acknowledging that 12 percent of the population consumed 70 percent of the resources.

“Typically it’s the old 20/80 rule where 20 percent of the populations account for 80 percent of the healthcare cost,” Valentine said. Providers need to target this population, which is generally the chronically ill Medicare patients, up front, stratify them into levels of care, assign a proper multidisciplinary team and then manage that chronic disease, he continued.

Another key trend for 2012 will be the utilization of embedded case managers, Valentine said. He recommended a centralized case management team, with the individual case managers placed in physician offices, or emergency departments, working “hand and glove” with the physicians and hospitalists, another key trend for the coming years, as hospitals and PCPs merge. The most effective case managers would reside with an ambulatory EMR, beside the patient and physician. Case managers would be least effective in the hospital space, where they tend to be used more for revenue reasons, Valentine added.

Over the next few years, health organizations will also have to reevaluate their logistical operations, reassessing workdays and hours, and trying to maximize volume. “Strategists need to broaden their reach in order to capture as much population as they intend to manage,” Valentine urged.

Valentine stressed that repercussions from the current economy will impact the healthcare industry for the next few years. Continued unemployment levels will lessen demand for elective procedures; and create more price shopping for services.

Other points from the webinar:

  • Co-management will be an attractive strategy for many organizations in 2012, especially as it is packaged with bundled payments.
  • Medical homes will continue to increase, with chronically ill patients, like diabetics, being moved into “mini medical homes.”
  • Health systems will need to target Medicare reimbursement by the year 2014.
  • Physician-hospital integration will have a high impact on ACOs, IDS/Health Plans, and a low impact on physician-owned hospitals and specialty institutes.
  • Related Posts:

    Comments are closed.