health-industryAs 2016 comes to a close, predictions for 2017 being released.  Pour a cup of eggnog (low-fat eggnog), and settle in for an overview of the top 10 health industry issues for 2017 released by PwC Health Research Institute.

We will have a new president in 2017, so we know that changes are coming. Will the ACA be repealed? If, so what would replace it and when? What else is on the horizon? Let’s take a high level look at PwC’s prediction. For the full detail on this research, download a copy of the report from PwC.

  1. ACA fate is unclear.  President-elect Trump intends to repeal the ACA.  Instead of the ACA, PwC predicts we may see tax credits, health savings accounts, high-risk pools, state Medicaid block grants and a transfer of regulatory control from the federal government to states.  It doesn’t sound like a quick transition, probably 2018 and beyond.
  2. Patients could be the new strategic partner for pharmacy companies as they try to justify cost and value, while addressing regulatory pressure.  Mobile apps, such as one developed by Eli Lilly, may help patients remember to take their drug and track symptoms.  Also, insurers are contracting with drug companies to pay based on performance as I discussed in a previous blog.
  3. Value-based payment models, which currently reward healthcare providers, will shift to have downside risk as well.   Medicare Access and CHIP Reauthorization Act of 2015, the physician payment reform act, begins performance standards in 2017 that put a portion of payment at risk based on factors including data collection and performance on quality metrics.  Accountable Care Organizations (ACOs) will be pushed to participate in the Medicare Shared Savings Program.
  4. More healthcare will be paid for via credit card transactions with security needing to be a priority.  The lack of a consolidated, secure credit card payment systems puts consumers at risk.  Hackers are targeting health care for identity theft.  The Mayo Clinic replaced more than 1,400 devices and improved security.
  5. Emerging technologies are coming, including artificial intelligence, drones and virtual reality, and the healthcare industry needs to be ready.  3D printing is gaining use and applications.  Technology could be used in the home to perform work currently handled by primary care physicians, and transmit information back to the physician.
  6. The US and Europe are collaborating in the battle against infectious diseases, which have become a global concern.  A focus is the spread of antibiotic-resistant bacteria.  Rapid and effective diagnosis is also needed.  An example is Zika, where as many as 80% of those infected had no symptoms.
  7. Nutrition as a new focus to improve health and prevent healthcare cost.  You really are what you eat, apparently.  According to data from the Centers for Disease Control and Prevention, nearly 40% of Americans are obese.  Nutritional information is now provided by some grocery store chains, even dietitians.
  8. Possible pricing restrictions on drug prices implemented by industry trade organizations and pharmaceutical executives rather than the government.  Due to pressure from consumers and the potential for legislative action, the pharmaceutical companies may implement their own pricing restrictions, such as limiting the percent of price increases to single digits, and only once per year.
  9. Additional consolidation of the health care industry, not only through mergers and acquisitions, but also through partnerships, joint ventures and other alliances or affiliations.  One example is Aetna’s partnership with Apple to provide smartwatches to nearly 50,000 employees and some plan members as a way to bring analytics and care management functions together through a device.
  10. Medical schools preparing students to practice medicine as value-based care.  Future physicians will need to lead teams and coordinate care, as well as assess quality of care, a different skill set than in the past.

So, 2017 will have its challenges and opportunities, from changes led by a new president to the continued evolution of value-based care. What can we do, to have a positive impact for our employees as these issues are addressed across the health industry? As I review the utilization data for my clients, obesity, diabetes and cholesterol continue to be common issues. Perhaps a focus on nutrition as part of our wellness program is a logical step. Have a salad with that low-fat eggnog.

Ellen Tucker

Ellen Tucker

Principal, Health & Welfare Consultant - Ellen’s expertise in the areas of underwriting, product development, financial analysis, provider relations, market research, strategic planning and benefit administration make her one of the most knowledgeable individuals in the healthcare industry today.
Ellen Tucker

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