[:en]by Robbie Hughes
2016 was a year of slow-but-steady progress for healthcare. Amid ever-rising costs (in August the Labor Department announced the highest rate of increased spending in 30 years) Centers for Medicare & Medicaid Services (CMS) are steadfastly laying the groundwork in the momentous shift towards Value-Based Care. With MACRA regulations and the focus on alternative payment models gaining traction, many commercial payers are following suit and investing in programs that link reimbursement to quality outcomes.
So what’s in store for 2017?
1. 2017 will be the Year of Bundles
We predict that at least 5 major insurers will launch their bundle propositions, predominantly through narrow network offerings with providers who focus on excellence in specialist areas. This will bring about further consolidation in the market through the integration of multiple care settings, such as Ambulatory Surgery Centres, into hospital systems and Integrated Delivery Networks.
2) Employers will continue to open their own healthcare provision
Following in the steps of 40 of Fortune’s 100 Best Companies to Work For, increasing numbers of employers will enable health care access in the form of on-site Primary Care clinics available to employees in the first instance, and then to their families. They will partner with a major insurer to provide coverage outside of these clinics, but the majority of care will be administered and managed from the Primary Care sites wherever possible. Quality will go up; costs will go down. Employee satisfaction will go up; and absenteeism down. People will wonder why this wasn’t done before.
3) Healthcare Exchanges are given the kiss of death
As prices for existing insurance products continue to increase due to a lack of liquidity in the market, the exchanges themselves will be targeted as the cause of the pricing issue, not merely a symptom. Press commentary and a desire for the new administration to be seen to be repealing the ACA will see these either killed off immediately or put on a timeline to end of life. The presence or not of exchanges will ultimately make no difference to the price of insurance.
4) Health Care Education and Reconciliation Act (HERA) is killed off
The one part of the ACA that can be easily repealed is repealed. This sparks a huge debate about the actual problems in the healthcare system as the general public start to realize what the ACA actually does as 18 million people who had coverage suddenly don’t.
5) U.S Hospitals go global
With protectionism and even tighter visa controls looming, leading U.S. hospitals don’t want to lose their stream of revenue from cash-rich self-pay international patients. The solution? Increasing international satellites. We foresee that when The Cleveland Clinic opens its doors in Central London, with a transparent bundle-based price list, at roughly 50% of what is charged for the same thing in the U.S. (despite being located on the most expensive real estate in Europe), nobody in the U.S thinks this is in any way odd.
There you have it. 2017 as the year of bundles. Are you ready?