- Patient Experience is Paramount
Patients are increasingly demanding the same consumer-centric experience they are receiving in retail settings when they are receiving medical care. It all starts with understanding your population and patient personalization. How do they like to receive care? How do they like to communicate with providers? Who is their preferred doctor? Next, you can build out technology and other solutions to customize the care you provide.
Most providers offer patient portals for viewing lab results and upcoming appointments. Many patients find these portals frustrating to access and not user friendly. Many patients also want online appointment scheduling and cancellation. They want waiting lists in the case of an earlier canceled appointment. They want to contact providers through electronic means/real time/video/email. They want convenient extended hours.
Improving communication and delivering a more retail-focused experience will go a long way towards developing patient loyalty.
- Lower Cost Healthcare is a Necessity
Lowering the cost of healthcare is imperative, not only for providers facing budget pressure, but for consumers who are shouldering more and more of the cost of care and for payers who are looking to minimize reimbursements for unnecessary procedures.
The goal for providers is how to deliver the best results while keeping costs down. In fact, 41% name financial constraints as the force that will cause the greatest disruption in healthcare this year. Increased budget pressure should increase innovation in delivery of quality care.
Consumers are increasingly struggling with rising drug prices and more cost responsibility due to high deductible plans. It’s likely we will see pricing models including paying prescriptions over time, rather than all at once. We can also expect to see increased governmental regulation to curb rising prices. In addition to this, the FDA has created new initiatives designed to unleash more competition that can moderate drug price trends. These include encouraging new market entrants to rapidly start developing generics in classes where there is no competition, streamlining the generic drug approval process, promoting biosimilars and taking steps to prevent branded drug makers from exploiting programs
During 2018, we predict an increase in consumer-focused medical plans. What consumers want in a plan is convenience and value. To achieve that goal, we will likely see bundled finance offerings with plans, loyalty programs similar to frequent flyer miles, professionals (similar to a financial planner) who manage one’s health spending.
Payers will continue to become more involved in the provider side as a way of controlling costs. They will continue to create policies, design plans, and narrow provider networks.
- Changing Governmental Regulations
45% of providers name government regulations as the force that will cause the greatest disruption in healthcare this year. Tax reform, healthcare reform, and governmental requirements will all significantly impact how the industry provides and pays for care.
With the probable reduction of the corporate tax rate, we will see change in the way companies invest, structure, and hold profits.
Efforts continue to loosen Affordable Care Act consumer protections and mandates, cut Medicaid spending, and expand access to lower-premium health insurance.
49% of providers cited increased regulatory and reimbursement requirements as the issue most likely to impact their orgs future. Providers worry the unknowns will affect bottom line, morale, and workflow.
For the foreseeable future, the healthcare industry will continue to see inconsistency in government policies and funding. This is especially dangerous for hospitals in underserved communities that rely almost exclusively on Medicaid and Medicare funding. Unless they are supported in some way, many of these providers will sink deeper into debt.
- The Shift to Non-Inpatient Care
47% of hospital revenue is currently from outpatient care, and this is expected to continue to rise, as inpatient care is more expensive and hospitals are looking for ways to cut costs. This can benefit patients, as they are looking for quicker and more convenient care. Ambulatory surgery centers are increasingly used for low risk patients who require a surgery. Care is moving from the hospital into the community giving consumers the quick and convenient access they desire.
Telemedicine and virtual care is currently offered by 75% of institutions. This growth is driven by patients’ desire for more convenient care. Reimbursement is currently the main barrier to expanding these offerings.
- Consolidations, Partnerships and Mergers, Oh My!
There is a new form of competition emerging: providers and payers are organizing themselves into vertically-integrated, high-value care and financing networks. Insurers, physician groups, health systems, and even retail organizations are each seeking to compete as high value care and financing networks.
Providers and payers have increasingly worked collaboratively. Payer-provider partnerships vary in type, size, location and model. There are 50/50 joint ventures with co-branding, and less intensive partnerships like pay for performance, accountable care organizations, patient-centered medical homes and bundled payments.
Employers are getting into the game, too. Amazon, Berkshire Hathaway and JPMorgan Chase partnering to cut costs and improve service to their employees could be a game changer, as they target tech solutions to simplify the healthcare system.
We expect to see the industry become increasingly hybridized with more and more partnerships, consolidations and mergers.