Key Trends for Next Year

Key Trends For Next Year imageAs providers, payers and others survey the health care landscape for next year and what potential strategic adjustments to make, keep an eye on these issues identified by some of the field’s prominent advisory firms.

New health economy to take flight. Ben Isgur, leader of PwC’s Health Research Institute, told FierceHealthcare that thanks to the rise of consumerism and corporations assuming a greater health care presence, the nation’s health system is rapidly transforming. No longer is it an economic outlier. If you want to see where the field is headed, Isgur says, keep an eye on where private equity places its bets in 2019. Investors see opportunities in health care because the nation’s health system is becoming more stable and aligning better with the overall economy. He adds that trends indicate that providers with high Medicaid or uninsured populations can perform better. A key challenge for providers remains, however. They still don’t have the workforce and privacy capabilities they need to leverage technology deployment to optimize care delivery transformation, Isgur notes.

First insurer to master blockchain wins. KPMG’s blockchain leader Arun Ghosh notes in Healthcare Finance that blockchain in the payer world will bear watching in 2019. He says blockchain offers at least three advantages to payers: (1) the ability to keep a record of transactions; (2) it can be augmented to connect payers to electronic health records; and (3) it can be used to automate time-consuming tasks like claims adjudication and prior authorization. In a larger context, blockchain can connect payers not only with providers, but also to distributors and pharmacists in an end-to-end transaction. “The first payer that gets this, rules,” Ghosh says. The report notes that one firm, Myndshft, has tweeted that it has this capability. A major hurdle remains to be cleared, however, in information sharing — trust. Ghosh says that in spite of this factor, organizations are moving ahead with blockchain pilots, including Change Healthcare, Optum and UnitedHealthcare.

Consumerism and data analytics top payer priorities. Even as payers explore blockchain and other technologies to improve efficiency and help reduce cost, their key 2019 priorities are consumerism, data analytics and achieving organic growth. That’s the takeaway from a new survey from North Highland consulting firm. Some 83 percent of responding payers cited data and analytics as a strategic priority for 2019. A similar percentage of respondents labeled delivering a customer-centric experience as a strategic priority. However, only 14 percent believed they were “very prepared” to address this. Similarly, 81 percent said organic growth is a strategic priority, yet only 26 percent felt their company was prepared to respond. Value-based care initiatives make focusing on consumers more important than ever, Roman Fry, a health care principal with North Highland, told FierceHealthcare. He added that the rise in payer mergers and acquisitions reflects the companies’ desires to obtain more consumer data.

Related Resources

AHA provides specific feedback to the Senate Bipartisan Working Group on the Stopping the Outrageous Practice (STOP) of Surprise Bills Act of 2019 (S. 1531).
Action Alert
Recently, a number of proposals have been introduced in Congress to address surprise medical billing.
This chart provides an in-depth comparison of the major provisions of three bills pending before Congress.
A quick look at the state of play on surprise billing legislation moving through Congress,.
AHA talking points on surprise medical billing and the major provisions of three bills pending before Congress.
Testimony of the American Hospital Association