Day 12: Sounding the Drums for 2017
Today we conclude our 12 Days of Christmas Posts. with warm wishes to all this holiday season.
On our final day it is only fitting to sound the drums for what is to come in 2017. We have asked 12 of our favorite drummers from this past year to help us see the future. Here is what they see coming…
For 2017, I predict that there will be great success by eligible clinicians in managing MACRA, MIPS and the Medicare Quality Payment Program. Having witnessed almost 2 years of saber rattling about how devastating this legislation and regulation would be for care providers; a majority of eligible clinicians are poised to not only stave off the 4% Medicare cut during the 2017 reporting period but rather are poised to achieve 1%-4% positive payment adjustments. I’ve been working with practices for months now getting them ready for MIPS and the QPP and I’m, excitedly, being pushed by them to set-up a great foundation for their success with this program as well as other quality and outcomes-based incentive initiatives. Care providers are rightfully skeptical and a little nervous about this change and evolution in our nation’s payment and care delivery model, but many are successfully engaging. Care providers will be pleasantly surprised by how easy it will be to avoid any negative payment adjustments in 2017 by deploying good MIPS plans and best practices and how simple as well as rewarding these programs will be to attract additional incentives and bonuses. I personally believe that all care providers that intentionally and deliberately engage with new payment & care delivery models, and create the right partnerships, will have more opportunity in the future than they have today. Here’s even a 4-point glide path to assist.
In 2017, I think we are going to see the rise of the longitudinal health record and its value to accountable provider organizations implementing risk based reimbursement models. The simple query transaction between systems will eventually become commoditized through various EMR-vendor driven industry initiatives. This is good, but limited. A complete longitudinal patient record that spans the full physical, behavioral and social service healthcare ecosystem will be vital to those advancing quality, efficient person-centered health in their communities. This next year will also bring the tangible cross-state connectivity between these longitudinal HIE networks through the efforts of SHIEC and its Patient Centered Data Home initiative. This push alerting and query-based network will support consumers as they seek care outside their local data home across state lines and will lay the groundwork for a national HIE network.
Ah, 2017: the year when the healthcare pendulum swings back from the significant progress towards universal coverage made since ACA’s passing, towards a “free market” tiered system that may deepen access, quality, and outcome disparities that already exist. This year is certainly going to bring its fair share of heartbreak: if key ACA provisions like Medicaid expansion and premium subsidies are repealed, tens of millions of individuals and families may lose insurance coverage, the decline of rural hospitals will continue, and the crisis of care access and affordability will strain the already fragile general or family medicine practitioner who is designed to be the “hub” of care coordination in a value-based care model. From that perspective, this year seems very bleak for healthcare (and for the health of those patients, families, and communities caught in the crosshairs). However, from desperation springs innovation: the need to do exponentially more with far fewer resources, in conjunction with what will likely be a less stringent regulatory environment, drives opportunity to try radically different approaches. Cross-industry partnerships, like Uber and MedStar Georgetown University Hospital, will emerge to address complex access issues in several urban areas. Beyond technology (because, certainly, digital health tools such as telehealth and remote monitoring will increase in use), rapid process evolution is likely – eschewing the traditional box of healthcare delivery and payment, developing new community-owned collaboratives and direct-to-consumer offerings. The only thing certain is that change is coming…
In 2017, we’ll see more hospitals enhancing their support of open messaging ecosystems as they strive to improve care team coordination. Many hospitals still have closed messaging systems, which means nurses using Wi-Fi phones or voice badges are limited in who they can communicate with, and physicians using a secure texting app can only message other physicians who are using the same app. This limited communications infrastructure isn’t conducive to facilitating timely and effective care coordination. Spok’s recent survey of 100+ hospital CIOs revealed that “care team coordination for treatment planning” was the No. 1 workflow needing improvement. Healthcare leaders are realizing that the device selected to accomplish this might be different depending on each care team member’s role. This means a flexible clinical communications system is needed to support collaboration with all care team members on their preferred devices—whether that means a secure messaging app on smartphones or Wi-Fi phones, an encrypted pager, or a voice badge. A broad, flexible, and device-neutral communications infrastructure is the best foundation for improving clinical workflows for everyone and fostering the effective care coordination that drives better patient outcomes.
Two major predictions for 2017 are around APMs and the 21st Century Cures Act. First, I expect to see a slowdown in APM applications due to the uncertainty around the Affordable Care Act and the impact on the CMS Innovation Center. Organizations are reticent to fully move forward until they are sure the APMs will remain in existence after modifications to the ACA. Secondly, the 21st Century Cures Act will have a major impact on EHR R&D efforts. The Act puts considerable emphasis on interoperability so vendors will not only be focused on how to comply, but also how to benefit economically through open application marketplaces. These changes and more will make for an interesting landscape for healthcare providers in 2017.
In the world of value-based care, enterprise image management has boiled down to one critical item – we can’t duplicate medical imaging. As regional networks expand and facilities acquire new organizations, they’re increasing risks to both patients and providers when prior imaging can’t be easily accessed in a timely manner or when images live in multiple different systems. A single source of truth for imaging has to stop being elusive. We’ve seen many facilities turning towards cloud VNA (vendor neutral archiving) as a method of safely storing data that acts as a central repository for all imaging, so priors are easily exchanged using the cloud when needed, and all imaging across the health system is shared, regardless of where the imaging was done.
There will be talk about a lot of buzzwords and the promise of certain technologies, but the real progress will be made behind the scenes and under the radar. There are many intelligent, proactive, innovative people who are trying to address concerns such as usability, workflow and interoperability, which means there will be a good solution in place sooner rather than later (hopefully).
In 2017, we see clinical data sharing becoming a Tsunami. What started as a trickle at the beginning of Meaningful Use is now a flood of data that will impact all players in the healthcare ecosystem. In fact, we have seen over a ten-fold increase in electronic health records moving across our infrastructure over the past year alone. Will your health IT infrastructure be prepared to take advantage of this big data wave? Thankfully, there are new cloud-based systems that will allow forward-thinking organizations to ride this wave by easily and effectively consume and distribute this information across any boundary — leading to better clinical decisions.
In 2017, providers will continue to be under heavy pressure to figure out the delicate balancing act around cost and quality of care. This, coupled with difficulties in optimizing HIT systems, will pave the way for a new generation of clinical decision support solutions. Advanced clinical decision support will enable providers to elevate care while curtailing costs as they move towards a more patient-centric care model. The payoff for artfully implementing these new technologies will be measurably improved outcomes and ultimately, clinical effectiveness.
The healthcare industry has been talking about consumerism for several years. 2017 is going to be the year of action where it’s less about talking and more about making the changes consumers are demanding. InstaMed’s Trends in Healthcare Payments Annual Report has tracked the rapid growth of consumer payment responsibility and consumer sentiment about the healthcare payment experience for six consecutive years. The data is clear – consumers are the new stakeholder in the healthcare industry. Organizations that have been slow to accept this trend will face customer dissatisfaction along with subsequent attrition and lost revenue. What do consumers want? They want the healthcare experience to be simple like other bill-pay experiences. Make it easy for consumers to understand what they owe upfront. Offer multiple payment options including automated payments. Communicate with consumers via electronic methods like email and text. Consolidate multiple bills for a streamlined payment experience. Consumer-centric organizations are going to have a great 2017!
The biggest trend I see for healthcare in 2017 is the increased vigilance of healthcare providers and payers to protect their data. And because some of healthcare’s most damaging breaches have been caused by non-diligent/compliant third parties, this focus will extend beyond internal measures to their business associates (BAs) as well. An increasing number of organizations now require or will soon require BAs to have the same type of protection and controls they have through security audits and industry-recognized data security certifications. According to the Ponemon Institute, in the aftermath of a breach, healthcare organizations must pay on average of $2.2 million in remediation costs, while BAs are on the hook for penalties of more than $1 million. In 2017, the negative impacts and credibility loss with customers, patients and other affected participants of a breach are simply too high for any of healthcare’s stakeholders to ignore any longer. Here’s to wishing for a more “stakeholder-secure” and prosperous 2017!
The US healthcare space will definitely see a lot of changes with MACRA implementation which will drive the emphasis on achieving value-based ecosystem. Big Data and interoperability will play a pivotal role in bringing technological advances into the one thing that matters the most – health care. Operational Analysis will be a priority as measuring outcomes will help in figuring root causes for underlying problems and reducing the cost of care.