In 2013 we made progress on the seismic shift from fee-for-service to value-based care models. The industry has taken the first steps so that everyone – patient, provider and payer – has the same agenda. And everyone profits from the same outcomes.
Some of the best industry trends I’ve seen in 2013 include:
1. Accountable Care Organizations (ACOs)
I like this model because everyone’s incentives are aligned. ACOs have to find the patients they should be treating. They need to reach those patients before there’s a problem, before a trip to the ER, or worse.
2. Population health management
I like this trend because it means caregivers are being more proactive. They are reaching the patients most likely to need healthcare and aggressively managing their health. Strangely, population health means that we treat the patient more individually.
3. Open, a more collaborative approach to Health IT
I think we’re seeing the beginning of the end of closed systems which will mean more innovation, more apps that providers can choose from and more opportunities to apply Health IT to advance healthcare.
4. Patient engagement
This has become an area with lots of potential. With the proliferation of devices, the industry is making a lot of progress. We, as patients, are getting much more involved in our own care, which is fundamental to success in population health management.
It’s too soon to tell if other 2013 trends were good for healthcare. For example, the relaxation of the Stark rules enabled more consolidation of provider groups and hospitals. Or the transition from ICD-9 to ICD-10 codes, which requires a lot more physician time. I hope these are good things for patients, but it’s too early to say for sure.
3 trends to expect in 2014
In 2014 I believe the industry will re-focus on physician productivity. There are so many priorities for physicians to manage “administrivia” – when we really need them focused on delivering quality care for patients.
Other broader trends include:
1. Changing financial models
In general, we’ll see more creative financial models adapted to support value-based care. Technology will play a key role, providing the tools to measure effectiveness, sharing best practices and enabling agility. It’s important for care providers to keep moving forward. The rules keep changing and they need to keep pace or fall behind.
2. Increased focus on population health
All care providers need to reduce preventable readmissions – and the penalties that now come with them. Proactive care management will become increasingly important and will heighten the need of population health data to help identify patients at higher risk up front to drive the most appropriate care plans.
This focus looks different, depending on the size of the caregiver. Small practices don’t have to be an HIE, but they should join together to share data, best practices, experiment and try new things. They are agile. They can make a decision and implement it quickly. The larger systems can sometimes struggle with that.
3. More personalized medicine
Connecting the dots can unlock a lot of information about our health. For example, think about breakthroughs in genetics and genomics that can help us make better clinical decisions.
Combine this data stream with a proliferation of apps, and we have powerful possibilities in personalized medicine. Take Genelex, a company that uses the genetic make-up to figure out if the drugs you are taking are working. And, if not, what will work for you? These advances are bringing truly personalized medicine into the mainstream.
What can care providers do to stay competitive in all three areas? Continue to embrace technology, especially mobility. Those practices that are agile and can adopt new innovations quickly will have the advantage.