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As health care transforms, boards need to focus on consumers, costs and new methods of care delivery
Health care delivery and methods of paying for it will continue to evolve during 2018 in a changing economic, polideal, technological and demographic landscape. Digital and oUier technological tools are coming of age in an increasingly consumer-driven world, and health systems will continue to seek ways to drive greater efficiency, highly reliable outcomes and more seamless care. And all Uiis will occur with the overarching pressure from payers of all types to reduce costs.
What are your organization's strategies for responding to these major trends?
COVERAGE AND COSTS
Uncertainty in insurance coverage and payment models
With debates continuing at the federal and state levels regarding the future of health care Insurance and payment models, expect continued uncertainty about (he Health Insurance Marketplace, or exchange, as well as ways to fund Medicaid and manage Medicare costs. There could be an increase in the number of uninsured in some markets as the number of exchange products decreases or prices rise. And the continued adoption of high-deductible plans as well as health savings accounts will require attention to pricing as well as payment, Expect Medicare Advantage enrollment to continue to grow; it now represents 33 percent of total Medicare enrollment (19 million people) nationally, having grown 6 percent between 2016 and 2017.
TRUSTEES SHOULD DISCUSS; What legislative and regulatory changes are occurring at the federal and state levels that could affect health care reimbursement rates? What are the states of key financial Indicators In our organization, and Is action being taken If Indicated? Is there a defined pricing strategy, especially for outpatient services for which consumer sensitivity is greatest? What Is the strategy for contracting (or partnering) with Medicare Advantage Plans in our service area?
Payer pressure and continued) evolution of value-based payment
While the Centers for Medicare St Medicaid Services has slowed the growth of value-based payment methods such as mandatory bundled payment, there is still strong support across the field for moving away from fce-for-service payment models. Ihere are some movements to simplify the quality reporting requirements for both hospitals and physician groups, but capturing and monitoring myriad quality indicators will still be a priority.
Bottom line: There...