POPULATION HEALTH TRENDS TO WATCH, TRENDS TO QUESTION IN 2019

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Healthcare organizations cannot afford to ignore consumers in 2019, as a number of major trends shape the future of care delivery (and a number of other trends warrant more critical thinking).

This article was first published March 18, 2019, by MedPage Today.

By Joyce Frieden, news editor, MedPage Today

PHILADELPHIA — The consumer will be where it’s at for population health in 2019, David Nash, MD, MBA, said here Monday at a Population Health Colloquium sponsored by Thomas Jefferson University.

“Whatever business model empowers the consumer, wherever she is,” including at home, will spell success, according to Nash, who is dean of Jefferson’s School of Population Health. “That’s where population health must go.”

Nash noted that back in 1990, Kodak, Sears, and General Electric were the most important companies in the Dow Jones Industrial Average; all those companies have disappeared or almost disappeared today.

“If we ignore the consumer, it will be at our peril,” Nash said, citing home healthcare, telehealth, and the use of wearables among the trends to watch in the coming year.

Nash, who is a columnist for MedPage Today, also cited these other trends to watch:

  • The growth of Medicare Advantage and managed Medicaid. “These are two programs that are working,” he said. “They’re working because they deliver value — high-quality care with fewer errors — and they follow our mantra: no outcome, no income.”
  • Tax reform. “Whatever your politics are [on this issue], park it at the door,” he said. “The sugar high is over, and now we’re in a carbohydrate coma. We’ve got the biggest deficits in American history; if we continue to spend money we don’t have, what will that do to healthcare? I think it will bite us in the butt when [it] comes to the Medicare trust fund.”
  • Precision medicine and population health. “[There is a notion] that precision medicine and population health are actually kissing cousins,” said Nash. “They are inexorably linked.”
  • Continued deal-making. The CVS/Aetna, UnitedHealth Group/DaVita, and Humana’s deals with Kindred Healthcare and Curo Health Services are just some of the more recent examples, he said. And he noted, the healthcare company formed by Amazon, Berkshire Hathaway, and JPMorgan Chase now has a name: Haven. “It’s a place where they’re going to figure it all out and they’ll let us know when they do.”
  • Continued delivery system consolidation. “Big surprise there,” he said sarcastically. “The real question is will they deliver value? Will they deliver synergies?” Nash noted that his own institution is a good example of this trend, having gone from one or two hospitals 5 years ago to 16 today with another two in the works.
  • Population health technology. “The gravy train of public money into this sector will [soon] be over; now the real challenge is for the IT [information technology] systems on top of those legacy companies; can they create the patient registry information and close the feedback loop, and give doctors, nurses, and pharmacists the information they need to improve care?”
  • The rise of “population health intelligence.” “That’s our term for predictive analytics, big data, artificial intelligence, and augmented intelligence … It says we don’t want to create software writers — we want doctors, nurses, pharmacists, and others who can glean the usable information from the terabyte of information coming our way, to [know how to interpret it].”
  • Pharmaceutical industry disruption. “This is really under the thumb of consumers … It’s all about price, price, price,” Nash said. “We’ve got to find a way to rationalize the pricing system. If we don’t, we’re going to end up with price controls, and as everybody in this room with a background in this area knows, those don’t work either.”
  • More venture capital money. Nash described his recent experience at the JPMorgan Chase annual healthcare conference, where people were paying $1,000 a night for hotel rooms that would normally cost $250, and being charged $20 just to sit in the lobby of one hotel. “What was going on there? It was more private-sector venture money coming into our industry than ever before. [These investors] know that when there’s $1 trillion of waste in an industry, it’s ripe for disruption.”
  • Workforce development. This is needed for the entire industry, said Nash. “More folks know a lot more [now] about population health, quality measurement and management, Lean 6 Sigma, and improving processes and reducing waste. The only way we’re going to reduce that waste of $1 trillion is to have the right kind of workforce ready to go.”

Lawton Burns, PhD, MBA, director of the Wharton Center of Health Management and Economics at the University of Pennsylvania here, urged the audience to look critically at some of these possible trends.

“You need to look for evidence for everything you hear,” said Burns, who coauthored an article with his colleague Mark Pauly, PhD, about the need to question some of the commonly accepted principles of the healthcare business.

Some of the ideas that merit more critical thinking, said Burns and Pauly, are as follows:

  • Economies of scale
     
  • Synergy
     
  • Consolidation
     
  • Big data
     
  • Platforms
     
  • One-stop shops
     
  • Disruption
     
  • Killer apps
     
  • Consumer engagement

“I’m not saying there’s anything wrong with those 10 things, but we ought to seriously consider” whether they’re real trends, Burns said. As for moving “from volume to value” in healthcare reimbursement, that idea “is more aspiration than reality” at this point, he said. “This is a slow-moving train.”

Burns also questioned the motives behind some recent healthcare consolidations. In reality, “most providers are positioning themselves to dominate local markets and stick it to the payers — let’s be honest,” he said. “You have to think when you hear about providers doing a merger, you have to think what’s the public rationale and what’s the private rationale? The private one is [often] more sinister than you realize.”

“IF WE IGNORE THE CONSUMER, IT WILL BE AT OUR PERIL.”

 

 

 

 

Two key areas hospitals are planning major tech investments in the immediate future

http://www.healthcarefinancenews.com/news/two-key-areas-hospitals-are-planning-major-tech-investments-immediate-future?mkt_tok=eyJpIjoiTkRsaU5HTTJNVEV5WldaaSIsInQiOiJFSTVVaHdzRmdQTGVCSXZORmhReEkrbVVWNjZOdzhlOWRuRUwxeUVXNktOa2FyNVpQWkc1dXk5SGNTQjc0YndcL3BuUTkrV2xkWEVLd01qWnd2UGNrWTBFTFFzRWxWaGM3bVFOclwvYjNlbXBPSjA2d1prU0tyMmNpQ0Qwdlg4TGhUIn0%3D

 

Providers are ramping up to focus on urgent care centers and population health initiatives.

Hospitals are gearing up to spend more on population health and urgent care centers in the coming years, according to new research from two different firms.

The market for population health technologies is expected to reach $69 billion by 2025 while the urgent care center space is forecasted to grow by roughly $8 billion in 2018 to $25.93 billion by 2023.

The global population health management market was worth $118.5 million in 2016 and is slated to grow at a CAGR of roughly 16 percent from 2017 to 2025, with the rise in demand for innovative technologies and adoption of healthcare IT tools fueling the growth, Transparency Market Research said in a new report.

In terms of end-users, it’s the healthcare provider segment of the market that is expected to account for the largest share of the global market thanks to rising use of PHM tools. Insurers, pharma and “others” follow in terms of segments.

The benefits of PHM tools like data integration, data analysis, care coordination, and lowering care costs have driven an increase in their adoption, especially in the case of chronic diseases like diabetes and cardiovascular diseases which require identifying high-risk patients and disease management measures.

“This is one of the factors projected to drive the global population health management market during the forecast period,” the report authors wrote. “Developed healthcare IT infrastructure and increase in healthcare IT spending are the other factors anticipated to propel the global market during the forecast period.”

Geographically, North America and Europe are expected to dominate the market thanks to the Affordable Care Act and a rise in healthcare IT spending, owing largely to providers.

“Well-established healthcare infrastructure and strong support from public and private sectors in terms of reimbursement are attributed to the largest market share of North America,” the firm said. “A rise in awareness about population health and government initiatives such as the Affordable Care Act are anticipated to drive the market during the forecast period.”

Urgent Care Centers, meanwhile, will represent a $26 billion market by 2023, and in this year will reach just over $20 billion, ReportsnReports projected. Health systems and corporations with a stake in the healthcare industry know the model is flourishing thanks to affordable pricing, shorter wait times, an increasing elderly population, and the market is seeing more investment activity as well as strategic development partnerships between urgent care providers and hospitals. Corporate-owned urgent care centers, however, are expected to occupy the largest share of this market in 2018.

Concentra, MedExpress, American Family Care, NextCare Holdings, and FastMed Urgent Care are already major market players with CareNow Urgent Care, GoHealth Urgent Care starting to gain more of a presence as well in the United States.

Health systems looking to diversify their portfolios might do well to look at both urgent care centers and population health programs when considering how to expand their footprints. With a reputation for faster service and better pricing, both things that the rising millennial population smile at, they could be a beacon for both primary and specialty care for younger consumers as opposed to traditional practices. Additionally, with the high-deductible health plans, reasonably priced care will be especially attractive to patients who will bear a greater portion of the financial responsibility related to their care.

As these facilities grow in popularity, including them could boost not only your reputation but also your bottom line.