7 healthcare strategists on what to expect post-election
Seven thought leaders and strategists discuss the election of Donald Trump and what his policies could mean for healthcare going forward.
Responses have been edited for length and accuracy.
Joe Carella, Assistant Dean of Eller College of Management at the University of Arizona (Tucson, Ariz.): "We at Eller Executive Education have done a short poll amongst industry professionals and over 40 percent of respondents said that the Trump administration would not be able to pass any meaningful legislation since there are too many conflicting interests to manage. Twenty-four percent said that this will lead to the opening of a competitive marketplace [for health insurance].
Professor Stephen Gilliland, PhD, executive director of our Center for Management Innovations in Healthcare at University of Arizona, commented that ''whatever path the Trump administration takes, there are now 20 million individuals who have gained health insurance through the ACA. It seems inconceivable that these people will now be dropped and not offered an alternative.'
The structural imbalances in the healthcare industry will simply not go away unless the administration does more to shift its efforts in prevention rather than cure. Not having a healthy workforce is ultimately a competitive disadvantage that the United States will need to address if it wants to stay competitive in a global economy."
Ron Howrigon, President of Fulcrum Strategies — a contract negotiation and practice management firm (Raleigh, N.C.): "Common wisdom suggests that the election of Donald Trump won't produce many changes in the healthcare landscape. Repealing and replacing Obamacare is much harder than it sounds, and taking coverage away from [millions of] Americans by getting rid of the exchanges and rolling back Medicaid expansion is a great way to become the ex-senator of your state. Many observers believe that very few changes will actually happen in the near term. Then again, these are the same people who thought Donald Trump had no chance of winning the nomination and absolutely no chance of winning the election. Given all of this, I would say; I don't know exactly what will happen, but it should be interesting watching it unfold."
Tom Lee, Founder and CEO of SA Ignite — a company focused on value-based care software (Chicago): "Given that many industry observers did not anticipate the election results, the new administration introduces uncertainty into the healthcare marketplace. While the ACA is clearly the area where the greatest amount of change may occur, the transition from fee-for-service to fee-for-value is a decades-long journey whose momentum is irreversible. The need to slow the growth in healthcare spending to preserve the Medicare trust fund and to reduce individual and employer healthcare costs while delivering higher quality care is universally agreed upon on both sides of the aisle.
For example, the highly bipartisan and Republican-sponsored [Medicare Access and CHIP Reauthorization Act] quality payment program that transforms clinician reimbursement is in full motion with no anticipated delay. While this is a time of uncertainty, history has also shown that new forced changes into a complex market can potentially spur further innovation."
Sean P. McDonnell, Principal of Avison Young, Heath Care Affinity Group — a commercial real estate company (Norwalk, Conn.): "It's just too soon to tell what a Trump presidency will mean for healthcare as a whole, but there is a good chance that some major changes are in store for the ACA. Those changes however will not affect the ongoing shift of the healthcare industry from an inpatient to an ambulatory service model, the 'retailization' of urgent care and other specialty centers to fill shopping mall vacancies and the conversion of older commercial properties for medical adaptive reuse."
Ron Peck, Senior Vice President and Counsel of Phia Group — a company focused on healthcare cost containment (Braintree, Mass.): "I foresee both positive and negative outcomes emerging from Donald Trump's election. On one hand, enabling individuals to shop for and purchase their own health insurance policies — presumably from traditional insurance carriers — means people will get inadequate coverage and strip away the lives employer-based group plans need to spread risk and secure the best rates with area medical service providers (through the use of steerage).
On the other hand, if Trump means what he says regarding transparency — as it relates to the prices hospitals and other medical service providers charge — those facilities that charge less but provide the best outcomes will finally be rewarded with the increased traffic they deserve. Facilities that charge arbitrary and excessive rates for the same care, without improved outcomes, will be forced to revise their pricing strategy or close their doors."
Jim Stone, President of The Medicus Firm — a physician staffing services firm (Dallas): "It is somewhat difficult to determine what the effect of the results of election will be on an entire industry, especially when there were not many details given regarding Trump's healthcare plan. That said, Mr. Trump did indicate that he plans to repeal and replace the ACA, which could mean we'd revert back to some variant of the discounted fee-for-service model of healthcare reimbursement, perhaps tweaked a bit from the pre-ACA payment model.
Also, Trump indicated he'd like to remove the state barriers for healthcare exchanges to facilitate competition among health insurers, which would hopefully lead to more competitive pricing for the insured. Either way, this election will have little, if any impact on physician supply and demand, and therefore workforce shortages will continue in many areas and specialties."
Mike Thompson, President and CEO of the National Alliance of Healthcare Purchaser Coalitions (Washington, D.C.): "With Donald Trump in the White House, one thing is for sure — change is coming to healthcare. With the threat of a total repeal of the ACA, we can expect rigorous debates on every component of prior health reforms. We anticipate that some elements will survive (e.g. coverage of children through employers to age 26), some will change (e.g. parameters around the individual insurance market) and some will be eliminated (e.g. excise tax on high cost plans). Most importantly, addressing healthcare costs will likely be a critical and more direct issue for the Trump administration due to growing concerns of both employers and consumers as well as the need to sustain our healthcare safety-net programs."
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