Michael Dowling: 4 most important healthcare trends in 2018

To say that it has been a tumultuous year for the healthcare industry is an understatement. Federal policy changes and recent transactions involving large insurers, health systems and retailers will affect providers, payers and patients alike.

While there are many new and emerging trends we need to pay close attention to in 2018, here are what I think are the four most significant issues that will command our attention in the year ahead.

1. Inconsistent healthcare policy will continue to dominate the headlines

 The federal debacle with so-called healthcare reform this year has been a case study in confusion, inefficiency and lack of focus. Every week seemed to bring a new twist in the direction of healthcare policy, especially in regards to the ACA, with almost no consistency to the legislative thought process. In many ways, the whole focus of ACA repeal and replace efforts was misguided — you can't take something apart without some ideas for a replacement. The federal government's lack of direction on healthcare policy has created chaos among all industry players.

Given the healthcare provisions in the proposed tax bill and potential future action with the ACA, there are serious implications for states across the country. The confusion surrounding Medicaid and other joint federal-state partnerships has discombobulated state budgets, and it is patients who will ultimately face the harshest consequences if states are forced to slash funding for healthcare.

For the foreseeable future, we're going to continue to see inconsistency in government policies and funding. This is especially dangerous for hospitals in underserved communities that rely almost exclusively on Medicaid and Medicare funding. Unless they are supported in some way, many of these providers will sink deeper into debt.

2. In order to keep pace with newly formed organizations and partnerships, hospitals and health systems need to innovate

The CVS-Aetna deal did not come as a surprise to industry leaders who have been keeping their ears to the ground and have paid attention to recent trends. But nevertheless, this merger is a major shake-up that cannot be ignored. Google, Amazon and IBM Watson are all looking to stake out a piece of the healthcare field, and deals such as  Optum's purchase of DaVita Medical Group underscore the ever-evolving nature of the ways people access and pay for care and services. Providers should not view this movement as a threat that must be stopped. Instead, we should spur innovation on our end. We can't sit still. That's why, in Northwell Health's case, we have been forging new partnerships and pursuing ventures that will enable the organization to compete more effectively in this rapidly changing environment. 

It will be especially intriguing to see what market segments CVS and Aetna pursue after the merger is finalized. Undoubtedly, they will offer prescriptions, preventive care and other primary services to supplement CVS' "Minute Clinics," but it remains to be seen what other health services will be provided as part of this new collaboration. Regardless of what new competitors enter the healthcare market, the seriously ill, elderly patients with chronic conditions and those who have suffered traumatic injuries will still be relying on hospitals to take care of them. It's highly unlikely that any of the new players will be providing inpatient care. As we all know, the bulk of healthcare funding is spent on long-term care for people at the end of life. The Amazons and Googles of the world are not targeting that population.

Recognizing that traditional healthcare providers do need to adapt to this era of consumerism, among my strategies are to continue expanding our ambulatory network, facilitating innovative partnerships, enhancing efforts in prevention, maximizing our use of artificial or augmented intelligence, and improving our already robust telemedicine program.

In the end, I believe competition is good. Market disruptions give all of us headaches, but they are ultimately beneficial because they force us to do better and be more efficient, productive and creative

3. Unless we continue to improve the customer experience, customers will go elsewhere for care

The more competitive the market becomes, the more work we as providers must do to continually improve the patient experience and develop customer loyalty. This can partly be done through improving communication and curating a more retail-focused experience.

This is unbelievably important, as patients now have more access and choice for their healthcare than ever before. This is not limited to the in-person experience, but also how hospitals and health systems communicate with patients to help them get information and make appointments. Online and mobile platforms are already important for engaging customers, and they will only grow more essential in 2018.

Online engagement is not only for younger patients. It's a medium that has become increasingly more effective than print or broadcast advertising for reaching older patients. Equally important is creating an experience that connects families with providers. We deliver more than 40,000 babies every year in our health system. Those are 40,000 families with whom we could be creating life-long bonds. Pursuing initiatives to maintain a connection with mothers and families is essential.

Over the past five or six years, we've seen major changes in the way innovative organizations in all industries treat their customers. For far too long in our industry, there was a pervasive attitude of, "We're hospitals, or we're physicians, people will always come because we’re here in the community," but those days are over. Consumers don't want to be told when to come or what to do – they want to access care and services on their terms, not ours. We are in the consumer service business, and our patients are educated and knowledgeable. They value easy access, a pleasant experience and quality care, so it's our job to adapt quickly to meet their needs and expectations. 

4. Strategies about "healthcare" must now encompass behavioral and mental health

As social stigmas surrounding mental health begin to break down and more people feel comfortable confronting behavioral health issues, it is the responsibility of providers to design their systems in a way that addresses the needs of these individuals. This is especially important at a time when opioid abuse has become one of this nation's most-challenging public health crises.

The problem goes beyond drug and alcohol abuse. For instance, studies have shown that younger generations' increased use of technology, particularly mobile devices, can lead to increased rates of anxiety, depression or loneliness. We as providers must consider these trends and tailor services accordingly, as more and more patients turn to us seeking care for issues that are destroying lives and breaking up families. All of us need to do a better job developing and training staff to meet this demand, especially when it comes to screening those who are trying to hide their addictions to opioids. It entails not only psychiatrists but nurses, social workers, case managers and other clinicians.

Regardless of the issues we face in this ever-evolving industry, we as providers must not resist change. We must continually adapt — those that don't will get left behind.

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