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Five healthcare delivery trends to watch in 2019

1. Employers get serious about the underlying drivers of their healthcare costs.

For years, in order to control their health care costs, employers have attempted to tweak benefits and push more of the share of costs to the employee. However, these efforts have been unsuccessful in changing the underling cost trend of health care. Looking for more sustainable solutions, employers will turn their efforts to address some of the root causes of healthcare costs—prices and utilization. Look for them to adopt narrower provider networks, reference-based pricing for common procedures, and new processes to control utilization of high-dollar services and specialty drug costs.

2. Medicare Advantage growth continues.

Seniors who are “aging in” to Medicare are choosing Medicare Advantage (MA) at increasing rates. Seniors appreciate the additional benefits, the simplicity of the insurance, and better coordination of their care. And providers groups are jumping in to meet this demand: AMGA members have indicated that revenue from MA will exceed their revenue from traditional Medicare by 2019. Look for more health plans partnering with medical groups and health systems to offer expanded MA choices for seniors in more markets.

3. Addressing social determinants of health will drive unique partnerships.

Medical groups, hospitals, health plans, government, community organizations, and private equity each bring a distinctive perspective to vexing social issues like transportation, housing, food insecurity, social isolation, or behavioral health. The coming year will bring many exciting experiments that combine new capital with on-the-ground partnerships that will work to measurably improve the underlying causes of poor health and resultant healthcare spend. Look for combinations of advanced technology with caregivers in their communities providing local services that prevent costly hospital admissions or emergency room use.

4. Convenience continues to shape the market.

Today’s patient/consumer is looking for a healthcare experience that is simple, convenient and personalized. They are choosing providers that provide access—simple ways to make appointments online, hours of service that include evenings and weekends, and a choice of how to receive various types of services. Patient preferences will increase demand for video visits, hospital at home, texting, urgent cares, and personal monitoring devices—and they will want all of these connected to their personal physician’s practice. Consumers also want to be treated well, and organizations that exhibit exceptional customer service, empathy, and communication will prosper.

5. Practice efficiency remains paramount.

Pressure on margins will continue be a critical issue for most medical groups and health systems, and they will look for ways to provide care that is cost-effective. Advanced practice practitioners, nurses, and other caregivers roles will expand into clinical care previously reserved for physicians. Technology will be implemented to overcome the inefficiencies of the electronic health records and increase productivity. Look for increased efforts to right-size organizations with the optimal mix of specialists, primary care, non-physicians, and sites of care.

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