7 Healthcare Trends to Watch in 2019

Navigate Healthcare 2019The beginning of the year is always a great time to reflect on the past and prepare for what’s ahead. For healthcare organizations, the past year brought challenges and opportunities that will continue – and evolve – through 2019. Here’s what we expect to see in the healthcare industry in 2019.

1. The shift to value-based care will accelerate.

This transition has been taking place slowly but is expected to gain more traction this year. Three years after The Medicare Access and CHIP Reauthorization Act (MACRA), MIPS and APM payment provisions will go into effect this year. As a result, we expect hospitals and health systems to take on more shared and full-capitation risk contracts. Under these new models, providers must focus on driving outcomes and managing overall patient health. This will require them to enhance processes and use clinical data in more sophisticated ways, enabling clinicians to make better decisions and deliver better care. As health systems pursue solutions to achieve value-based care, health plans – who have historically operated in a value-based, data-driven world – will provide fruitful opportunities for collaboration and partnership.

2. Mergers and collaborations between healthcare providers and plans will continue.

The line between payers and providers will continue to blur as more health plans merge with care delivery organizations (e.g., United Health Group’s Optum or Highmark Health’s Allegheny Health Network). The shift toward value-based care and the necessity of data-driven decision making to achieve patient outcomes is a primary driver of this consolidation. Providers will benefit from insurers’ comprehensive data sets and expertise in managing care. Health plans will benefit from the providers’ understanding of care delivery and clinical effectiveness. Leveraging the strengths of both organizations is a win-win. Moving forward, the competitive advantage will belong to organizations that can best utilize healthcare data to demonstrate superior value and outcomes.

3. Nontraditional players will continue to enter the healthcare market.

Expect to see more nontraditional players in the healthcare space in 2019, as the shift to value-based care takes hold. This last year we saw Amazon partner with Berkshire Hathaway and JP Morgan Chase to rein in employee healthcare costs, along with the acquisition of innovative specialty pharmacy company, PillPack. Similarly, Comcast partnered with Independence Health Group (parent of Independence Blue Cross) on a technology platform aimed at improving patient communications and education. Through the new internet-based platform, a patient can access content and information related to their personal healthcare journey anytime, anywhere. The rate and scope of these initiatives will continue to increase, and companies who can effectively drive outcomes, eliminate waste, and manage patient health will experience significant financial gains as a result.

4. Telemedicine will gain momentum.

The shift to value-based care – providing quality care at more cost-effective prices – has also led to an increase in telemedicine services, which will continue in 2019. Previously limited to pilot initiatives, telemedicine is gaining momentum and enabling healthcare organizations to expand the scope of their services. This virtual healthcare model appeals to millennials, who expect care where they want it, when they want it. Even Medicare is adding codes to reimburse telemedicine appointments. The state of care delivery is transforming. In 2018, Oscar Health reported that half of its members used telemedicine, and more than half of Kaiser Permanente’s patient visits were virtual. In 2019, telemedicine will become more integrated into regular healthcare practices to deliver convenient, cost-effective care – and usage is expected to double for everything from the cold and flu to chronic disease management. This will require robust technology that patients find easy to use and beneficial to their health and that providers can easily implement to reach a broader consumer base with digital healthcare offerings.

5. Hospitals and health systems will embrace artificial intelligence.

 Achieving value-based care requires efficient processes and effective analysis of data, making artificial intelligence and machine learning increasingly important in healthcare. Expect to see providers leveraging artificial intelligence (AI) to improve clinical and administrative processes that will reduce financial risk, enable better decision making, and help assess patients. Clinicians will use AI and machine learning as clinical-support tools to improve diagnostics and customize treatment plans for patients. Administrative staff will use AI to automate currently manual tasks and improve the accuracy and speed of core functions such as compliance. risk management, claims, and the supply chain. This will take years to fully come to fruition, but we’ll begin to see strides over the next year.

6. The healthcare system will prioritize mental and behavioral health.

Nearly 1 in 5 Americans 18 and older suffer from a diagnosable mental disorder. As hospitals and health systems assume more clinical and financial risk for the health of patient populations, they will incorporate more aggressive strategies and tactics to address mental and behavioral health. Such strategies and tactics will be designed to keep healthy patients healthy and those with chronic medical conditions as healthy as possible. We’ll see health systems merge with behavioral health organizations (like Hackensack Meridian Health and Carrier Clinic), an increase in mental health services that are available through telehealth (like Atrium Health), and greater access to behavioral health experts. This will lead to a reduction in costs, improved quality of care, and better overall outcomes.

7. Patient engagement is changing care delivery.

There’s a greater understanding and appreciation now of the role a patient plays in the success of their own healthcare. The need for effective patient engagement, combined with consumerism, is driving demand for a seamless, digitally enabled, patient-friendly experience in healthcare. These new demands will prompt health systems to continue developing digital health tools that can better enable and engage patients in their own care journey, such as coaching apps and personal electronic health records. But providers should also expect a push for a unified experience. Patients want an ecosystem where they can find a doctor, schedule an appointment, pay a bill, make sense of test results, and get information on treatment options all via the same app/portal. Patients will increasingly want to engage providers and payers and navigate their healthcare seamlessly. In 2019, expect to see more engagement programs, technology, and health literacy initiatives that aim to educate people on their health and provide a comprehensive experience.

Being aware of these trends enables you to proactively address them, gain a competitive advantage, and improve your outcomes. For more information about these trends and how they will impact your specific organization, contact me at [email protected] or 215-287-0899.

Stef Kuonen, Manager



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