It will come as no surprise that in 2019, healthcare costs will continue to rise. At a projected 6 percent increase, this is consistent with the past five years, but it’s still an unsustainable trend long term. To help manage costs for your patients and your practice as you begin the new year, we’ve compiled nine trends to keep in mind. Read on for a summary of these trends, or scroll to the bottom and click the button to read the full briefing.
1. Patients yearn for a wider range of care delivery options
With patients embracing their new roles as educated consumers, 78 percent of patients long for a greater variety of care options.1 Patients are also assuming a larger obligation for the cost of their care, leading to increased financial risk for small practices. It can be difficult to collect fees from self-pay clients; in fact, patient balances after With patients embracing their new roles as educated consumers, 78 percent of patients long for a greater variety of care options.1 Patients are also assuming a larger obligation for the cost of their care, leading to increased financial risk for small practices. It can be difficult to collect fees from self-pay clients; in fact, patient balances after insurance (PBAI) have risen from 8 to 12 percent.2 Implement new technologies to measure underpayments, track patient responsibility, and provide real-time adjudication at the point of care. Keep current credit card information on file to reduce the “chase” of patient payments, and consider other useful strategies to improve revenue cycle streams.
2. Increased access to care is driving up utilization
Too often, patients opt to receive care in a non-traditional office setting, rather than visiting their their Primary Care Provider (PCP). Having numerous care access points is anticipated to lower costs in the future, but it’s currently raising utilization rates, leading to overall higher costs for a provider’s patient population.3,4 According to the Horizon BCBS 2019 Quality Metrics Report, we’re also seeing a rise in unit costs of imaging, labs and procedures, forcing independent practices to look for other ways to lower costs.5
3. Avoiding hospital employment
Between 2012 and 2015, the number of employed physicians grew by nearly 50%.6 Physicians believed that hospital employment would improve the healthcare landscape and opted for employment over managing independent practices. Yet 58 percent of respondents now believe the trend toward hospital employment will neither enhance quality of care nor decrease costs.7 To encourage physicians to seek opportunities other than hospital employment, physician leadership must look for new operating models or best practices to implement in 2019.
4. Relieving physician burnout
The 2018 Survey of American Physicians reported that 78% of physicians sometimes, often, or always experience feelings of stress and burnout.8 Luckily for providers in independent practices, studies have shown that physicians working in smaller-sized practices may be more resilient to burnout because they’ve retained their autonomy and decision-making capabilities.9 In 2019, it will be important to promote patients over paperwork and strive for a healthy work-life balance. Check out our blog post on Treating Physician Burnout to create a healthier work environment for your practice.
5. Continued fallout from the ACA battle
Following a tumultuous year for healthcare policy and the repeal of the Affordable Care Act’s (ACA’s) individual mandate, the number of uninsured or underinsured individuals is expected to rise in 2019. To combat weak coverage or insurance plans that don’t conform to ACA regulations, develop methods of triaging patients to lower-cost care options.10 Independent specialty practices should also embrace bundled payment models. Last year alone, 34% of healthcare dollars moved through alternative payment models (APMs), which represents a 50% increase in only two years.11
6. The rise of high-performance networks
With continually rising healthcare costs, employers are angling to cut out health plans and go directly to high performance networks. Independent practices who join these networks will garner further financial security as the network’s financing and care delivery models evolve. To succeed in a high-performance network, providers must manage post-acute transitions and gain insight into where patients receive care outside the PCP office. Develop a continuum of care designed to manage high-risk patients.
7. Helping patients avoid high healthcare costs
Despite the rise in savvy-shopper patients, most patients still trust their physician’s referral over their own price checking (usually with good reason). However, when patients compare costs using a mobile or online resource, they pay an average of 36% less than those who don’t compare prices.12 To help patients “shop” for lower-cost treatments—while ensuring they still receive quality care—supply patients with referrals to high-quality, high-value specialists and facilities.
8. New technology will continue to drive connected care solutions
With patients increasingly interested in managing their own health, there is a “clear, upward trend of patients seeking to take control of their healthcare via digital tools, like wearables.”13 Digital devices and services give greater visibility to care delivery and offer new ways to improve patient outcomes. However, independent practices planning to incorporate connected care solutions, should prepare for an increased amount of health data from devices and mobile phones. To effectively leverage these additional data streams, evaluate workflow processes and establish methods of integrating data into electronic medical records (EMRs).
9. Leveraging data and analytics
At the HealthCare Executive Group’s (HCEG’s) 30th Anniversary Annual Forum, over 100 executives and industry experts ranked “data and analytics” as the top healthcare challenge for 2019.14 Artificial intelligence (AI) is becoming increasingly prevalent in the healthcare industry, and in the next few years machine learning algorithms will be widely used for identifying trends in cost and quality.15 These trends can then help target high-risk and rising-risk patients, while developing strategies for intervention and care coordination that prevent repeat hospitalizations and avoidable ED utilization.
No matter what type of medicine you practice, the overarching theme for 2019 remains the same: increase value and lower costs—without sacrificing your sanity. Read full brief of all nine trends to better prepare you for success this year.
If you find yourself looking for additional support, enlist an outside practice partner for guidance or discover the benefits associated with a larger independent medical group. Contact firstname.lastname@example.org or call (856) 762-2469 to learn more.