The future of the ACA was uncertain throughout 2017, and though President Trump recently took steps to dismantle it via executive order, it remains unclear how, and how soon, his actions will affect healthcare.
It should come as no surprise then that, according to Managed Healthcare Executive's 2017 State of the Industry Survey, government requirements and mandates top your list of challenges. In addition, shifting toward value-based care is high on the list, as is using big data to improve healthcare quality and reduce healthcare costs. Controlling rising specialty drug costs is another big burden.
The survey’s findings, based on more than 300 responses received during the third quarter of the year, show the biggest challenges that executives at health systems, health plans, pharmacy benefit organizations, and more are facing and anticipate continuing to face next year. Here's a closer look at the survey results, and what industry experts advise organizations to do to overcome these challenges.
Challenge #1: Complying with government requirements and mandates
Adhering to government requirements and mandates tops all challenges, at a whopping 34%. This is down just a tad from last year’s survey, when it was 36%. “The big question on everyone’s mind is, what will become of the ACA?” says Zach Hafner, national partner, consulting, Advisory Board, a healthcare consultancy firm. “Addressing this question at this point requires more precision because the government is deconstructing the broader legislation and taking on various components of it.”
President Trump recently announced he will end cost sharing reduction payments to insurers, and he scaled back requirements for employers to provide birth control as part of health coverage for employees. “But these aren’t the only potential targets; pre-existing conditions, mandatory insurance coverage, minimum policy inclusions, Medicaid expansion, and selling health insurance policies across state lines are all potential pressure points as the law is revisited and revised in the coming year,” Hafner says.