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The healthcare industry trend that won’t change with Trump


As stakeholders anxiously await the impact of a Trump administration agenda, there is at least one safe bet that all can make.

The healthcare industry is abuzz with predictions about the future of the Affordable Care Act (ACA). As stakeholders anxiously await the impact of a Trump administration agenda, there is at least one safe bet that all can make: value-based care is here to stay.

As such, providers and payers must remain undeterred in their efforts to deploy the best infrastructures and strategies for future positioning. Forward-looking organizations recognize that arming physicians with evidence-based clinical decision support tools and analytics at the point of care is critical to this equation.

Treatment guidelines combined with population data-based predictive modeling and physiological duration data to set realistic recovery expectations with patients aligns with Trump’s strong advocacy of greater consumer engagement to drive down costs. Any new platform is expected to resolutely emphasize consumer choice, cost containment, clinical performance and value.

Equipping physicians with evidence-based guidelines and other decision support tools at the point of care will prepare organizations for any of these platform elements, but also for value-based care models, which the industry at large increasingly acknowledges and embraces.

Trump administration: same goals, new strategy

Current movements on the national stage suggest that a full repeal of current legislation is unlikely. The reality is that some aspects of ACA and value-based care are effective, and it is more probable that efforts will prioritize elimination of elements that are unpopular with voters and do not align with the Trump platform.

For instance, a less-regulated approach to alternative payment models is predicted as is increased oversight of payment reform decisions made by CMS. In addition, Trump’s previous policy statements point to a preference for bundled payment expansion and Medicaid reform in place of Medicare shared savings programs and accountable care organizations.

One key piece of legislation-the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)-was strongly bipartisan and is expected to unfold as planned. The January 1 enactment of this law will considerably raise the stakes for value-based care, shifting the philosophical focus for participation from incentives to penalties.

Minimizing variation for optimal care delivery

Standardization of industry best practices is a critical part of any strategy to improve performance from an outcomes and cost perspective. Healthcare organizations must deploy the most advanced evidence-based point-of-care clinical decision support tools to guide physicians to the safest, most cost-effective treatment plans that help promptly return patients to activity.

Clinically-validated guidelines can help clinicians set realistic recovery expectations and develop stronger provider-patient partnerships for more effective care plan engagement. When the same best-practice guidelines, predictive modeling tools and physiological duration data are shared across the care continuum, clinicians are better equipped to collaboratively optimize care by eliminating variations. Ultimately, physicians are empowered with the same evidence-based treatment plans, setting the stage for more effective and efficient care.

While there is uncertainty in the air, providers and payers can anticipate growth of value-based care models under Trump. MACRA alone should prompt increased uptake of evidence-based practices to improve performance in terms of both outcomes and cost.

Joe Guerriero is senior vice president of MDGuidelines.

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