The presidential hopefuls have very different views about the ACA. Expect three healthcare things that will stay the same even after Obama leaves office.
One of the many things we’ve learned during this wild and controversial race toward the White House is the Republican and Democratic nominees for this country’s top office have vastly different perspectives on the Affordable Care Act (ACA). On one side, Donald Trump vows to repeal the ACA and replace it with something “better.” On the other side, Hillary Clinton has made it clear that while improvements need to be made to the ACA, she plans to focus on expansion of the program. Regardless of who is elected to be the next president of the United States, the health care industry’s transformational focus on value-based care (providing the best outcomes for patients at the lowest possible cost) isn’t going away anytime soon-whether this continues under the current ACA, a modified version, or total replacement.
SabloffIn recent years, the business of healthcare has fundamentally changed. The once supply-driven and fragmented healthcare system is striving to achieve a more integrated, patient-centered and outcome-driven delivery model. In other words, the value-based care train has left the station. CMS and state Medicaid agencies appear to be steadfast in moving the industry away from the fee-for-service model toward capitation- and performance-based reimbursement models. As these value-based models push physicians, hospitals and ancillary health care service providers to embrace more streamlined and collaborative approaches across the care continuum, they will continue to undergo massive system overhauls and adopt new technologies at a rapid rate. This new reimbursement model, along with the interconnected workflows and IT systems necessary for success, have paved the way for a much more effective and efficient healthcare ecosystem.
Regardless of which nominee is ultimately elected, or how the ACA may evolve over the next four years, the modernization of the healthcare industry will continue.
Here are three things that won’t change after President Obama leaves office:
1. Population health management (PHM). Many healthcare technology vendors warp the term PHM to fit their legacy or “slice of the pie” offerings. However, true population health management incorporates aggregated patient data across disparate sources and systems, the analysis of that data into actionable information, and patient-centered actions by the interdisciplinary care team to provide the best possible care, improve outcomes and lower overall cost. A complete, end-to-end PHM solution that is purpose-built for value-based care will be a critical component of the sustained success of today’s healthcare delivery and reimbursement models. As CMS and the states continue to drive qualitative and data-driven approaches to managing populations, they’ll force equally evaluative and analytical approaches to healthcare technology solutions. New PHM solutions that provide a 360-degree view of the member or patient-providing data, tools and business intelligence within a single ecosystem for care team collaboration across the health care continuum-will remain in high demand as a critical component to success.
Next: Integrated healthcare systems
2. Integrated healthcare systems. Advancements in healthcare technology have helped pave the way for more cohesive, efficient and collaborative care delivery models across the care continuum-including providers, facilities, community services, long-term care agencies, home care organizations, etc. Innovative healthcare information technology (IT) companies are empowering previously disparate systems to realize true interoperability, track patient care and collaborate and communicate across healthcare systems. Forward-thinking healthcare systems will continue to expand horizontally and vertically, leveraging PHM to create efficiencies and outcomes that will expand market share.
3. Patient engagement tools. Developments such as mobile health and telehealth help providers bridge geographic gaps to connect remotely with patients and keep closer tabs on their care. New technology platforms with patient portals that capture and track data on patients’ vitals are enabling better self-management of care, while allowing providers to intervene when necessary. Beyond mobile health and telehealth, healthcare organizations will increasingly adopt new IT tools to further connect and extend care management and coordination. These tools will provide greater patient access to informational and educational tools as well as a higher level of engagement between patients and their respective care teams.
The healthcare industry is in the midst of an exciting and unprecedented transformation toward value-based care delivery. Regardless of the outcome of the presidential election or the ultimate fate of the ACA, the industry will maintain its focus on decreasing costs and increasing quality of care for value-based reimbursement. The transformation and evolution of critical components of this new approach to care delivery, such as population health management, integrated healthcare systems and patient engagement tools, will persist long after President Obama leaves office next January. Right now, forward-thinking healthcare companies are leading the way by leveraging advanced platforms that provide the data, tools and business intelligence within single, cohesive ecosystems. The industry can expect to see a rise in the adoption of these new strategies over the next four to eight years and beyond.
Adam Sabloff is founder and CEO of Virtual Health.