There’s no question that the healthcare industry will experience significant changes this year. But what do those changes mean for healthcare organizations?
Avalere Health’s 2017 Healthcare Outlook Report offers information and insights in three key areas to help stakeholders make the most of this uncertain environment:
- Policy Change:
The inevitable repeal of the Affordable Care Act will offer private sector more flexibility and less regulation as new policies are put in place. Experts also believe Medicare and Medicaid spending cuts will promote more private plans to cover the gaps.
Public pressure for lower drug prices will persist, but efforts to lower costs will focus on market-based solutions instead of price caps. Avalere’s Elizabeth Carpenter noted that the shift offers “an opportunity to propose meaningful solutions.” One solution may be outcomes-based contracts, which link drug prices to clinical performance.
- Pursuit of Value:
Value-based payment will continue to move from concept to reality in 2017. As providers receive more responsibility, Avalere predicts that they will seek out third-party vendors to help identify and implement strategies that improve care delivery.
Standardizing quality measures through Qualified Clinical Data Registries (QCDR)will also encourage collaborations among public and private entities as they determine how drugs and devices are included in QCDRs.
Finally, a focus on post-acute care will promote partnerships among providers, payers, and health plans as new models of care offer incentives to enhance care coordination across settings.
- Access to Care:
The FDA’s recent approval of four biosimilars signals a turning point in the marketplace. While these new drugs may mean more competition, they also offer manufacturers new pathways to health plans and more options for providers to offer consumers.
Digital health innovations will also continue to break down barriers as more “high-tech, high-touch” innovations engage and empower clients in clinical and non-clinical environments. Avalere’s experts note these technologies should be developed with users’ needs and preferences in mind to encourage sustainability. They also note that technology adoption will rise as more financial incentives are aligned with consumer needs.
Want more insights? Check out a full copy of the report here.