Among the experts who weighed in on what practices could expect in 2018 for the Jan. 1 Part B News predictions issue was Lyndean Brick, CEO of the Mokeno, Ill., health care consultancy The Advis Group. Advis had more predictions than we could fit, so we’re sharing some of the others here:
Consolidation and closures in post-acute care markets
“Cuts to reimbursement coupled with the need for economies of scale will necessitate market changes in the post- acute world,” says Brick. Big players in home health, hospice and skilled nursing facilities (SNFs) like Kindred Healthcare and Amedisys -- “national post-acute care companies and health systems with large post-acute care continuums that can absorb the hit” – will be the winners; “mom and pop” shops will be the losers.
More micro-hospitals
“This flexible, cost-effective venue continues to grow in popularity with consumers and providers alike,” says Brick of these mini-facilities that measure their beds in dozens (when they have beds at all). She thinks investors in micro-hospitals, such as the Allegheny Health Network, will steal a financial march on “stodgy health systems stuck in traditional models of care.”
Other payers follow Anthem’s lead on advanced imaging in hospitals
Anthem has dramatically scaled back the payments it will authorize for MRIs and CTs done in the inpatient setting, and other payers will follow suit. “[Imaging] in outpatient facilities instead of costly hospital settings is a no-brainer for payers,” says Brick. “Anthem has seen scant push-back from consumers or the industry at large.” But patients with complex conditions who truly may be better served in a hospital environment stand to be hurt by the trend.
Elimination of certificate-of-need laws
For years, state certificate-of-need laws that subject new health care facility building to thorough government review were taken for granted. But now industry advocates are fighting back and starting to get referenda on such laws onto the ballot. “Mega-mergers among providers and for-profits crying for free-market principles continue to pressure state governments with CON laws to eliminate their stringent requirements and onerous market oversight,” says Brick.
#MeToo moves to healthcare
“Health care is most certainly not immune to the widespread abuses of a misogynistic culture,” says Brick, referring to the wave of high-profile firings and resignations occasioned by women speaking out against sexual harassment and abuse.
“Health care workers who find and share their voices and providers who proactively implement sexual harassment prevention education and policy enforcement” will prevail over providers and executives “who abuse their power and position to bully a coworker for sexual favors.”