Health Care Systems Brace for Disruptions in 2018

Health Care Systems Brace for Disruptions in 2018

Look for more care in outpatient settings as hospitals consider cost containment and hiring strategies to stay above water.

After a wild ride for healthcare in 2017, the industry is bracing.

The year started with a White House transition that begat a series of regulatory changes and late-night debates in Congress as lawmakers came perilously close to repealing the Affordable Care Act. It ended with repeal of a key element of the law and a burst of M&A activity, showing how the sector is responding to a year of lower patient admissions and reduced reimbursements.

It all sets up a 2018 where these trends will start hitting healthcare bottom lines. Others that have surfaced here and there are likely to come into their own. And Congress will probably still be debating the future of the ACA.

Here’s a look at hot themes to monitor as the year progresses.

When Anthem announced in August it would stop paying for MRIs and CT scans performed on an outpatient basis at hospitals, the industry saw concrete evidence of the beginning of a major shift in where patients receive care. Payers prefer the lower costs of outpatient services and patients like the convenience. But the corresponding reduction in inpatient stays are cutting into hospital bottom lines.

“It’s pretty interesting right now when you look at healthcare utilization and admissions being down over the past three years, actually going in a negative direction. That’s a big trend,” said David Wildebrandt, a healthcare operations expert at Berkeley Research Group.

Other insurers will be following Anthem’s lead, and efforts that push patients toward outpatient services will become more of a hard shove, he said.

“You’re seeing the payers really bake into their plan designs a lot more of these type of initiatives,” he said.

 

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