2015 in Review: Top Healthcare News Stories
2015 was a year of continued upheaval in the healthcare industry driven by rising costs and changing regulations. But as necessity is the mother of invention, some of the industry’s toughest challenges have led to innovations that are steering patient care in a positive direction. Below is a recap of the most important healthcare news of 2015:
- Costs continue to rise with no end in sight: Steep increases in drug costs and expanded access to the healthcare system have driven continued increases in overall healthcare spending in 2015. PwC’s Health Research Institute estimates an overall spending increase of 6.8 percent in 2015 and predicts another 6.5 percent jump in 2016. While these increases are down from the double digit rises we experienced between 2000 and 2007, healthcare cost are still growing at three times the rate of GDP.
- Accelerated Consolidation of Hospital Systems: The number of hospital mergers has been on the rise since 2011 with nearly 100 per year and that trend continued in in 2015. The primary stated rationale for consolidation has been to increase economies of scale. Unfortunately, there is no indication that these savings are being passed on to the consumer. Instead, large hospital systems have driven increased in-network specialist referrals with virtually no price competition. A summary of research on the impact of consolidation performed by the Robert Wood Johnson Foundation revealed that hospital mergers in concentrated markets generally lead to price increases between 20 and 40 percent.
- Growth in Transparency Initiatives: The need for transparency in healthcare pricing and quality has never been higher, and several promising initiatives gained traction in 2015 to address this gap. The Center for Healthcare Transparency was launched in May, 2015 with the goal of providing meaningful cost and quality information to patients, providers and purchasers to enable value-based healthcare decision-making. Several state-based initiatives are also showing positive results with California and Massachusetts leading the pack. Modern Healthcare reported results from a recent survey which found that 80% of respondents listed price transparency as a key factor in choosing a healthcare provider—on par with bedside manner.
- Increased focus on price/outcome tradeoffs: Many insurers and healthcare systems have taken steps in 2015 to control drug costs by limiting access to high-priced, specialty medications. Patients faced with a larger percentage of their healthcare financial burden are making more conscious trade-off decisions about which medications and treatments to pursue. Insurers are increasingly looking for physicians to provide detailed clinical justification when they prescribe high-end specialty drugs. A new decision guide, published by the American Society of Clinical Oncology, was created to help physicians and patients make more informed cost/outcome tradeoff decisions. And the American College of Cardiology and the American Heart Association recently announced that they would begin to use cost data to rate the value of treatments in their joint clinical practice guidelines and performance standards.
- Focus on Healthcare Interoperability: In early 2015, the Office of the National Coordinator for Healthcare Information Technology published the first comprehensive plan for healthcare interoperability, Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap version 1.0. The plan creates a path to spark collaboration across the ecosystem of players required to evolve our health IT infrastructure. Surescripts, a Virginia-based IT company that supports the electronic transmission of prescriptions between health care organizations and pharmacies, announced the launch of its National Record Locator Service with various electronic health record (EHR) vendors, allowing 480,000 providers to access and exchange patient health records stored anywhere in the United States. And the Workgroup for Electronic Data Interchange and the National Association for Trusted Exchange have partnered to work on the next phase of the Virtual Clipboard Initiative aimed at developing a blueprint for standardizing the patient intake process, including automating the collection of health insurance and demographic information.
- The Rise of Virtual Healthcare: With a new generation of millennials and Medicare eligible baby boomers entering an already stressed healthcare system, the expansion of virtual healthcare delivery solutions is facilitating improved patient access and engagement. Virtual health can be delivered via health kiosks and portals and remote tele-consultations. Some primary benefits of virtual healthcare access include; reduced hospital admissions and readmissions, ability to monitor and manage long-term and post-hospital patient care while a patient rests and recuperates at home, and an increased number of patients who can be seen and treated during a given period of time. In short, virtual healthcare aims to reduce patient costs and increase convenience. In April 2015, United Healthcare, the nation’s largest healthcare insurer, announced expanded coverage for virtual care physician visits. As a result, virtual health is poised for rapid growth in the next few years. According to projections by PwC, by 2018, the U.S. market for telemedicine devices and services is projected to grow to $1.9 billion.
While some of these trends are still in their infancy, they signal positive movement to make healthcare more affordable, accessible and efficient. Let’s hope we see continued progress in 2016.