In 2020, the healthcare industry will continue building upon a commitment to value-based care, patient-centric choices, pricing transparency, and technological innovation. New proposals to improve access to affordable care, enhance treatment options, and simplify billing and payments will also be explored and implemented.
Consumerism in Healthcare
The industry has undergone a significant shift to a model that rewards quality, value-based care. But patients have also pushed for increased, verifiable value, and will continue to do so next year. They are confronted by exorbitant health insurance premiums, higher deductibles, and greater responsibility for paying for their care. So they are demanding care that is based on a competitive consumerism model.
As buyers of healthcare, they want assurance that they will get their money’s worth, and they want to compare prices and services as they shop for healthcare. That means providers need to focus on greater transparency in 2020, as well as flexible approaches to pricing with innovative payment plans that help patients solve their financial challenges. They also need to provide clear, complete treatment plans to convince patients that their treatments are necessary, valuable, and will lower their overall costs through proactive prevention.
New Payment Models
CMS has proposed changes that it hopes will reduce costs and expand patient choices and benefits, particularly for the rapidly-growing senior demographic. Those changes can be expected in 2020, and so can five voluntary payment models that were recently introduced by the Department of Health & Human Services (HSS). HSS designed two specific categories of payment models. One of those, called PCF General, provides primary care practices with a way to qualify for substantially reduced administrative burdens, as long as they assume more financial risk.
The other path, PCF-HNP, was designed to incentivize primary care practices that treat patients with special needs such as lifetime treatment for chronic conditions or hospice care. PCF General and PCF-HNP programs both reward participating practices with higher performance-based monthly payments and simplified payment paperwork. New proposals for physician fees in 2020 also increase the number of telehealth services that are included. Steps will also be taken to lower the administrative burden on providers with changes in coding and required documentation.
Telehealth and AI
Today’s patients expect faster, more personalized delivery of healthcare products and services, wherever they are. That will accelerate advances in telehealth in 2020, especially technology that allows medical specialists to reach underserved communities lacking access to robust healthcare infrastructure. Medical researchers and providers will also benefit from the use of artificial intelligence and cloud technology. The combination will give them greater access to big data and the capability to more quickly and meaningfully analyze it and put it to good use.
That is expected to usher in a new era of groundbreaking research in the areas of both pharmacology and treatment. But that kind of progress will first require innovations to vastly increase security and privacy, for the protection of patient identities and records. In all of these critical ways, digital health technologies will be a major driver in 2020, and will further facilitate enhanced interoperability across healthcare systems.