Healthcare

Charles Darwin might have been talking about the world of healthcare when he said, “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

The healthcare industry has experienced monumental shifts in 2017—changes in policy, regulations, technology and mergers that make it difficult to keep up. That’s why our goal is simple: To help our clients anticipate, adapt and take advantage of a transforming industry to accelerate their growth.

With the proposed changes to the Quality Payment Program (QPP) released Wednesday, the new administration aims to reduce some administrative complexity and extend the flexibility that CMS provided in the initial year of the program, while incentivizing more providers to move into Alternative Payment Models (APMs).

President Trump’s vision for tax reform has raised more questions than answers. Just one of these provocative questions is how a 15% corporate tax rate—which would apply to pass-through income as well as corporate earnings—would affect physicians and other business owners.

Last week House Republicans gave us a first glimpse of what they mean by “repeal and replace” of the Affordable Care Act (ACA). 

Lack of unity in the GOP and opposition from leading healthcare industry groups means the American Health Care Act (AHCA) faces significant hurdles and likely changes as it works its way through congressional committees and the budget reconciliation process. However, we can glean a few insights into how the final legislation might impact healthcare providers.

Wait-and-see is no longer a viable strategy for payment reform—especially with regard to MACRA implementation.

In my 30 years serving healthcare practices, I have seen innovations come and go. I certainly understand the impulse to sit back and let the dust settle before rushing to implement a new regulation, and the steady Republican drumbeat of “repeal and replace” is enough to give any provider pause.

Living in interesting times may be a blessing or a curse, but 2016 proves that it certainly isn't boring. Healthcare in the United States continues to evolve—sometimes very rapidly—and those guiding healthcare organizations have particular challenges ahead of them in the coming years.

I've just returned from the National MACRA MIPS/APM Summit in Washington, D.C., where the overarching discussion centered on how to create and implement strategies that pay physicians fairly, while controlling spending in the Medicare program. It's a question we've wrestled with for almost 20 years and a challenge we must solve.

In a move that was widely applauded by medical groups such as the Medical Group Management Association, the American Medical Association, and the American Academy of Family Physicians, CMS announced that it is making the start of MACRA implementation more flexible next year. Although the performance evaluation period may be delayed, the start of payment changes will not be delayed.

The HORNE Healthcare team has been blogging recently about the necessary business model changes we think are inevitable to healthcare transformation. We’ve focused on the macro level, urging healthcare organizations to take action. While I believe our advice is sound for large systems, I am additionally concerned about the pressures physicians are feeling in their practices, particularly in small practices. In this blog, I’d like to introduce three issues I think will be important to physicians going forward. I will write in greater depth on each topic in the coming weeks. 

At a recent national conference, I heard top executives from some of the largest healthcare systems in the country discuss their business models and their healthcare delivery transformation during the past several years. We can count on the Geisingers and the Mayos, as well as other large systems, to lead the way, but I was struck by the extent of their progress towards offering value and outcomes to patients rather than the traditional models present today in many systems. They are doing, quite successfully, what many smaller systems are only beginning to debate. They are proving that new models can deliver better patient care and still be profitable.

Bundled payments. Volume-to-value. Cost accounting. Process improvement. Patient engagement. Population health. Organizational leadership.