As the US heads into an election year, healthcare will be in the spotlight as never before. We expect both parties will be under pressure to propose solutions that appear substantive without threatening benefits that many consumers value. The current administration is likely to continue its incremental steps toward a market-driven model, as commercial payers grow bolder in their promotion of value-based payment. Pressure from employers and consumers for lower costs and higher quality outcomes will continue to grow. Perhaps most important, the threat of competition from non-traditional disruptors is becoming increasingly real. The net of these forces will be to raise the urgency of change, and subtle but important shifts in emphasis for providers. We predict that 2020 will mark a turning point in the evolution of a market-based model of care. In more forward-leaning markets, delivery organizations will focus more concretely on conceptualizing, differentiating and commercializing new offerings that are more responsive to their market. In short, 2020 looks to be a year of accelerating change.

Delivery organizations will continue to use consolidated purchase volumes as leverage for price concessions from vendors, pharma and device suppliers. Eventually, risk sharing schemes will supplant straight discounting as technology and process management capabilities mature.

Government mandates and pressure from employers and consumer advocates will accelerate transparency in pricing, and development of tools to facilitate comparison shopping for non-emergent care. As an offset to other bottom line pressures, market leaders will continue to build out direct contracting efforts with employers to reinforce their competitive advantage. Likewise, payers will continue to pursue more risk-based reimbursement arrangements, and ventures with providers in select markets.

Continuing emphasis on total cost of care will drive integration across the care continuum by payers. Acute care providers will increase their focus on patient accessibility through retail and urgent care clinics, telehealth services, centralized scheduling with physicians, and coordination with post-acute care providers. Consolidated delivery organizations will standardize data platforms, processes and organizational structures. Consolidation among acute care providers and acquisition of physician practices will continue at a slower pace than in years past. The FTC will raise the bar for future consolidation proposals in response to growing concerns about market impact.

Given this outlook, what’s next?  We recommend these key action steps:

At Numerof & Associates, we support healthcare delivery organizations in reinventing their strategies, processes, structure, and analytics to succeed in our evolving healthcare landscape. From competitive strategy to implementation of new payment and delivery models, we have solutions. Read more about our perspectives and solutions for healthcare delivery and see our case studies.

Need critical insights across the healthcare sector? Check out our 2020 outlook infographics for pharmaceuticalsmedical devices and diagnostics, and payers.