News and Insights
The Numerof 2019 US Healthcare Delivery Outlook
We expect continued turbulence across healthcare delivery in 2019, driven by policy uncertainty at the top, and continued pressure for affordability and quality care by employers, consumers, and payers. Prodded by MACRA and commercial payers, the use of care models that incorporate accountability for cost and quality is slowly expanding. As our Healthcare Delivery Outlook infographic illustrates, 2019 will be about the search for a more sustainable model through changes in roles and relationships. Hospitals, systems and IDNs, as buyers, sellers and partners, will engage in new and different ways with CMS, payers, consumers, employers, pharma and device suppliers, physicians, retail clinics and post-acute care.
Delivery organizations will look to make up for shrinking reimbursement by reducing vendor pools, consolidating volumes, and requiring discounts, risk sharing, and other concessions from pharma and device suppliers. The high cost of specialty drugs will continue to be a sporadic headline issue, settled case-by-case absent a draconian policy solution, which is not likely.
The growing burden of deductibles and copays will slowly reshape non-emergent healthcare purchases to look more like other consumer transactions. Public demands for transparency in pricing and quality will stimulate development of tools to facilitate comparison shopping. Meanwhile, employers will engage in more direct contracting, while payers seek joint ventures with delivery. Payers will also pursue more risk-based reimbursement arrangements.
Growing emphasis on total cost of care will drive integration across the care continuum by contracting organizations. Acute care providers will continue to evolve their strategies to make care more accessible and appropriate through retail and urgent care clinics, telehealth services, centralized scheduling with physicians, and coordination with post-acute care providers. Consolidated delivery organizations will focus on sharing data, standardizing processes and aligning incentives. Consolidation among acute care providers and acquisition of physician practices will continue.
Given this outlook, what’s next? We recommend these key action steps:
- Manage variation in cost and quality across the continuum.
- Develop/commercialize bundled and capitated products and services.
- Demonstrate differentiated outcomes and value for growth.
- Redesign the business to ensure patient centricity.
- Unlock the value in alliances/collaborations and CINs.
- Accelerate performance in new delivery/payment models.
- Realign structure, roles, and competencies with market needs.
- Build service line capability to drive clinical and financial performance.
- Rationalize/realign care delivery platforms.
At Numerof & Associates, we support healthcare delivery organizations in achieving these key action steps for success in today’s 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.