Author: Craig Beam, President

If you work in the healthcare industry, as we do, what do you have to look forward to in 2019? While no one has a crystal ball, our experience and expertise gives us insight into what the year ahead may — and may not — bring. Here’s a look at 2019 healthcare trends to watch.

  1. “Medicare for All” Won’t Happen

While there is widespread support for “Medicare for all” in public surveys, that support fades away with the addition of consideration of tax increases or delays in tests and treatment — ultimately making it a no-go.

  1. AI Will Remain an Emerging Technology

Artificial Intelligence, or AI, is the buzz in healthcare and has the potential to make a significant impact — but not quite yet. In 2019, AI will continue to be an emerging technology in its application to healthcare services. Despite significant dollar investment in this arena, the practical applications for AI in healthcare have been minimal, due to the challenges of healthcare’s complexity. As a 2019 healthcare trend, considering first-generation AI as “Augmented Intelligence” is more realistic, in which data and analytics help predict and bring evidence to care while practitioners’ cognitive skills remain dominant.

  1. Genomics and Precision Medicine Will Make Headlines

While still emerging, genomics and precision medicine will lead to life-saving treatments for rare life-threatening diseases. Expect to hear a lot more about it in 2019, within the healthcare community as well as in the mainstream media. CAR T-cell treatment is an example of a therapy showing dramatic results for secondary leukemia treatment in pediatric patients. Pharmacogenomics also offer advances in prescribing the most effective medications for patients based on results of saliva or blood testing, resulting in fewer side effects, faster recovery, and lower costs.  Meanwhile, genome editing, specifically the CRISPR-Cas9 system, will be controversial and launch serious ethical discussions among academic research and medical centers in the year ahead.

  1. Telemedicine Won’t Grow As Expected

Telemedicine will continue to grow, but at a slower pace than many had hoped. Until reimbursement becomes economic, telemedicine will remain most effective for stroke, behavioral, and some specialty uses. While the use of telemedicine should improve access to care for organizations like Avera Health, which supports many rural communities, issues around reimbursement will remain a barrier to implementation.

  1. Fee-For-Service Will Continue to Dominate

With a few geographic exceptions, fee-for-service will remain the predominant payment system for healthcare. It’s an outdated payment methodology that doesn’t match today’s complex patient conditions and treatments. This means population health management and value-based pricing will remain a small portion of how healthcare is delivered in the U.S. Until the economics of delivering “more care” versus “more health” change, practice patterns will remain the same and it will be difficult to bend the cost curve downward.

  1. Hospital Price Transparency Won’t Create Consumer Clarity

The widely heralded Hospital Price Transparency Rule that went into effect January 1 — requiring all hospitals to publish a list of prices for all items, fees, and services — unfortunately, will be meaningless for consumers as hospitals publish complex lists based on their own chargemasters. Consumers will be further confused until prices are published on a “cash pay” basis for bundled services. Some healthcare systems still don’t view patients as customers who are purchasing services, based on the healthcare system’s mission, patient relationships, and the fact that buying healthcare is more complex than purchasing a commodity. This view not only impacts how the rule is perceived, it may also affect how it is implemented. Stay tuned.

  1. Outpatient Migration Will Challenge Health System Profitability

The shift to providing services in outpatient settings will continue, which is good news for patient outcomes and access to care, as well as overall costs versus inpatient settings. The bad news is hospitals and health systems will continue to struggle to make providing care in outpatient settings profitable. Overall outpatient revenues remain less than inpatient revenues, and though the gap is shrinking, experts predict a shift will still be several years in the making.

  1. Addiction Treatment Will Get a Lot of Talk but Not Enough Action

One clear 2019 healthcare trend is our U.S. addiction crisis. As the devastating opioid crisis continues its vice-like grip on our country, a lot of attention will be focused on mental health services and addiction treatment — as it should be. Unfortunately, treatment options will be under-serviced and under-reimbursed until major changes in healthcare, insurance, and even legislation are made. It’s clear we need change, it just won’t come soon enough in 2019.

  1. U.S. Life Expectancy Will Continue To Shrink

Until we’re prepared to make changes, the average life expectancy will continue to decline in the United States. While life expectancy in most developed nations is rising, U.S. life expectancy is on an historic decline. This is perhaps among the most sobering of 2019 healthcare trends, and one that will generate much analysis and discussion in the year ahead. In addition, look for increased funding and focus on mental health and addiction, which is the cause of much of the decline.

  1. The Amazon-Berkshire-JPMorgan Health Venture Will Remain “Wait and See”

The Amazon-Berkshire-JPMorgan health venture, which aims to ultimately reduce wasteful healthcare spending, will take time to mature into meaningful programs and results — not only for its own insureds but also for the healthcare industry as a whole. It is definitely an innovation worth following, as part of our 2019 healthcare trends and beyond, as future implications could be quite interesting, indeed.

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