Healthcare is a hotly contested subject within government, and the conversation has been shifting for decades. The last few years change has rapidly accelerated with new legislation, changes to the way insurance provides payment, fresh hope for chronic disease and a rapidly evolving approach to patient care. Let’s take a brief look at what happened last year to create such sweeping change and discover what patients and providers can expect in 2018.
The Opioid Crisis Takes Center Stage
Opioid overdoses have quadrupled since 2000, making the opioid crisis a key focus for government and healthcare officials in the year ahead. Overdose is now one of the top causes of death for adults under 50 in the United States. Every practitioner in the healthcare arena can play a part in reversing the trend.
One major focus will be on prescribing practices, since for many opioid addiction started with prescription pain pills. Almost every community is affected, and the physicians who prescribed medications must now evaluate how to limit supplies and improve patient awareness.
Physicians will need to find ways to coordinate with state and local agencies to address opioid addiction and recovery. For now, they can take immediate steps to limit supply, educate patients,
identify patients dependent on opioids and provide medical expertise in their community.
States Prioritize Price Transparency
Colorado implemented a law the first of this year that requires state hospitals to publish what they charge for commonly-performed treatments. The state also now requires doctor’s offices to furnish the cost of their top 15 procedures. Patients are tired of not knowing what their care might cost and how much of that they might be required to pay. Other states are developing their own legislation. Expect to see requirements that allow patients to comparison shop along with increasing competition between providers.
Natural Disasters Disrupt Healthcare
2017 saw hurricanes Harvey, Irma and Maria. California wildfires raged across a larger portion of the state than ever before. During each natural disaster, some health care facilities were forced
to close. Others saw an influx of patients they weren’t prepared for. Disaster displaced patients, destroyed records and disrupted billing cycles. Pharmacies and medical equipment suppliers also
experienced devastation. Every aspect of the supply chain was disrupted.
In the aftermath, some facilities were so badly damaged they’re still undergoing repairs. Others will never be rebuilt at their current location. When a disaster covers such a large geographic area or impacts large populations, as in the California wildfire crisis or the Houston hurricane damage, repairs move slowly. It may be months or years before patient volumes and billing cycles return to pre-disaster levels. Experts are only beginning to evaluate the long-term impact on healthcare in affected regions.
Medicare Advantage Sees Increased Enrollment
Individuals eligible for Medicare can elect to receive benefits through a Medicare Advantage plan, also known as a Part C or MA plan. Medicare approves some private insurers to provide coverage and reimburses them for approved expenses. Medicare Advantage Plans may include the following:
- Health Maintenance Organization Plans
- Preferred Provider Organization Plans
- Special Needs Plans
- HMO Point of Service Plans
- Private Fee-For- Service Plans
Medicare Advantage is experiencing a surge in enrollment, with five percent more participants already in 2018 compared to last year. As more consumers realize the opportunity exists, they choose options they feel better meet their needs.
Health Care Reform After Obamacare
The Affordable Care Act (ACA) dominated the news after Trump became president, with representatives on both sides pointing out flaws in our current healthcare system. The debate isn’t over, as lawmakers try to lower Medicaid spending, provide all Americans with reduced health insurance costs and repeal ACA related legislation.
The Individual Mandate that assessed uninsured Americans with a penalty expires in 2019. Republicans also state they want to rework Medicaid and Medicare processes to add eligibility
requirements and prevent waste.
The Internet of Things Necessitates Greater Security
Internet connectivity is no longer just confined to smartphones, tablets and desktop devices. It’s in every aspect of our lives including appliances, home features and business systems. Connectivity improves medical devices and information exchange, but it also creates security issues.
Devices flow through hospitals and care facilities with different encryption, passwords and capabilities. Data flows through unmonitored channels, so there’s a potential for insecure migration. Information technology staff and vendors often install or connect devices to the hospital network, creating risks and vulnerabilities. Healthcare facilities will need to focus time and resources on securing connected devices, protecting patients and planning for future defense.
Artificial Intelligence Humanizes Care
Technology is taking over many of the paperwork tasks and administrative duties people had to perform in the past. Artificial intelligence (AI) gathers information, analyzes it for errors and stores it in a central location or passes it on to authorized receivers, all without the need for human interaction.
Companies use AI to simplify accounting processes, generate reports, evaluate best prescribing practices by patient and more. Staff is free to spend more time interacting with patients, and when they do, they bring improved insight to the relationship. Providers will also use AI for image recognition and medical diagnosis.
Electronic Health Providers Supply Stronger Analytics
Electronic Health Record (EHR) systems are required across the nation, and vendors are continually improving the insights they provide. While at first physicians saw these systems mostly as expensive technology they had to install to meet legislative demands, they now benefit from real-time reporting and patient insights that weren’t possible just a few years ago. Improved patient data results in better patient outcomes, smoother insurance claims processing and better healthcare practices overall.
Health providers also benefit from technology like claims processing software and medical billing software. Practitioners and staff spend less time inputting patient data and more time with the patients themselves. Revenue improves because of sophisticated medical claims processing and that income can be directed right back into providing quality care and a better patient experience.
Apex EDI is a powerful tool for improving productivity, increasing revenue and enhancing patient care. See how your organization can benefit from a medical billing clearinghouse with a free software demonstration today.