Two thousand nineteen will be a significant year in the healthcare industry. Changes in governmental policy will impact everything from patient care to billing. This happens at the same time that major shifts are occurring with the aging of America and all the implications that come with that. As we look toward 2019 and beyond, we see a number of major trends:
- Home health care continues to grow: Demand for treatment outside the traditional doctor’s office is on the rise. In fact, a 2018 survey conducted by the PwC Health Research Institute showed that 54 percent of respondents would prefer “hospital care at home if it cost less than the traditional option.” This customer preference is changing job opportunities for that market as well. According to the Bureau of Labor Statistics, the demand for home health aides and personal care aides is booming. Employment for those occupations between 2016-26 is expected to surge 41 percent during this period to more than 4.1 million.
- Skilled nursing facilities (SNFs) are diversifying: As home health care grows, occupancy at SNFs has been taking a hit. The decline is compounded by pressure coming from payers and providers to reduce lengths of stay for patients. To help drive occupancy, SNFs are turning toward other services, this according to Skilled Nursing News. The publication notes that some providers will “look to add additional types of services inside and outside their buildings, such as assisted living, adult day care offerings or even meal services.” The story goes on to note that they are even looking to include patients that might normally be challenging for hospitals to place, be it the patient’s background or specific medical condition.
- MIPS: The Merit-based Incentive Payment System, which took effect January 1, 2019, is a value-based payment model for physical therapists. Depending on the volume of business, MIPS may be mandatory, opt-in or completely voluntary. Initially, PTs will only be assessed on quality and clinical improvement activities as opposed to all four of the MIPS categories participating physicians are subject to.
- PDPM – Benefits and Savings: The biggest change to payment in more than 30 years takes effect October 1, 2019. And with that, there will be no shortage of changes people will experience on a day-to-day basis as caregivers, patients, and payers. While much of the discussion to date has been about the financial side of the equation for SNFs, what’s equally interesting is the types of patients these facilities will pursue. Citing research from Integra Realty Resources, a Los Angeles-based real estate market research firm, Skilled Nursing News reports that under PDPM “facilities will seek out clinically complex patients, who will become more profitable.” The story goes on to add that PDPM could also generate cost savings in paperwork and administration approaching $2 billion over 10 years..
- Artificial Intelligence in healthcare will surge: With the availability of big data and drive to lower healthcare costs, implementation of AI in healthcare is expected surge in 2019 and in the years ahead. In fact, research firm MarketsandMarkets predicts that AI in healthcare will grow from $2.1 billion today to a $36 billion industry globally by 2025. The report cites recent examples including the commercial launch of Sugar.IQ, a collaboration between Medtronic and IBM to improve diabetes management as well as projects from Micron/Intel and ResMed as just a few ways AI is increasingly a part of day-to-day treatment efforts.
- PDGM – A change is coming: While the introduction of the new payment model for Medicare Part A is still a year off, home health service providers will certainly use the next 12 months to get ready for this rollout. This new model is designed to ensure access to care for vulnerable patients as well as to eliminate the number of therapy visits as a payment factor. The major changes include payment based on patient characteristics, the elimination of therapy thresholds as a component of payment and changing to a 30-day unit of payment from 60 days.
Healthcare and patient care is undergoing rapid transformation, a result of a range of reasons – political, demographic and technological being among the key drivers. The end result is a new normal where care is delivered to the patient where the patient is, and often by skilled nurses or other practitioners as opposed to doctors. The benefit is that it can keep costs down while meeting growing market demand, and most importantly, improving people’s lives.
Top Health Industry Issues of 2019: The New Health Economy Comes of Age
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Artificial Intelligence in Healthcare Market
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Merit-based Incentive Payment System (MIPS)
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