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51 HEALTHCARE NEWS The 10 challenges, opportunities healthcare executives expect to face in 2019 By Rachel Popa H ealthcare Executive Group outlined the top challenges, opportunities and issues healthcare executives will face this year. Ten things to know: 1. Analyzing data. Using clinical data in decisions concerning payers, providers and individuals is a top opportunity for 2019. 2. Total consumer health. is involves caring for the patient as a whole, including their medical, fi- nancial and social health. 3. Population health services. Operationalizing community-based health strategy, pushing forward clinical integration and acknowledging health bar- riers like social determinants are all issues health- care executive expect to face this year. 4. Value-based care. e transition to value-based care will impact healthcare executives' deci- sion-making in 2019. 5. e transition to digital healthcare. Wearables, patient portals and digital payments are opportuni- ties for healthcare executives. 6. Increasing pharmacy costs. Healthcare execu- tives will need to put strategies in place this year to address rising pharmacy costs. 7. Market disruption. Amazon, Apple, Google and Walmart have the power to disrupt the healthcare industry. 8. Slimming down operations. Automation, lean quality programs and making processes more effi- cient are just some of the ways healthcare execu- tives are looking to make operations more effective in 2019. 9. Opioids. Managing opioids and supporting those with addictions is a challenge many health systems are facing. 10. Cybersecurity. Healthcare data breaches are a top challenge for healthcare executives in 2019. n The 5 biggest health insurers in 2018 by membership By Angie Stewart W ith 49.5 million plan enrollees, UnitedHealth Group was the largest health insurance company in the U.S. as of Dec. 31, 2017, accord- ing to Forbes. Forbes ranked the country's larg- est health insurers by health plan enrollees. The top five: 1. UnitedHealth Group (Min- netonka, Minn.) Health plan enrollees: 49.5 million Revenue: $201 billion 2. Anthem (Indianapolis) Health plan enrollees: 40.2 million Revenue: $90 billion 3. Aetna (Hartford, Conn.) Health plan enrollees: 22.2 million Revenue: $60.6 billion 4. Cigna (Bloomfield, Conn.) Health plan enrollees: 15.9 million Revenue: $41.6 billion 5. Humana (Louisville, Ky.) Health plan enrollees: 14 million Revenue: $53.7 billion n Nicklaus Children's Hospital to freeze wages, lay off staff By Ayla Ellison M iami-based Nicklaus Children's Hospital made cutbacks in re- sponse to industry pressures, including dwindling reimburse- ment, according to the Miami Herald. Nicklaus Children's executives outlined the cutbacks in a memo to staff obtained by the Miami Herald. The hospital will eliminate pay raises for all employees this year, limit the number of new hires and reduce pen- sion contributions, according to the report. These cutbacks could create significant savings for Nicklaus Children's, which has roughly 3,500 workers. Labor costs make up 57 percent of the hospital's operating expenses, according to the report. The letter to staff also said it is necessary for Nicklaus Children's to re- duce the size of its workforce to lower operating expenses. In a written statement to the Miami Herald, a hospital spokesperson said the cutbacks and layoffs will help preserve the hospital's finan- cial position in the face of several industry wide challenges, including "reductions in reimbursement … a shift from inpatient services to out- patient care, and financial pressures due to rising costs and increased competition." n