Becker's Hospital Review

Save the date! CEO Roundtable + CFO/CIO Roundtable — November 18-19, 2015 — Chicago. Please call 800-417-2035 to register. 11 D ay after day and week after week, many of the same tired phrases are used when discussing healthcare. Some say it's going through a period of unprecedented change while others phrase it as progress- ing through a significant transition, but no matter what words are used, one thing is clear — healthcare is a complex industry that is always transforming. From the backlash against HMOs in the 1990s to the controversy surround- ing the Patient Protection and Affordable Care Act that still exists today, the number of debatable healthcare topics is limitless. In an attempt to find a model that works for everyone, including providers, patients and payers, the healthcare industry has molded into different forms, reacted to industry outcry and taken progressive steps, only to leave some groups satisfied and others disappointed. Due to the continual modifications, it's nearly impossible to know what healthcare will look like one, 10 or 20 years down the road. However, it is possible to identify the words that will influence healthcare this year and — who knows — maybe forever. 1. Accountable care organization Created under the Patient Protection and Affordable Care Act, ACOs are meant to reward providers for improving quality of care while reducing healthcare costs. Although many of the intricacies of these organizations are still being ironed out, with more than 626 ACOs already formed and more created every week, the industry will likely see more ACOs in coming years. 2. Bankruptcy Anything from administrative mismanagement to a natural disaster can send a hospital down the road to bankruptcy. With 11 hospitals filing for bank- ruptcy in 2013 and 16 hospitals filing in 2014, according to a report from Value Healthcare Services, bankruptcy is becoming a commonly used term in the healthcare industry. 3. Big data Healthcare organizations are harnessing big data technology to give them a more complete picture of a patient, which can help improve care coordina- tion and outcomes. With the focus on improving quality of care and cutting costs, big data is more relevant and useful in the healthcare industry than ever before. 4. Bundled payments Used as a mechanism to reduce healthcare costs and transition from fee-for- service to value-based reimbursement, bundled payments have grown in popularity since provisions for them were included in the PPACA. A bundled payment includes a set price meant to cover every element of clinical care and support for a specific procedure or condition. 5. Cadillac tax Scheduled to take effect in 2018, the PPACA's "Cadillac tax" is meant to re- duce overall healthcare costs by encouraging employers to offer cost-effective health benefits. With the tax looming, many large employers are already scal- ing back the benefits they offer employees, causing the affected workers to be offered plans with higher deductibles and co-payments. 6. Collaboration The success of value-based payment models and population health hinges on providers and payers working together more than ever before, and they are joining forces under new types of agreements every day. These types of agreements include value-based contracts between insurers and health sys- tems, clinical affiliations between competing health systems for certain types of care and partnerships between hospitals and outside agencies to improve the social determinants of health. 7. Consolidation Whether driven by a desire to increase bargaining power or to stay financially viable, there is rampant consolidation in the healthcare industry. Although there has been some friction between antitrust laws and consolidation under the PPACA, 2014 brought 95 hospital transactions, making it the third con- secutive year in which at least 95 hospital transactions were announced. Of the 95 transactions between acute-care hospitals, 80 involved the acquisition of nonprofit organizations and 15 involved the acquisition of for-profits. 8. Consumerism With the increasing popularity of high-deductible health plans and the avail- ability of data about prices and outcomes, healthcare is increasingly becom- ing an industry in which consumers shop for care. As patients take on more responsibility for healthcare costs, the industry will likely become even more patient-centric. 9. Coordinated care There are numerous participants involved in coordinated care — such as pri- mary care physicians, specialists, post-acute care facilities, family members and the patient — and each is responsible for a different aspect of care deliv- ery and health outcomes. In their efforts to provide coordinated care across the healthcare continuum, providers must identify and eliminate gaps in the episode of care, share information and reach out to patients to help improve health outcomes. 10. Culture An organization's culture can affect everything from patient safety to em- ployee engagement, from innovation to financial performance. There is a tremendous amount of buzz around culture in the healthcare industry, as it can cause employees to become invested in an organization's mission and propel it forward to reach its goals, or it can lead to setbacks for hospitals and health systems. 11. Data breach The healthcare industry is being transformed through the increased use of technology. However, as more patient information is stored electronically, the threat of data breaches becomes greater. With this increasing threat, last year was even dubbed by some as the "year of the data breach." Across industries, the healthcare sector experienced the highest percentage of breaches in 2014, according to Identity Theft Resource. Of the 761 data breaches reported last year, 322 of them came from the healthcare industry. There have been several headline-making healthcare data breaches in recent years, including a signifi- cant one earlier in 2015 that involved a cyberattack on Anthem.

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