Becker's Hospital Review

9 The List Issue The 7 Biggest Healthcare Issues in 2015 So Far By Molly Gamble and Scott Becker A s we continue into the second half of the year, this article examines some of the biggest issues that have emerged so far. 1. Healthcare costs for the average family are going up. Over the past two to four years, something fascinating happened. First, healthcare insurance costs stayed largely the same. is gave some people the illusion that family healthcare costs might be staying flat. In reality, the consum- er portion of costs went up substantially. "Healthcare costs for this family have doubled in the past decade, and tripled since we began track- ing this information in 2001," said Sue Hart, co- author of the Milliman Medical Index. "As has been the case throughout the time we have stud- ied costs for this family, the rate of increases far outpace the consumer price index." e concept where employers shi more of the costs to em- ployees and insurance companies offer more high deductible and similar types of plans is not abat- ing. Rather, insurers are preparing for another set of significant increases in costs. 2. Consolidation continues at a fairly rapid pace; will regional systems con- solidate; will payers consolidate? It has become increasingly clear that rural hospitals and independent hospitals may have a very hard time surviving in the future. us, more and more of those are looking to align with bigger systems. And on the other hand, bigger systems are eagerly searching for hospitals that can expand their mar- ket reach. A fascinating issue will be whether the regional systems, and there are increasingly great region- al systems in the country, (see "50 Great Health Systems to Know"), will start to align with each other. ese types of deals, oen referred to as "mergers of equals," can be transformative for or- ganizations and their markets. A second fascinating issue has emerged this sum- mer: Consolidation within the health insurance industry. Here, it seems as if a merger frenzy or bubble is heating up among the big five insur- ers, prompted by Hartford, Conn.-based Aetna's definitive agreement to acquire all outstanding shares of Louisville, Ky.-based Humana in a deal valued at $37 billion. 3. State budgets, whether states picked up Medicaid expansion or not, are being shellacked. State budgets are now in trouble on two different fronts. ey are, in many states, overwhelmed by the cost of pension and health- care responsibilities to former state government employees. Second, they are increasingly over- whelmed by Medicaid expenditures, and in some states the decision about whether to expand Med- icaid is a messy one. Paul Volcker, the former chairman of the Federal Reserve, recently issued a report that said nei- ther Democrats nor Republicans can claim to have superior budgeting practices at this point. He criticized states for kicking the can down the road, living beyond their means year aer year in a "never-ending sense of crisis" that results in "stop-and-go funding of vital programs," such as those for infrastructure, education, pensions and city and county services. SAVE THE DATE learn more & register at beckershospitalreview.com November 18-19, 2015 Ritz Carlton, Chicago, IL Becker's Hospital Review CEO Roundtable + CFO/CIO Roundtable 77 Health System Executive Speakers

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