Other Voices

Emerging trends will rock the healthcare industry in 2016

Dr. Darren Kumar, center, performs a heart catheterization procedure at the new Heart and Vascular Invasive Care Center at JPS Health Network Patient Care Pavilion.
Dr. Darren Kumar, center, performs a heart catheterization procedure at the new Heart and Vascular Invasive Care Center at JPS Health Network Patient Care Pavilion. Star-Telegram

We have no special powers. We are not clairvoyant. But collectively we have lived within the healthcare management world for nearly 100 years.

Here are trends we anticipate will become more visible in 2016 and beyond.

Turmoil will accelerate as insurance companies merge and withdraw from the Affordable Care Act marketplace. Neither patient nor provider will be happy campers. As premiums increase, people will attempt to bring them down by choosing a higher deductible.

ACA is here to stay. Regardless of what the news media or your father-in-law have to say, a repeal is unlikely to happen. The rollout of ACA has significantly raised awareness of many healthcare issues, and turbulence is bubbling in the industry.

Like any new product, sometimes it takes several “new and improved” versions before all is working like a well-oiled bike.

Consumers will be their own advocates. With the disappearance of the family doctor caring for patients from crib to coffin, the onus for health maintenance will be on the patient. Search engines and sites like WebMD are replacing long chats with friendly docs.

Patients will be switching providers frequently and stopping in to multiple facilities for routine, preventative and urgent care needs.

Entrepreneurs will take advantage of this growing trend and create apps for mobile devices that enable consumers to be more informed.

Providers will boost their marketing efforts, similar to what bariatric and laser eye surgery services have been doing for years. Prices will become more of a selling factor, and therefore more visible.

Healthcare services will evolve like the airlines. A few players will run enormous fields. Local/regional providers will venture out of their home state and service the entire country. As they accelerate and intensify their focus on the consumer, access and high value will be drivers of organizational change.

Size alone will not ensure success. All providers will need to reorganize to ensure ease of access and high-value services.

Doc in the box will be the norm. Retailers such as Walgreens, Target, CVS and Wal-Mart will expand services and attract more regular healthcare customers.

As some companies rev up their marketing efforts, patients will more frequently travel out of their home area for services.

The cost of drugs will rise. This will cause more intensive government review and involvement. Price controls may be considered, similar to what other countries have established.

We will see rural health deserts. State budgets are being pummeled, and healthcare is being hit hard. These shortfalls result in lower Medicaid payments and reduced access for many in rural areas.

Employers will feel the pinch. Accelerating healthcare inflation will result in aggressive responses by employers. Employee premiums and deductibles will rise.

Another potential scenario is forcing employees to shift to a voucher approach, leaving employees totally responsible for securing their own coverage.

Hospitals will be lean. Productivity will be the goal.

Information technology will be a silent driver of profound change. Major IT systems are becoming dominant and more sophisticated. As more corporate consolidations occur, so will more IT alignment.

The result is standardization of healthcare processes, and, in turn, behavior change by providers. IT will move from programmable computers to cognitive systems. There will be more reliance on machines and less on clinical expertise.

Thomas Royer, Peter Maddox and Jay Herron, former leaders of CHRISTUS Health, now run a healthcare consulting firm, Royer Maddox Herron Advisors. Royer lives in Southlake and Herron in Colleyville.