In 2019, seismic changes taking place in healthcare will help trigger the evolution of our nation’s healthcare system, including new services available to the aging population.

To help you succeed in the year ahead, check out the following five things that healthcare leaders and clinicians need to know.

1. Pricing Transparency 

What it is: Increasingly, the current Administration and the Centers for Medicare and Medicaid Services (CMS) are mandating pricing transparency in healthcare. This includes the January 1, 2019, implementation of hospitals posting standard charges online. All hospitals in the US, including standard acute-care hospitals, long-term acute care hospitals, psychiatric hospitals and rehabilitation hospitals, will have to post a “digitally accessible document” that is updated annually, at a minimum, and includes the hospital’s standard charges for items and services provided. Additionally, CMS has a proposal to enhance prescription drug price transparency, which would require manufacturers to publish wholesale prices (AWPs) of Medicare and Medicaid prescription drugs in television advertising.

Why it matters: CMS and the Administration believe that price transparency is a critical element in enabling consumers to make informed healthcare decisions. This is part of an ongoing effort to make the healthcare system more consumer-friendly and easier to navigate. Additionally, the prescription drug proposal is aimed at reducing the rising costs of drugs within public payer programs, such as Medicare and Medicaid. However, critics of the transparency efforts argue that the data does not necessarily reflect realities, such as insurance coverage of drugs, and that consumers are unlikely to research or consider drug prices in emergency situations.

2. Megamergers

What it is: News and rumors of megamergers between health plans, pharmacies, retail and health providers dominated 2018. Often these megamergers bring together partners who would not make sense in a different healthcare environment. In late 2018, the Department of Justice announced conditional approval on several announced mergers including the CVS/Aetna deal. This activity is expected to ramp up in 2019 with moves that would further redefine how seniors in America access their healthcare. 

Why it matters: Mergers and acquisitions, like the examples above, seek to break down traditional silos and create vertical integration in healthcare. Such M&As are the next step for payers and providers who are working to reduce inefficiencies in care and improve care coordination for patients. These new organizations become increasingly important to acute care hospitals in the form of strategic partnerships that support the move toward value-based care, as well as improved clinical outcomes and clinical decision support for patients post-discharge. Lastly, such vertical integration has the potential to pass along reduced healthcare costs to consumers.

3. Increased Congressional Oversight 

What it is: With the recent shifts in control of the House of Representatives, it is likely that committees may once again take up additional healthcare oversight and investigative hearings. In the past, these types of hearings have focused on abuse, neglect and substandard care across nearly all acute and post-acute settings. In 2019, it is anticipated that a specific focus will target improper payments to providers from Medicare payments. Further, policymakers have indicated that their emphasis will be on providers with a high risk of abuse. 

Why it matters: While investigations may target Medicare providers that are the greatest risk for fraud or improper payments, these types of oversight activities and hearings could tarnish the reputation of all related Medicare acute and post-acute providers in the court of public opinion. This means that in a new environment of hearings and investigations, all Medicare providers need to enhance their efforts to manage their online reputation and strong positive presence in the local community to combat potential negative media coverage from a disruptive oversight process.

4. Growing Emphasis on Patient Engagement 

What it is: Research underscores the growing value of a positive patient experience, including findings that show hospitals that deliver a better patient experience perform better financially. Not only is increasing a patient’s participation with their care plan well recognized as a core component of high-quality care, but it is also associated with improved healthcare outcomes and overall population health, and reduced healthcare costs. In 2019, technology innovators will continue to make new tools available to more fully engage patients in their own healthcare information.

Why it matters: By effectively engaging patients across the continuum of care, providers can empower patients and earn the trust needed to become the consumer’s provider of choice. Therefore, providers need to implement robust patient engagement strategies that focus on leveraging technology, particularly mobile applications, to meet and support patients how and where they communicate and access important information.

5. Quality Reporting 

What it is: CMS and Congress continue to put increasing emphasis on value-based programs, which are helping the Medicare program emphasize quality outcomes rather than the quantity of care provided. In most final 2019 payment rules, CMS updated the quality outcomes that each provider type must publicly report, which also are available on the Medicare.com compare websites.

Why it matters: With more than 80% of consumers researching their healthcare options online and the increased reliance  on the reputation of a hospital, physician, or provider before making healthcare decisions, publicly reported quality scores are increasingly important. Websites like Medicare’s Hospital Compare provide critical quality performance and comparison data, which helps consumers to make informed decisions. Additionally, when considering the potential for an increase in Congressional oversight and hearings, high-quality providers can highlight strong clinical patient outcomes and strong patient engagement scores in proactively maintaining a favorable standing in the local community.

How Kindred Can Help

Kindred Healthcare is committed to pursuing innovations in care delivery and payment models as it provides new tools and solutions to patients and their families. These resources are designed to help navigate a confusing healthcare system, provide ongoing support after they are discharged from our care, and ensure efficient care management for each patient for whom we have the honor to provide care.

Two key ways Kindred is delivering on this comment are through our RehabTracker app and the Kindred Contact Center.

• RehabTracker is a new, mobile application used by our rehabilitation teams to encourage our patients to engage with their recovery process. Since implementing RehabTracker, key quality metrics of functional Independence Measure (FIM) gain and Discharge to Community have improved. RehabTracker is available in our acute rehabilitation unit (ARU) offerings and is rolling out to our long-term acute-care (LTAC) hospitals in 2019.
• The Kindred Contact Center aims to fill gaps in care through the patient journey by providing a 24/7 nurse-led customer hotline, clinical after-care services, and hospital placement solutions.

Further, Kindred’s remains an advocate to help shape new health policies as Congress and the Administration seek to establish value-based healthcare payments and delivery reforms.

Lastly, to help our healthcare professional partners stay informed, Kindred publishes articles such as these twice a month. Sign up now to stay up to date on all of the latest healthcare news.

To learn more about our services, please reach out to your Kindred representative, contact us or visit us online at www.kindredhospitals.com.