Rapid change as well as uncertainty will continue to characterize healthcare in 2018. Organizations will have to stay on their to toes to weather the many changes ahead.

While the pace of change is dizzying and each week seems to bring a new twist, several key issues are taking shape for the coming year. Among the many new and emerging trends to keep an eye on, here are three significant issues that will take center stage in 2018.

More mergers and acquisitions activity

The major mergers and acquisitions activity announced late last year (CVS-Aetna, Dignity Health-CHI, and, potentially, Ascension-Providence St. Joseph) will carry over into 2018.

Providers and others will continue to join forces or find new partners in order to remain financially viable and thrive. Lower patient admissions and the move toward value-based reimbursement are two big forces driving these mergers, as providers look for ways to reduce costs and improve outcomes.

While it is too soon to tell how the recent wave of mergers and partnerships will affect the industry, partnerships that allow for better care coordination should lead to better outcomes and lower costs – but those who fail to transform care delivery are only compounding their issues. Many large systems have been and will continue to invest in digital health innovations in the shift to value. With newly merged organizations, there is an opportunity to scale those digital health innovation efforts to benefit even more patients.

The shift to value-based care continues with BPCI Advanced

Though CMS has recently announced several changes to the current mandatory bundled payment models, including canceling two mandatory models, there is no question that value is the future for healthcare.

BPCI Advanced, the next generation of the original Bundled Payments for Care Improvement (BPCI), was announced earlier this month. BPCI Advanced marks the further progression of the value-based care movement. Similar to other bundled payment programs, BPCI Advanced rewards clinicians for improving outcomes and lowering costs. Providers will be given an all-inclusive bundle price to cover the inpatient and post-acute care costs during an episode of care. With control of the entire episode, providers can earn additional revenue by improving care management to reduce post-acute care costs and readmissions.

The introduction of BPCI Advanced will demonstrate CMS’ commitment to smart payment reform that incentivizes programs that tightly control an episode of care. Engaging patients in their care will be a key ingredient to drive patient satisfaction, reduce unnecessary utilization, and reduce costs under voluntary bundled payment models.

Digital health moves into the mainstream

Digital health innovations, such as patient engagement and remote monitoring, continue to prove that they contribute to higher quality healthcare at lower costs. As the U.S. Food and Drug Administration and the Centers for Medicare and Medicaid Services becomes more supportive of these innovations, digital health technology will move into the mainstream in 2018.

The FDA recently announced its Software Pre-Cert Pilot Program, aimed at building a new regulatory process for software used in the prevention, treatment, and diagnosis of medical conditions. Under the program, medical software and digital health companies that are pre-certified by the FDA will be able to reach the market without a lengthy regulatory approval process of pharmaceuticals and medical devices. This new agile regulatory framework is a positive step towards ensuring patients and physicians don’t have to wait months or years to benefit from a new digital health innovation.

CMS added a patient engagement measure to the Improvement Activity category under the Merit-Based Incentive Payment System (MIPS). The move demonstrates CMS’ vision that activating patients in their care and keeping physicians and patients in contact through the appropriate sharing of patient-generated health data is valuable.

In another positive development for digital health, CMS released a final rule for the 2018 Medicare Physician Fee Schedule.  In the Fee Schedule, CMS will reimburse physicians for using remote monitoring technologies. Beginning this year, physicians can be reimbursed for time spent collecting and analyzing health data that is generated by a patient, digital stories, and transmitted to the providers at a rate of $60 per month per patient for a cumulative 30 minutes of monitoring.

These milestones represent a big leap forward for physicians and patients using digital engagement tools. This progress sets the stage for high-quality care delivery systems to continue bringing patients into the care team to improve outcomes and lower costs.

Digital health will continue to move into the mainstream as it gains critical mass. Among the developments, we hope to see in the coming year is CMS taking a more expansive approach to reimbursement for digital health. While reimbursing providers for time spent on remote monitoring is a great step, CMS must take the next step and reimburse providers for the set-up and use of the remote monitoring technology itself.

Prepare for change and uncertainty

2018 promises to be another year of change for the healthcare industry. Even amidst rapid change and uncertainty, healthcare providers must be prepared to respond. Those who take a “wait and see” approach will be left behind.

Photo: lvcandy, Getty Images