Closing the Book on 2014

This past year was one of “getting down to business” in the healthcare industry. Having shrugged off legal challenges, a government shutdown, and highly publicized technical glitches, the Affordable Care Act went into effect in 2014, moving the healthcare sector toward a value-centric system.

ECG worked with providers across the country to traverse and keep pace with these transformational changes. In 2015, we’ll continue to lead healthcare forward, helping our clients develop key competencies and implement strategies to become thriving value-based enterprises.

As we close the book on 2014, let’s look back at a few of the key themes that appeared in this space during the past year and take a peek at the issues our clients will encounter in the coming year.

From Independence to Interdependence

Commitment to value-based care requires organizational transformation, and in 2014 many healthcare organizations opted to band together with strategic partners rather than attempt to navigate the transition on their own. While merger and acquisition activity remains high in the healthcare sector, many sought to maintain autonomy through more collaborative models.  An early lesson learned by participants in these models is the importance of identifying and leveraging those functions and characteristics that define a more interdependent rather than an independent entity.

This year we saw increasing numbers of organizations choosing collaboration over consolidation. Hospitals, health systems, and physician groups partnered together in record numbers to form clinically integrated networks, enabling them to test new care models, advance adoption of care protocols, and measure and report results.  Next year, we expect more activity between these networks and the post-acute providers who are critical to success but have largely been left out of the network formation discussion.

In 2015, we’ll continue to support the success of these collaborative networks. Affiliation is an idea that enjoys widespread industry support, but challenges inevitably arise because success requires disparate organizations to cooperate as they seek to expand healthcare delivery while eliminating duplicative services. Some of these ventures have already come and gone, while other networks are actively working to define themselves to payors, employers, and the community. One thing is certain – leadership is the greatest differentiator among organizations, and thus we will see successes and failures in all manner of integrated models.

A Bigger Role for Advanced Care Practitioners

How advanced care practitioners (ACPs) have been referred to has evolved over the years, and so too have their responsibilities.  During the past several years, ACPs have been assuming greater roles in healthcare delivery. But 2014 saw increasing instances of nurse practitioners (NPs) and physician assistants (PAs) moving beyond traditional physician support to more active participation in patient care and population health. Resource-challenged healthcare organizations have imbued ACPs with greater clinical authority to work “at the top of their license.” And this past summer, The Joint Commission reiterated its support for accrediting patient-centered medical homes (PCMHs) led by ACPs. Legislation in a number of states is poised to expand this practice further.

The notion of an ACP taking on increasing clinical duties was broadly accepted in 2014. But the models for ACP care are still evolving and will likely continue to evolve through 2015.  Some organizations utilize NPs and PAs for many routine patient encounters, freeing up physicians to spend more time with complex cases. Other ACPs are being utilized in partnership with physicians to manage the most chronically ill patients.

As the healthcare industry grapples with a growing physician shortage in 2015 and beyond, leveraging ACPs more effectively will be a critical means of increasing patient access and extending organizational capability to manage population health.

Using Technology to Improve Patient Access

Expanding patient access is a primary objective of the Affordable Care Act – and one of the most challenging to achieve. Recognizing that the traditional ways of delivering care are not adequately meeting the evolving needs and expectations of patients, we worked with health systems in 2014 that experimented with open access scheduling, aligned primary and urgent care centers, and even developed patient contact centers in an effort to provide the right care at the right time and in the right place. But perhaps the most visible tool that many organizations adopted this year was the patient portal.

While patient portals were not a new innovation in 2014, their utilization enabled physician practices to satisfy important meaningful use criteria. But portal utilization is more than just another requirement to be crossed off an organization’s checklist. Health systems we worked with watched portals lower costs by reducing phone calls, paperwork, and unnecessary patient visits. What’s more, patients are increasingly demanding this functionality, wanting to be able to make appointments, communicate directly with their provider, access their medical records, and retrieve educational material in an online setting.

Many organizations struggled to maximize this technology, sometimes due to vendor shortcomings or to difficulty in changing providers’ attitudes about the value of patient portals. Despite these difficulties, patient connectivity is a critical tool for realizing a more efficient and effective care model. Access will continue to be a key practice differentiator in 2015, and if your practice can’t accommodate patients who want to be more engaged in their healthcare, those patients will find a provider who can.

The healthcare landscape looks very different today than it did at the beginning of the year. And yet this monumental shift toward value-based care is still in its earliest stages. Our clients will continue wrestling with these topics and many more in 2015, and we’ll help them make decisions that are sensible for their organizations and beneficial to the communities they serve.

As we leave 2014, consider the following quote from Bill Gates:

“We always overestimate the change that will occur in the next 2 years and underestimate the change that will occur in the next 10.”

What part of that 10-year cycle is your organization in?

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