4 trends affecting insurers this year
The healthcare industry is evolving in the post-reform market, bringing in new competitors, compelling innovative incentives and refocusing priorities--all with an eye toward providing better care at a lower cost, according to a blog post in the journal Health Affairs.
In the post, Susan DeVore, CEO of Premier healthcare alliance, outlines eight trends that will affect insurers and providers this year. Here's a sampling, rounded out with some examples from our own recent FierceHealthPayer news coverage:
1. Chronic care
As insurers and providers continue to partner in new accountable care organizations (ACOs), the shared savings programs will likely increasingly focus on consumers with chronic conditions. "Since each chronic condition increases costs by a factor of three, managing this population is the sweet spot for the ACO, and the deepest pool from which to pull savings," DeVore wrote.
That means implementing more patient-centered medical homes that aim to manage chronic conditions with specific care pathways that address behavioral health needs, decrease hospital admissions and emergency room visits.
ACOs and medical homes will also increasingly make use personal health coaches who motivate patients on a one-on-one basis and help coordinate care with all players. Exemplifying this trend is Health Care Services Corp.'s own medical home model where nurse care managers help consumers with chronic conditions while coordinating and monitoring patients' progress, as FierceHealthPayer recently reported.