From the Affordable Care Act to technological advances, and changes in patient demands to service delivery, the American healthcare system is facing some rapid and fundamental transformations.
What are current healthcare managers expecting for their facilities, staffs, and patients? And what should online MBA students with a focus in health services be aware of as they progress in their studies and prepare to enter or advance within the field? Here is a look at six top issues.
1. Baby Boomers Approaching Retirement Age –
Approximately 28 percent of the entire population of the United States was born between 1946 and 1964. As Boomers age, they will reshape the nation’s healthcare delivery system in a variety of ways.
The sheer size of the age cohort presents both challenges and opportunities for healthcare managers and the systems and facilities for which they are responsible.
Boomers can expect to live longer than their parents and grandparents, but may not necessarily be healthier. A cover article in Hospitals & Health Networks (H&HN), a resource for health executives and emerging leaders, predicts Boomers could experience higher rates of age- and lifestyle-related chronic conditions such as hypertension, high cholesterol, diabetes, and obesity.
For aspiring healthcare managers, understanding how to provide the levels and types of care Boomers will require – and deal with the associated expenses – without shortchanging other age groups will become an increasingly significant topic. Another issue on the horizon is the need for long-term care facilities and staff, which will be rising at the same time that Boomer doctors and nurses will be retiring.
2. Data Breaches Are Increasing –
According to the U.S. Department of Health and Human Services (HHS), data breaches of healthcare systems have increased some 23 percent since 2015. Over the same period, the U.S. Office for Civil Rights Breach Portal reported that 60 percent of all targeted attacks struck small and medium-sized organizations because they have yet to adopt basic practices such as blocking executable files and screensaver email attachments.
Healthcare organizations should brace for new and more sophisticated attacks, according to Experian’s “Data Breach Industry Forecast” for 2017. Experian is a global leader in consumer and business credit reporting and marketing services.
“The healthcare sector may continue to be the focal point for hackers as medical identity theft remains lucrative and easy for cyber criminals to exploit,” according to the report. “Personal medical information remains one of the most valuable types of data for attackers to steal, and cyber criminals will continue to find a market for reselling this type of sensitive information on the dark web.”
Experian advises healthcare managers to put a premium on security.
“As attackers shift their focus, an increase in hospital breaches means the consequences for healthcare organizations that don’t properly manage this risk will increase,” the report warns. “Healthcare organizations of all sizes and types need to ensure they have proper, up-to-date security measures in place, including contingency planning for how to respond to ransomware attack and adequate employee training and the importance of security.”
3. More Accessible Healthcare –
In an effort to keep up with the rigors of technology and the skyrocketing costs of pharmaceuticals and increased deductibles, providers have begun to offer a number of for-profit healthcare alternatives, including subsidiaries such as digital and remote pharmacy solutions, ambulatory health care centers, urgent care centers, and physical therapy and physician practices.
Keeping costs down, especially for patients who are unable to leave their homes for treatment, could greatly affect the infrastructure of traditional hospital care and those who manage the programs and facilities. Managers entering the healthcare field will need to be aware of the complexity of regulations and payment models associated with healthcare subsidiaries.
4. Consolidating Health Systems –
While managers eye technology and hospital alternatives to help mitigate rising costs, health system consolidation may exert the opposite effect. Many small and mid-sized hospitals and health systems may be forced to consolidate into larger facilities, according to Express Scripts’ recent report, “7 Ways Healthcare Will Change By 2017.”
In addition to changing the way healthcare is delivered, the decrease in competition could mean higher prices for healthcare consumers.
“Due to the massive amount of corporatization across healthcare practices, competition will decrease and potentially inflate prices,” according to the report, “making home healthcare more desirable for patients.”
Independent community hospitals are frequently vulnerable to consolidation. While the strategy can bring additional resources, consolidation often comes at the loss of community control and good-paying local jobs.
The challenge for healthcare managers is to find ways to demonstrate additional value from consolidation while also improving quality and lowering costs for healthcare consumers.
5. A Change In Consumer Payment Strategies –
A move to drive customer engagement through an interchangeable payment system is taking shape inside the healthcare industry. One example is the straightforward incentive system Pay For Play (“P4P”), which improves providers’ shared-savings agreements based on meeting and/or exceeding established metrics.
Bundled Payment Arrangements are another increasingly popular and simple payment method in which patients make a single payment for all provider services for an episode of care, regardless of how many providers were involved. The arrangement holds providers accountable as a group to eliminate duplication and waste.
Students considering a career in healthcare management should be prepared to understand the details of flexible payment models that accommodate patients’ financial needs.
6. Healthcare Law –
The Affordable Care Act (ACA) increased access to medical coverage for more than 20 million Americans who had previously been uninsured. It has touched nearly every part of the healthcare system, including Medicare, employer-sponsored insurance, and Medicaid and covered costs for preventive procedures such as mammograms and colonoscopies.
With a new administration in place in Washington, D.C., change is likely – but no one knows what new healthcare legislation might look like or how long implementation of a new plan might take. Coverage for 2017 is set and some experts, according to a January 15, 2017, article in Business Insider, predict that significant changes could be as long as two to four years away.
But Susan Devore, president and CEO of Premier, Inc., a leading healthcare improvement company, thinks the timeline will be shorter. Writing in the “Health Affairs Blog,” she sees “significant pent-up energy among Republicans and a limited 18-month window for legislation.”
Healthcare managers, both those already in the field and those about to enter it, find themselves in a wait-and-see situation.
Change Is Constant
Healthcare management is a complex, ever-evolving field. Managers who can understand and adapt to changes in technology, policy, and patient populations will find themselves better able to make informed decisions that benefit all parties.
About UAB’s Online MBA Health Services Concentration
The real-world application of current trends in healthcare can prove useful to students studying management within healthcare organizations. The University of Alabama at Birmingham offers an online MBA degree with a concentration in health services. With a mixture of foundational business principles and practices and modern technological and management strategies, students can develop into adaptable, well-rounded leaders ready to face the challenges of modern healthcare management.
Sources:
https://www.prb.org/Publications/Media-Guides/2016/aging-unitedstates-fact-sheet.aspx
https://www.hhnmag.com/articles/5298-Boomers-Will-Transform-Health-Care-as-They-Age
https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf
https://www.besmith.com/thought-leadership/articles/2017-aha-environmental-scan
https://lab.express-scripts.com/lab/insights/industry-updates/design-test-innovate
Experian: https://www.experian.com/assets/data-breach/white-papers/2017-experian-data-breach-industry-forecast.pdf
https://lab.express-scripts.com/lab/insights/industry-updates/7-ways-healthcare-will-change-by-2017
https://healthaffairs.org/blog/2017/02/01/a-look-forward-to-health-care-in-2017-top-five-trends/
https://www.modernhealthcare.com/article/20161231/MAGAZINE/312319988