Mid-Year Update: 4 Major Payer Trends

Q3 is in full swing and now is the time to look at what healthcare trends will bring us into 2017. Many payers are looking at current healthcare trends to help predict changes in the marketplace and isolate places of improvement.  From data security to value based payments, it has been a big year for healthcare. Here 4 of the biggest trends payers can expect to hit in Q4 and continue into 2017.

1. Partnerships
   

Payers are partnering-up with healthcare providers to offer jointly-owned health plans, challenging the traditional payer-provider relationship. This type of partnership is adopted from the Accountable Care model, focusing on shared-risk and quality of care improvement.  Payers and providers see jointly-owned health plans as a more sustainable way of working together, focusing on value based care and the healthcare triple aim.

2. Value Based Payments

Value Based Payments (VBP) have been a major trend as fee-for-service payment models become a thing of the past. VBP models are designed improve care outcomes and reduce costs by requiring providers to meet quality and cost thresholds. This significant departure from traditional models shifts the focus to quality of care over quantity. The Department of Health & Human Services (HHS) goal is to tie 90% of all Medicare payments to value by 2018.

3. Data Security

Cyber-attacks and data breaches are eerily common in the healthcare industry, with 3 of the largest data breaches in history occurring in 2015 alone¹. Payers have access to a wide variety of sensitive data and investing in cyber security is more important than ever. Investing in resources to bulk-up security systems and protect patient data will be keep to preventing attacks and data breaches.

4. Telehealth

Telehealth has become a fundamental way for all types of patient to receive the care they need. From remote patient monitoring to rural health, telehealth is revolutionizing the healthcare industry. While some payers already have comprehensive reimbursement policies in place, many have yet to embrace this important change in healthcare. Telehealth reimbursement can help payers reduce costs through improving quality of care and patient satisfaction. Embracing telehealth and the important care that comes with its services will be a must for payers in the years to come.

Editor’s Note: BHM is on-top of all healthcare trends and understands the importance of improving and changing with the industry. Click here to learn more about BHM’s consulting services or click here to contact us directly.