2015 will see the healthcare industry pinned between two powerful forces—pressure to hold down health spending and continued growth in the number of insured Americans as the result of Obamacare coverage expansions.
It also will be a year of uncertainty as the healthcare reform law faces major legal and political tests, and everyone watches to see whether alternative payment and delivery models yield hoped-for cost savings and quality improvements.
Meanwhile, providers will continue to search for ways to cope with declining inpatient admissions, reduced Medicare and private insurance payment rates, dampened consumer demand related to the growth of high-deductible health plans and increasingly price-sensitive purchasers and consumers. Those factors have squeezed margins, and in turn, reduced hospital spending on labor, supplies and construction.
But whether exchange customers in states using the federal exchange can continue to receive premium subsidies that make coverage affordable will be decided by the Supreme Court by June. A ruling to strike down the subsidies likely would lead to millions of people dropping coverage, rattling the markets and the industry. And the new Republican-controlled Congress is likely to try to chip away at other features of the law, such as risk-adjustment payments to insurers that enroll sicker pools of members.
2015 also will bring new incentives for better coordination of care and improved quality and safety. There will be a growing push to treat patients in the least costly settings, including a greater use of telehealth.
Quality and safety experts are expected to release new recommendations to reduce overtreatment and diagnostic errors as the push to monitor performance expands beyond acute care. Meanwhile, health systems and public health officials will be looking for gaps in infectious-disease preparedness that were exposed by the limited Ebola outbreak in the U.S. in 2014.
Healthcare consolidation is expected to continue in 2015, as stronger hospitals and systems prepare for population health models and weaker providers seek partners for survival.
Read on for predictions and analyses from Modern Healthcare reporters on what 2015 may bring for insurers, hospitals, physicians, dealmakers, construction companies, medical manufacturers and supply chain companies.
Follow Melanie Evans on Twitter: @MHmevans
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