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The Radical Redesign of Healthcare Begins

Healthcare providers have resisted the call to lead the value-based care movement. In 2019, the energy they are expending to resist change gets replaced by the energy to lead it. Why? They realize that the medical disciplines and business models that support them are no longer financially viable. The result?

Full-Scale Panic Mode
The clinical lab is panicking over phased Medicare reimbursement cuts over the next seven years. They can weather the first two cuts, but after that, all bets are off.

Pathologists and radiologists are panicking. With AI-driven algorithms that don’t sleep or take vacations, the days of needing people to interpret images with the naked eye are looking numbered.

Orthopedic surgeons are panicking. Their knee replacement reimbursement is now capitated and does not include the cost of infections, ER visits, revisions, and readmissions. A single occurrence during the 90-day post-op period is paid by the surgeon and their facility.

The post-acute care space is panicking. Reimbursement cuts of 47% and higher are driving closures and consolidation of the exact home medical equipment companies required to care for patients in the least cost-intensive environment: The home.

Primary care physicians are panicking. They spend more time documenting care than providing it. And the patients they serve are panicking when at their sickest, as they struggle to get timely access to a professional.

Flaming the panic is the rise of internet ratings, high-deductible health plans, and pricing transparency as patients compare prices, research reviews, and shop for care. The upside of all this panic?

Reinvention—From Within
Providers see that silo-based care is history. In order to survive, they must reinvent their clinical practice and their roles within them. New skills and behaviors like cross-departmental teamwork, communication, innovation, and entrepreneurism are now minimum requirements. New roles such as data scientists, care coordinators, genetic counselors, and disease navigators are now in great demand.

Providers have now opened themselves to new technology-enabled care models such as telemedicine, telemonitoring, cloud-based AI, connected therapies, consumer-driven services, disease prevention, and genetic screening.

2019 is the year providers fully commit to reinventing healthcare. It is the year they recognize that they must radically redesign American healthcare in order to save it. If they don’t, their roles and their futures will be reinvented for them.

Tom Dudnyk
Written by: Tom Dudnyk
January 17, 2019
This article originally appeared on pm360online.com
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