It is day nine of our 12 Days of Christmas Posts and we rounded up these 9 ladies in health IT. The debate still continues if 2019 is the “Year of the Woman”. The fight continues for equal pay and equal access. The dialogue continues on #metoo and respect in the work place. But there is no denying these women are at the top of their game and we wanted to hear what they have to say about what we can expect in 2020. From digital health and telemedicine to interoperability and healthcare payments, here is what they are predicting about the new year.
Mariann Yeager, CEO, The Sequoia Project
I see the coming year as one where we will finally see some movement on various regulatory proposals. While 2019 saw a multitude of regulatory proposal drafts, 2020 should be the year in which we get some finality on these regulations (such as information blocking).
As payers and providers seek to navigate the complexities of healthcare and movements to value based care which rewards organizations based on specific outcomes, there will be an increased need to bridge the information gap that exists within and between healthcare systems and simplify processes. These efforts have tremendous potential to reduce overhead and improve care coordination while aligning incentives. Healthcare organizations have spent a lot of time and money purchasing and implementing technologies. We are going to see a push to optimize the technology platforms and overlaying processes and prioritize data and document interoperability to increase revenue, quality and patient safety and decrease cost.
From healthcare-retail partnerships to the introduction of apps, wearables and data-driven AI applications, disruption and innovation are now central to healthcare. Telehealth and other digital tools are gaining in popularity, as patients continue to embrace digital interaction. Patient wait times and physician shortages are getting worse. Growth in virtual care adoption will continue its momentum in 2020 and become imperative to the survival of healthcare organizations (HCOs).
For the first time, providers will compete on cost as price transparency is enforced. Negotiated rates are set to be made public in 2020 thanks to an executive order. This sets the stage for a new era of competition among providers and new entrants alike. Integrated, optimized and interoperable systems that support the portability of patient information and care coordination across transitions of care will be necessary in the new world of price transparency and market value.
2020 will be a year where increases in consumer responsibility continue to be a driving force in healthcare. InstaMed’s Trends in Healthcare Payments Ninth Annual Report revealed that 93 percent of patients were surprised by a medical bill, including 61 percent who received a bill for more than expected, and 50 percent who received an unexpected bill. We will continue to see payers and providers pressured to deliver a consumer healthcare payment experience that matches those found in today’s digital world.
This includes leveraging advanced payment technology to:
- Offer multiple payment options upfront such as online payments and automated payment plans
- Digitize the payment process to help staff streamline their workflows
- Enhance patient convenience through eStatements, email notifications and text notifications
Kelly Thompson, CEO of the Strategic Health Information Exchange Collaborative (SHIEC)
I believe that more providers will be engaged in value-based care in 2020. This will require the increased care coordination and connections that HIEs provide in their communities. Also, successful value-based requires the integration of behavioral health information and providers – an area of growth for HIEs in 2020. We should also see a greater effort regarding HIEs assisting with hurricanes, floods and other national disasters in the coming year.
To date, digital health has given rise to technologies that have done more than disrupt the industry; they are transforming the way we deliver care. Patients’ phones are an integral part of their lives, and we are now at a point where this has to extend to access to care, communicating with providers, making payments, and coordinating care for our loved ones. Making phone calls and physically going to a clinic is no longer the most convenient. As we look at where healthcare will progress in 2020, a huge focus will center on how innovative digital health technologies – particularly asynchronous communications and other telehealth platforms – meet the needs and desires of today’s healthcare consumer.
Providers have seen the value that telehealth can offer in bringing efficiency and convenience to the healthcare experience, all while improving outcomes and enhancing the patient relationship. But for many, securing reimbursement has been the real hurdle to overcome. We’ve already seen a growing expansion of instances in which doctors can now bill for their telehealth services, and my prediction is that by the end of 2020, all 50 states will adopt asynchronous modality of telehealth to address the needs of the population, reduce the cost of care and improve access. Patients demand immediacy to their care, convenience to their lifestyle, and transparency with their healthcare providers. Telehealth communications platforms that meet the needs of the patient – where they are – are what will drive the healthcare we see in 2020.
What will be top of mind in 2020? It’s fairly simple. For patients, it’ll definitely be healthcare costs – the premiums and the costs of care. As costs are rising and high deductible health plans become the norm, a patient’s main concern in many cases is how he/she can afford a procedure after the large percentage of their income is devoted to healthcare premiums. For providers, reimbursement will continue to be a main driver – ensuring billing is done accurately so as to maximize reimbursement. For payors, cost containment will be key – protecting premium dollars with critical claims review solutions that monitor for fraudulent, wasteful and abusive billing patterns.
In 2020, both providers and payors will put a greater emphasis on transparency in the billing process. Most providers want to bill accurately and understand how a payor would view a claim so as to know if it will be approved or denied. The process has been a complex one to date, but some great strides are being made on both fronts to ensure transparency between providers and payors to improve billing accuracy.
This year, industry collaborations and partnerships were driving forces in advancing healthcare interoperability and I fully expect that momentum to continue throughout 2020. One such partnership that made great strides in 2019 and helped blaze a path towards interoperability was the Trusted Network Accreditation Program (TNAP) – developed by a diverse collection of industry collaborators. Established to directly align with the 21st Century Cures Act and the Trusted Exchange Framework with Common Agreement (TEFCA), the collaborative finalized criteria for its inaugural accreditation program. The program works to promote interoperability by assuring healthcare exchange entities are adhering to the latest best practices and standards in privacy and security, as well as meeting all current federal privacy and security compliance mandates. In the year ahead, I’m looking forward to new collaborations within our industry that will continue to place a dedicated focus on improving the current state of interoperability along with a commitment to data security and industry best practices that resonates with all stakeholders.
Rosemarie Day, Founder & CEO of Day Health Strategies
I expect healthcare to dominate the 2020 political conversation as we head into the November election. The two key factors driving this are the continued threats to the Affordable Care Act and the inexorable rise in the cost of healthcare (which keeps getting passed on to consumers). These factors combine to create too many pain points for American voters to ignore.
I predict that in 2020, the Health and Human Services (HHS) Office of the National Coordinator (ONC) will continue to drive for better use of information technology in healthcare while striving toward their ultimate goal of delivering high-quality patient care while lowering costs, thereby achieving a healthier population. These efforts are the driving force shaping healthcare today. The long-standing message of patients becoming more engaged in the supervision and direction of their health has been that a major component contributing to the success of this endeavor.
Patients’ use of services like Physician Compare, that allow them to see which providers are achieving the best outcomes, will increase as technology-savvy patients approach the age where their need for healthcare becomes more prevalent. Whether it happens in 2020 or after, the new-age patient will want to be better informed than prior generations—from a better understanding of their options for types of healthcare intervention (e.g., different types of procedures and services) to costs and expected results.
All the while, in 2020, providers and payers will continue to struggle with finding workable approaches to interoperability and switching to the mindset of the industry from fee-for-service to value-based reimbursement.
Payer-specific quality payment programs will continue to be adjusted, and maybe, when the provider and vendor community say “enough is enough,” there will be a return to one of the base rules of administrative simplification legislated by HIPAA: HHS has the legislated right to identify “standard transactions.” If there was a standard transaction for quality reporting across all payers, the job of vendors and providers would be easier and the resulting data could be normalized. This would greatly help the industry move advance HHS’ overall goals.
While this prediction goes beyond 2020, interoperability will continue to be targeted not only within the provider community, but with the participation of the payer community as well. The insurance industry has been sharing patient health status data for years among themselves to allow for the setting of premiums. The time is coming where providers will require payers to also provide them with open access to prior claim data for the purpose of improved patient outcomes and lowering costs through less duplication of procedures and services.