Healthcare is constantly evolving and innovating with new technology or new workflow procedures. This means we can begin looking at healthcare trends you’re likely to see in the coming year. Changes to the way physicians and medical practices handle their billing, along with emerging research, and new technologies will have a direct impact on healthcare moving forward. Here are 3 of the healthcare trends doctors and those working in the medical environment will be hearing about in 2019:
The shift to value-based care should see increased attention throughout the new year. There are several different approaches to value-based care, but they all center on the idea that health care providers should be paid based on the overall quality, efficiency and outcome of their care as opposed to being paid for each separate service that they perform.
With the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) instigated the push toward value-based care for Medicare and private insurers followed their lead. A report from earlier this year claimed value-based care was reducing unnecessary medical costs by almost 6% while improving quality of care. We can see why this might be trending toward a larger adoption rate throughout 2019.
The CMS recently issued a final rule regarding the Physician Fee Schedule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019. Keep in mind, this is the last year there will be an update to the physician fee schedule through 2025. After 2025, payment rates will be updated based on the eligible clinician’s participation in MIPS or Advanced APMs. This is why many medical practices have begun preparations to begin reporting under MIPS as 2018 comes to an end.
According to a recent estimate, hospitals should anticipate prescription drug rates to increase in 2019. However, drug rates are growing at a slower rate compared to previous years. The new year will also bring much debate regarding consumer drug prices. In Washington, a bipartisan drug pricing bill looks to target some of the tactics drugmakers use to overcharge taxpayers for Medicaid rebates. The bill would grant The U.S. Department of Health & Human Services (HHS) authority to reclassify a drug and recoup rebates when a manufacturer deliberately misclassifies a drug to pay lower rebates to Medicaid.
These healthcare trends are expected to dominate the healthcare news cycle throughout 2019. However, we can expect other topics to make a splash as new regulations and innovations are consistently being developed.
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