In the healthcare field, there’s never a dull moment. Federal and state healthcare reform and ever-present pushback from union groups on topics like staffing and price transparency are sure to keep administrators and clinicians on their toes for the foreseeable future. Shifts in the industry are plentiful, but here are three that are likely to be front-and-center in 2016.
More attention for behavioral health
Behavioral health seems to be getting a little more respect from public and private insurance payers, thanks in part to legislative changes resulting in better reimbursement for mental health and addiction treatment. With a number of local projects underway to serve those populations, conditions for those in need of treatment will improve.
Risk-based contracting
The transition from fee-for-service contracts between providers and insurers has been underway for a few years. These contracts incentivize providers to manage patients on or under budget, while meeting certain quality guidelines. About a quarter of UMass Memorial Health Care’s insurance contracts are now risk-based and their share is expected to increase.
Continued push for transparency
Unions have advocated for commercial insurance contracts to be made public in a system where a few providers are paid a lot more money than the rest for the same services. Meanwhile, the Health Policy Commission has said price transparency is a major priority for the year ahead. What the solution will be remains to be seen but don’t expect the issue to fade away.
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