The Rise of Healthcare Consumerism
Over 98 million Americans will be 65 or older by 2060, more than doubling today’s 46 million, a growth of 28% over the next decade. 25% of Medicare beneficiaries have 5 or more chronic conditions, see an average of 13 physicians, and fill 50 prescriptions per year. Additionally, with increasing obesity rates and wide economic disparities, the US healthcare challenges and financial impact of providing healthcare are expansive.
With the implementation of the Affordable Care Act fully underway, the Centers for Medicare & Medicaid Services (CMS) is aggressively moving away from the Fee-for-Service model. This cost shifting is clearly demonstrated by the Value–Based Payments and Alternative Payment Models (APMs.) CMS has proudly achieved their goal of reaching 30% of all Medicare payments based on APMs by the end of 2016 and have set a goal of 50% by the end of 2018. Furthermore, CMS recently announced the expansion of the Bundled Payments for Care Improvement Initiative to include cardiac care, specifically impacting patients admitted for heart attack or bypass surgery. The proposed payment models expand the episode of care to include 90 days after discharge.
Shifting the Cost of Healthcare: What is the impact?
The impact on the healthcare delivery system is rapidly evolving. New benefit plans and networks are making healthcare consumers more selective and cost-conscious. This shift toward to “consumerism” is related to healthcare premiums increasing for employers, who in turn raise the cost for employees. As economists would predict, this results in increasing popularity for the high deductible health plans, which decreases the amount taken out of employee paychecks each month. Subsequently, this financial decision has quality of care implications, leading people to postpone care or seek out lower cost options, such as the ever-growing retail clinics.
With patient cost sharing rising 6 times wages from 2010 to 2015, the growth of a consumer mindset in healthcare is certain. Successful healthcare leaders are identifying ways to respond to this shift and become the preferred provider in their region.
To learn more about value-based healthcare and leading your organization toward becoming the regional leader in high quality care, join us October 6th on the Columbia University Medical Center campus for our annual Network Day Event ~ details at http://columbiaheartsource.org/annual-network-day