Why IT priorities could evolve in an era of reform
The news this week in healthcare was dominated by the passage of a GOP bill to repeal and replace the Affordable Care Act. It became a spectacle of partisanship and visuals, from representatives admitting they hadn’t read the bill to a garish celebration on the lawn of the White House after the successful vote.
As most know, that celebration was a bit premature. To use a handy marathon analogy, congratulations—you’ve made it past the first mile. Only 25 more to go.
But it’s clear that the winds of change are blowing. As the Senate works on a version of a repeal-reform bill, it’s likely that there eventually will be some form of legislation that replaces Obamacare. If not, I’m not sure things will revert to anything resembling normal, since the GOP is intent on creating a toxic environment in which the ACA cannot survive.
That has implications for healthcare providers, and for the information technology they need to survive what likely will be a bumpy ride.
We’ve sought out viewpoints from many in the healthcare industry on what this week’s news portends for the healthcare IT industry. I believe that the thoughts of the following two experts in the industry offer a balanced view, and marching orders for HIT executives.
John Kontor, MD, Executive Vice President of Consulting at Advisory Board
First I would say that there is no reason to overreact, as there are likely going to be significant changes in the bill as it is considered by the Senate. But we are likely to see certain fundamental impacts on patients and providers that persist, including a rise in uncompensated care, reduced Medicaid payments, an acceleration of the trend towards consumerism, and associated general downward pricing pressure on providers.
As the effect of these trends start to be felt across the next year, there are a few changes we can predict in the HIT market. And while you might think that these financial pressures would result in reduced spending on IT, I suspect the opposite trend will occur.
For example, changes to Obamacare will likely spur even faster growth of Medicare Advantage, and we should see more provider organizations sponsoring their own plans. Participation in these and other downside risk models carries major risks and complexities, and providers are almost certain to look toward IT solutions for help. In particular, I expect increased spending on decision support and analytics solutions that help payers and providers measure and monitor performance, capture risk scores, reduce inappropriate utilization and minimize care variation. Additionally, the major EMR vendors are also likely to accelerate their research, development and marketing efforts to deliver and monetize similar capabilities.
Finally, I’m really interested in seeing how the rising tide of consumerism triggers innovation in HIT—not just technology used by provider organizations, but also patient-facing decision support products and mobile solutions. One thing is certain in this time of health policy uncertainty—the HIT industry will almost certainly be a prime benefactor.
David Muntz, principal of Muntz and Company
Muntz, former CIO of Baylor Health Care System and former principal deputy at the Office of the National Coordinator of Health Information Technology, adds these thoughts:
Uncertainty in the policy arena has created challenges for patients, their families, providers, and payers. Planning in this environment is challenging enough without the new political uncertainties.
I’m concerned that the intense emphasis on costs and payment models diverts many experts and leaders from focusing on quality and outcomes. I would have preferred modifications rather than “repeal and replace.” My hope is that the Senate’s version of the bill will provide real support for the underserved and improve quality, service delivery, and affordability for all participants. I think it’s time to discuss the ethical implications of any actions that limit or cause delays in delivery of care to patients.
Healthcare IT—defined as the combination of people, process and technology—impacts every aspect of care. When done well, HIT can provide the benefits we all deserve. There are a few areas, regardless of the political environment, where I’d like to see rapid improvements. They are many others, but my top three are positive person identification, interoperability, and ease of use.
A final note
Despite the massive amount of attention paid to policy machinations in Washington, IT leaders will continue to be faced with much of the basic block-and-tackling needed to support healthcare organizations. In some cases, it will be providing the information backbone to support the organization, no matter what reimbursement winds may blow. And there are still the technical hurdles that Muntz mentions, which need to be solved if healthcare IT is to be the helpful, seamless and error-free tool that provider organizations need it to be.
So take a deep breath this weekend. Despite the bombastic week in Washington, it’s back to that monstrous IT to-do list on Monday. Back to that marathon analogy, there’s only 25 more miles to go for you as well.