2015 Healthcare Technology Trends

 In News

There is much debate whether the long awaited ACO reimbursement model introduced through the Affordable Care Act (ACA) will be successful in achieving the goals of health reform. I think critics are missing the point. ACO’s are just one of many emerging and evolving reimbursement models that are moving U.S. Healthcare away from a fee-for-service, pay-for-volume approach to value-based payment models.

Even if the ACO structure is not it, the horse is out of the barn. Bundled payments, gain sharing, managed care, readmission penalties and value-based purchasing are just variations on the same theme. The growth in healthcare is moving toward payment models based on cost-effective outcomes.

The transition to a value-based payment system is going to be rocky. U.S. healthcare is broken into silos of care that are locally optimized based on a dysfunctional fee-for-service payment model. Poor hand-offs between these silos result in failed transitions that undermine clinical outcomes and waste a lot of money. In addition, there are significant gaps in visibility of outcomes, making it difficult to know what is (and is not) an effective clinical intervention. For example, up to 30% of hospital readmissions are patients that are discharged from one hospital, only to be re-hospitalized at another.

Read more: HITECH Answers

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