As a field we are still on the journey from volume to value. The emphasis on the integration of value-based care into payment reform efforts will increasingly affect all stakeholders. It will drive movement toward a common set of metrics that will constitute the value and quality provided. It will require a comprehensive data strategy to assess performance and analyze different risk-sharing models and ultimately move to enhanced models of care.

— MaryJane Wurth, executive vice president, American Hospital Association

  • At least half of health systems will partner with low-cost providers for some activities that traditionally have been conducted directly by the health system.1
  • Since 2010, more than 90 firms with little to no prior medical experience have become health care advisers. These new health advisers are sometimes competing, but more often partnering, with health insurers, providers and employers to help individuals navigate the complex terrain of the health ecosystem. Members can find out where they stand in terms of how much they need to pay for a specific service at a particular setting, how much of their deductible they have used and what remains, and if there are any cash rewards for a particular setting.2
  • There are now almost 2,000 retail clinics in the U.S. There will be more than 2,800 retail clinics by 2018, according to a forecast by Accenture. Two key drivers will bolster retail clinics’ relevance and quality in local health delivery systems: the ability to forge relationships with health care providers and the clinics’ adoption and effective use of information technology that enables data sharing and data liquidity.3
  • Among hospitals and health systems, announced provider-provider transactions nearly doubled from 2007 to 2015. The percentage of announced nontraditional partnership transactions, such as management services agreements, joint operating agreements, joint ventures and minority investments, rose to 16 percent in 2015, up from 7 percent in 2007. The partnerships will help meet patient needs under a value-based care delivery model and expand the competencies required to manage population health.4
  • Hospitals and health systems are collaborating with community partners to expand their scope of services to address nonmedical factors that influence health status, including obesity, preventive and screening services, access to care, behavioral health, substance abuse and tobacco addiction. A recent survey revealed that more than three-fourths of surveyed hospitals had partnerships with school districts and local public health departments.4

2017 AHA Environmental Scan

Download the complete 2017 AHA Environmental Scan PDF sponsored by B. E. Smith.

Resources

  1. “Pharmacy Forecast 2016-2020,” ASHP Foundation, Dec. 2015
  2. “National Health Expenditure Projections, 2015–25: Economy, Prices, and Aging Expected to Shape Spending and Enrollment,” Keehan, Sean P., et al., Health Affairs, August 2016 35(8): 1533-1531.
  3. “Retail clinics continue to shape local healthcare markets,” HealthcareIT News, Jane Sarasohn-Kahn, July 25, 2016
  4. “Guide to Health Care Partnerships for Population Health Management and Value-based Care,” Allen, P.M., Finnerty, M.J., Gish, R.S., et al. Health Research & Educational Trust and Kaufman, Hall & Associates LLC, June 2016