Many organizations across the continuum of care expect 2019 to be a year of uncertainty, as well as innovation. Experts predict change in terms of healthcare financing, merger and acquisition activity, and new technology coming into play. The need keeps growing for everyone in the industry to work together to provide value-based healthcare and to deter hackers. Like usual, most providers will continue to focus on employee recruitment, development, treatment, and retention. Uncertainty also creates opportunity—expect both through the coming months.
This blog post, focused on trends 4-6, is the second of three based on our Webinar, 10 Trends That Are Redefining Care Across the Continuum, presented by HealthStream’s Robin Rose, Vice President, Healthcare Resource Group, and Robyne Wilcox, Channel Director, Continuum. These major trends are affecting many care environments, ranging from demographics and workplace characteristics to the financial side of healthcare and the technology on which we are depending more and more.
Trend Four: We Need More Help
Recruitment for many jobs across the continuum keeps getting harder. While there are a lot of job opportunities, they involve hard work for relatively low pay and the turnover is high. When you hear a company offering $15 hourly wages, it inspires fear throughout our industry. For example, a certified nursing assistant (CNA) is typically paid $12.76 an hour, for much harder work than standing behind a cash register. A big problem for our industry is the low pay for these workers and the challenges we face from other employers.
Compounding the issue, there’s also a shift toward more homecare. In 2015 for the first time nationally, more money was spent on homecare than nursing home care. Jobs in this sector continue to grow at breakneck speeds. While the projected growth by 2026 of jobs in the whole healthcare setting is 18%, the demand for home health and personal care aides is going to be 41%, amounting to 4 million new jobs. Of the six healthcare jobs that are going to experience the biggest supply gaps by 2025, home health aides are at the top, with a 446,300 person shortage. Care outside the hospital will be particularly hard-hit by anticipated labor shortages.
Trend Five: Continuum Care, Not Hospital Care
Traditionally, the hospital was the focus of the healthcare industry, and that’s now changing. COOs for major health systems don’t think of themselves as primarily hospital systems anymore. The new way of thinking is more like a large clinic that also operates hospitals and provides care across the continuum. The hospital is starting to be thought of as a cost center rather than the center of everything in healthcare.
Our current economic models have big incentives to keep people out of hospitals and to spend their time instead in other care environments. The ideal situation for the continuum of care involves highly coordinated networks, to provide patient-centered care everywhere across the continuum. This new model is focused on providing care at the right time, in the right place. Not just in the acute care setting.
Trend Six: CMS Is Changing Course
After a long time spent pushing process improvements, CMS is changing course. This move dates from late 2017 when the American Hospital Association put out a report about regulatory overload and the high cost of government supervision of the healthcare industry. Hospital systems, hospitals, and post-acute care providers together face 629 discrete regulatory requirements at a cost of nearly 39 billion a year. Anytime somebody enters a hospital there is a $1,200 charge that’s going just toward regulation. The average community hospital needs 59 FTEs just to meet these requirements. Proposals have been made to cancel Stage III of Meaningful Use, get rid of the Medicare 5-Star ratings, and other requirements.
The new CMS administrator, Seema Verma, has been very receptive to these changes. The new CMS emphasis is on helping healthcare workers to understand what their impact is on care and quality measures, and so the focus is really shifting to patient outcomes instead of patient volume. So many of the earlier regulations take providers’ time away from the patient, and CMS wants to support a more value-based, outcome-based approach, moving away from a fee-for-service approach. Early changes include cancellation of some of the mandatory bundled payment programs, a 12-month moratorium on the LTCH 25% rule, and putting the home health pre-claim review project on hold. Also, CMS is reviewing Stark Laws that may be hindering telehealth and standing in the way of value-based care. It’s a very optimistic time for healthcare organizations who feel burdened by unnecessary regulation.
Access the full webinar about trends redefining care across the continuum here.
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