Tops Trends to Watch in 2014

Top Trends to Watch in 2014

Empowered consumers and disruptive new business models are ringing in a new era in healthcare. While many of those trends have been emerging for some time, never before have they been accompanied by a rapid shift in dollars, triggering major changes in behavior and fundamentally altering the business. And while nobody can predict the future with certainty, leaders who understand these trends will be ahead of the game. Below are three areas we’ve identified as top trends to watch throughout this year:

New reimbursement models will continue to develop, expand

The transition away for fee-for-service paves the way for outcomes-based medicine and metrics. In light of this and the many other benefits derived from shared savings, we’ll continue to see this trend grow as more and more physicians are incentivized to keep costs low, while maintaining quality and improving patient satisfaction.

Looking ahead, we can expect to see new models in development as CMS’ Center for Medicare and Medicaid Innovation (CMMI) continues to pilot new bundled payment programs that seek to expand the application of bundling from inpatient to specialty outpatient care, such as orthopedics, and shifts the focus of bundling from institutions to individual physicians who specialize in treating patients with complex chronic diseases.

Block of the two-midnight rule

CMS' two-midnight rule is meant to outline and clarify the difference between hospital inpatient and outpatient stays. While medical necessity will still be taken into account, the rule says, if a patient’s stay is fewer than two midnights, the hospital will be paid on observation status instead of inpatient status.

The American Hospital Association and other delivery systems have sued the Department of Health and Human Services over the “two-midnight rule,” arguing that the policy undermines medical judgment and safe care practices, they weren’t given adequate time to prepare for the new rule and that its attendant 0.2 percent cut is both unlawful and causes financial harm to the organization. Due to the potential fallout for hospitals, we may see this rule go away if providers use the delay to find a way to block it.

Rise of designated surgical teams

There’s a tremendous amount of data to back the notion that designated or intact teams lead to greater patient outcomes. Surgery requires the coordinated efforts of a number of trained professionals and technical experts. This is supported by a study published in Health Care Management REVIEW noting surgical outcomes improve when people:

• Know the procedure

• Know their roles and the roles of others on the team

• Have the necessary skills and resources to perform the task

• Have communication processes that support and encourage behaviors that allow for situational adjustments in case of unexpected events or complications.

This year, you can expect to see more hospitals building designated orthopedic teams to ensure consistency and optimal work precision and efficiency. These teams can drive value, streamline operations and improve patient outcomes.

Do you agree with these trends, or are there other top trends orthopedic departments should note for the rest of 2014?

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