Magnificent Seven Healthcare Business Trends for 2017

By Clive Riddle, January 3, 2017

Here’s seven trends, in no particular order, that we see weighing heavily on the business of healthcare during 2017. If they all come to pass, of course you should marvel at the wisdom and insight emanating from this blog. If they are well off the mark, well, here’s hoping for short memories and I’ll search for the delete button on this post.

1. Inaction on Several Fronts While Waiting For Other Shoe to Drop

The individual health insurance markets will be in a holding pattern pending the outcome of sorting through the weeds of the Repeal and Replace activities in Congress and the Trump administration. Ditto for Medicaid initiatives. CMS innovations could even end up in a holding pattern.

2. A new Trigger for Prescription Drug Pricing Backlash?

Furor over Mylan EpiPen pricing and other prescription drug cost stories have subsided a little, and it remains to be seen how and if the Trump administration and Congress weigh in on this. But if a new major prescription drug pricing story erupts, and the odds are sooner or later one will, it should trigger a new groundswell of support for some public response.

3. Year of the MACRA

MACRA was separate from the ACA and is somewhat insulated from ACA dismantling. While the framework for Medicare Quality Payment Program MIPS and APMs are already in place, 2017 will witness widespread activity as physicians follow through on positioning themselves.

4. Private Sector Embrace Also Keeps Value Based Care Momentum Strong

Even if ACA repeal goes so far as tearing asunder Medicare ACO initiatives and other public value based purchasing innovations, the private sector’s embrace of all things value based care will ensure an onward march in this direction.

5. Consumer Driven Care Gains New Momentum

The Trump Administration and new Congress policy agenda would seem to favor increased emphasis on all things consumer driven.

6. Aftermath of Health Plan Mega Mergers

The ACA was credited with helping set the stage for mega health plan mergers. It is difficult to imagine further mega merger activity in the current environment. Cigna and Anthem will surely unwind their deal.  Trump administration emphasis on deregulation might cause the DOJ to take the foot off the gas on their opposition to the Aetna-Humana deal, or at least be more prone to negotiation.

7. Impact of New Technology and Innovation

We may not know what the next New Big Thing is, but we should know that there will be one, and then another. And that one or more of these next new big things will have a major impact on the business of healthcare.