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This Week in Health Care Reform: November 9th, 2018

The midterm elections redistribute legislative control; insurers play a critical role in transparency; challenges remain in addressing the impacts of mental health; and, health systems ramp up consumer research in pursuit of delivering an improved patient experience.

Week in Review

Midterms: As the dust settled from Tuesday’s midterm elections, the balance of power in Washington and in statehouses across the country had undergone a dramatic shift.  But, beyond determining who would have their hands on the levers of control going forward, voters also headed to the polls to decide a number of ballot initiatives, including Medicaid expansion, voter rights, and marijuana legalization.  While there are still a number of races to be decided, analysis is already underway, as experts look for substantive takeaways from an eventful election night, with particular focus on what the results might hold in store for health care.  And, more broadly, insiders turn their attention to the looming lame duck.

Transparency: Health care stakeholders continue to emphasize the need to address rising costs in our evolving health care delivery model.  But, without knowing the prices commonly associated with medical tests or procedures, our system’s ability to effect meaningful change is somewhat compromised.  With this in mind, experts have begun to recognize the crucial role that payers play in expanding quality and price transparency in the larger effort to improve patient outcomes and lower health care costs.  In addition to increasing the public availability of patient safety scores and assessing providers’ performance in promoting transparency, insurers are also able to advance quality-driven value-based payment models, while bringing to light the intersection shared between health care quality data and cost data.

Mental Health: Despite the increased attention being paid to mental and emotional well-being as cornerstones of overall health, challenges remain as our system continues to operationalize how best to meet the needs of this patient population.  And, that attention couldn’t come quick enough as, according to a new estimate, failure to adequately respond to the rising prevalence of mental health disorders could cost the global economy upwards of $16 trillion between 2010 and 2030.  While some of those projected costs are tied directly to health care services, such as medicines or other therapies, most of those costs are indirect – tied to a loss of productivity, as well as increased spending on social welfare and education

As our health care system works to integrate greater consumer centricity into its overall design, emergent themes have established themselves as critical to the long-term success of those efforts – namely, affordability, continuity of care, digitalization, and patient engagement.  In seeking to overcome persistent challenges, health systems have looked to ramp up consumer research in their attempt to deliver improved care and a better patient experience.  Historically, hospitals haven’t placed much stock in this kind of information gathering, electing instead to rely on their own long-held assumptions about what exactly patients expected from the health care experience.  However, as patients have begun to wield greater power in their own health care decision-making, more health systems have had no choice but to embrace consumer research in the hopes of attracting and retaining customers.      

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