—Albert Einstein, 1879-1955
Another New Year and many occupational health professionals find themselves reflecting on past experiences and applying them to opportunities and challenges that lie ahead. When considering business development strategies, it is helpful to consider broad trends and specific forecasts for 2012 and beyond. Here is a selection:
Health Care in Motion
Health Care Employment Continues Growth Trend
The healthcare sector continued growing in November 2011, adding more than 17,000 jobs in the month, with the hospital industry accounting for nearly half of the new jobs, according to the U.S. Bureau of Labor Statistics. Health care is the second-fastest-growing sector of the U.S. economy and it has one of the highest injury incidence rates in comparison to other types of industries.
Healthcare Trends 2012, a Strategic Industry Forecast, Steve Valentine, president, The Camden Group
Mr. Valentine of the healthcare management and consulting group cited the following trends during a recent webinar:
- Accountable Care Organizations and “bundled payments” will have a major impact.
- Physicians will be “movers and shakers” in terms of changing the delivery system and containing costs, especially with regard to scaling down post-acute care.
- Leaders will need to identify healthcare needs in their geographical area, identify available resources, articulate goals, and structure their network of care around these elements.
- Utilization of embedded case managers and centralized case management teams will increase, with individual case managers in physician offices and hospitals working closely with physicians, including hospitalists, to effectively manage in-patient and outpatient care.
- Medical home models will continue to expand, with chronically ill patients being moved into “mini medical homes.”
Top Ten Healthcare Trends, Jack Uldrich, Futurist and Author
1. Genomics: The era of personalized medicine is finally upon us.
2. Robotics: Expect many more hospitals to have in-house virtual training simulators in order to teach, improve and hone surgeon skills in the use of Robotics.
3. RFID: As Radio Frequency Identification (RFID) technology and sensors continue to improve expect hospitals to deploy the technology in new ways, including monitoring patient compliance with prescribed medications.
4. Smartphones: Low-cost applications will allow patients to remotely monitor themselves and send the information directly to their primary care physician. Coupled with continued advances in bandwidth capability and low-cost, high-resolution mobile web video the revolution in telemedicine is coming.
5. Artificial Intelligence: As more facilities get serious about electronic health care records and as ever-increasing amounts of genomic data are created, expect more hospitals to employ artificial intelligence to better manage this information.
6. Tissue Engineering: Nanotechnology supports advances in biotechnology.
7. Gaming: There is considerable potential for the development of gaming dynamics in the healthcare and insurance industries.
8. Business Analytics: One future possibility is that publicly available social network data can be data-mined by health insurers to offer discounted rates to individuals who travel in healthier social circles. (Privacy concerns and regulations may prevent such uses but, then again, maybe not.)
9. Mobile Web Video: The technology won’t eliminate hospital visits but it will gradually reduce the number. Expect a growing number of facilities to use the technology to monitor patients to lower re-admission rates and associated costs.
10. Heal Thyself. Healthcare professionals must become significantly more proficient at tapping into the most valuable resource at their disposal the patients themselves. Patients, in turn, will continue to turn to their fellow patients for more healthcare-related Information.
Top Ten Trends for Healthcare & Wellness in 2012, Bart Foster, founder and CEO, SoloHealth
SoloHealth is a health care technology and data analytics company that supplies kiosks and other products designed to help consumers take charge of their own health. According to Mr. Foster:
1. Technology will lead the way, providing a more efficient and effective experience among consumers, providers, insurers, and health and wellness businesses. Digital, social and mobile technologies will play a major role.
2. Awareness and prevention will have a renewed focus.
3. The “empowered consumer” will continue to rise along with the use of self-service technologies and channels.
4. Retail-based clinics and health care kiosks will connect with consumers to improve health care access, awareness and treatments.
5. Open access to health care data (while respecting privacy) will be more prevalent.
6. Lines between health care insurers and providers will continue to blur as mergers and partnerships cross traditional lines.
7. There will be increased government involvement and focus on health care as a major national issue
8. Health care costs will be more transparent.
Wall Street Journal – CEO Council edition
In this annual special edition, experts including members of the Wall Street Journal CEO Council address domestic and global challenges. Their top-two recommendations for improving the U.S. health care system are 1) prevention and awareness of chronic diseases and 2) the advancement and importance of healthcare technology.
Health Information Technology
Electronic Health Record Systems and Intent to Apply for Meaningful Use Incentives Among Office-Based Physician Practices, Centers for Disease Control and Prevention (CDC)
A newly released survey found 52 percent of office-based physicians in the U.S. intend to take advantage of incentive payments available for doctors and hospitals through the Medicare and Medicaid electronic health record (EHR) incentive programs. EHR incentive payments for eligible health care professionals can total as much as $44,000 under the Medicare EHR Incentive Program and $63,750 under the Medicaid EHR Incentive Program. The CDC data also show the percentage of physicians who have adopted basic electronic health records in their practice doubled from 17 percent in 2008 to 34 percent in 2011, with the percentage of primary care doctors using this technology nearly doubling from 20 to 39 percent. Refer to www.healthit.gov or www.cdc.gov/nchs
Three Technology Trends Your Company Can’t Ignore, Daniel Burrus, CEO, Burrus Research, Information Management Magazine, Nov/Dec 2011
In this commentary, Burrus Research, a consulting firm that monitors global advancements in technology-driven trends, focuses on three related trends, all relevant to occupational health operations:
1. Rapidly expanding power of “virtualized processing” on mobile devices via cloud-based technology, e.g., “Now your handheld device is as powerful and advanced as your desktop.”
2. Creative applications, e.g., “give people the ability to do what they currently can’t do, but would want to do, if they only knew they could.” The key is to implement a communication vehicle that engages the different groups you serve.
3. Just-in-time training that will enable people to use their laptops, cell phones and tablet computers as a tool to receive training precisely when they need it.
Managing Paper Patient Records in a Clinical Practice, Nuance
This 2011 report by the speech software company discusses the use and implementation of electronic health records in ambulatory physician practices:
- Review of paper documents and integration into the EHR are major issues.
- No ideal solution is available whether through technology or process.
- Personnel-intensive workflows are common in handling paper, along with errors that result when humans are involved.
- A technology solution that helps automate the handling of paper is needed.
- The ability to extract data from unstructured paper documents would be welcome.
We Can’t-Wait: U.S. Department of Health and Human Services (HHS)
HHS announced plans to expedite the use of health IT in doctors’ offices and hospitals nationwide to improve health care and create jobs. While protecting confidential personal information, health IT can improve access to care, help coordinate treatments, measure outcomes and reduce costs, HHS
Secretary Kathleen Sibelius said. The new administrative actions are supported by the HITECH Act. To encourage faster adoption of electronic health records, the secretary announced that HHS intends to allow doctors and hospitals to adopt health IT applications this year without being required to comply with new implementation standards until 2014.
These policy changes are accompanied by greater outreach efforts that will provide more information to doctors and hospitals about best practices and to vendors whose products allow healthcare providers to meaningfully use EHRs. For example, in communities across the country, HHS will target outreach, education and training to doctors who have registered for the EHR incentive program but have not yet met meaningful-use requirements, which are the foundation for impending payment changes involving patient-centered medical homes, accountable care organizations, bundled payments and value-based purchasing.
Cost Containment
Behind the Numbers: Medical Cost Trends for 2012, PwC Health Research Institute
The PriceWaterhouseCoopers Institute predicts medical costs will increase from 8 percent in 2011 to 8.5 percent in 2012. Reactions to the recession and slow recovery, health reform and other variables are factored into the equation, which takes into account trends contributing to rising costs (accelerators) and decreasing cost trends (deflators). Noteworthy accelerators include:
- Continued provider consolidation
- Cost-shifting from Medicare and Medicaid
- Increasing burden of post-recession stress on the workforce Deflators include:
- Blockbuster brand name drugs going off-patent
- Out-of-network provider “tiering” (defined as the classification of health care providers or treatments into different groups based on objective or subjective criteria such as measures of cost, quality, safety or value)
- • High-deductible health plans forcing cost-sharing
Refer to www.pwc.com/us/en/health-industries
2011/2012 Staying@Work study, Towers Watson/National Business Group on Health
Findings from this study paint a complex picture: Although companies with highly effective health and productivity (H&P) programs have gained ground, advances are tempered by shortfalls in some key areas for all companies, including those with best practices. Challenges include the difficult economic environment, a growing epidemic of workplace stress claims and failed attempts to change unhealthy lifestyles. These issues have a collective impact on direct medical costs as well as the hidden costs associated with absence, presenteeism and overtime.
As North American employers seek to control these rising costs, they are increasing their investment in the health and work effectiveness of their employees. What’s more, employers are finding this strengthened commitment — demonstrated by a philosophy and programs that make employees accountable for managing and improving their own health — can have positive effects on their organization and bottom line, according to the report.
Refer to www.towerswatson.com/united-states/research/6031
Amy Gallagher, vice president, Cornerstone Group, New England
Advising large companies on benefits, Ms. Gallagher predicts healthcare cost hikes of approximately 10 percent for employers in the coming year. She also cites the following as emerging trends likely to shape the future of health care in 2012 and beyond.
Benefits: New value-based benefit plans that use incentives such as reduced co-pays and deductibles to encourage patients who are chronically ill to follow recommended treatment plans and change unhealthy behaviors. HMOs: A resurgence of interest in Health Maintenance Organization (HMO)-style delivery models that focus on the primary care relationship to manage patient care. Wellness: More employers are realizing that helping employees improve their health impacts the bottom line. PEOs: Professional Employer Organizations allow companies to colease employees for purposes of benefits only, pooling risk with other small businesses for purchasing clout.
Fitness
Worldwide Survey of Fitness Trends for 2012, ACSM’s Health & Fitness Journal®, Nov/Dec
According to more than 2,600 fitness professionals who completed an American College of Sports Medicine survey of the top fitness trends for 2012. The top ten fitness trends predicted for 2012 are:
1. Educated and experienced fitness professionals.
2. Strength training.
3. Fitness programs for older adults.
4. Exercise and weight loss.
5. Children and obesity.
6. Personal training.
7. Core training.
8. Group personal training.
9. Zumba and other dance workouts.
10. Functional fitness, i.e., using strength training to improve balance and ease of daily living.
Outcome measurements and clinical integration/medical fitness both dropped out of the top 20 this year. Outcome measurement as a way to quantify progress in clubs and wellness programs had a five-year run in the top 20 and ranked 13th in 2011. Clinical integration/medical fitness, perhaps tied to last year’s national healthcare reform, only appeared in the top 20 in 2011 and claimed 18th place. Pilates, which first dropped out of the top 20 for 2011, remained off the list for 2012. Meanwhile, the U.S. Department of Labor’s Bureau of Labor Statistics predicts that jobs for fitness workers will increase faster than many other occupations. Refer to www.acsm.org
Performance Measurement
Comparative Effectiveness Research, Patient-Centered Outcomes Research Institute
The institute recently announced it has received more than 850 applications for two-year comparative-effectiveness research grants. The organization will announce funding for 40 projects in March. Established under the Patient Protection and Affordable Care Act, the institute said it attracted a larger-than-expected number of applications from stakeholders, patients and patient advocates because of a “high level of interest and readiness to shift the research paradigm toward a patient-centered approach.”
Projects that receive funding will address methods for engaging patients in various aspects of research. The findings will be used to build a foundation for the institute’s activities moving forward. The Patient-Centered Outcomes Research Institute (www.PCORI.org) is an independent organization created to help people make informed healthcare decisions and improve healthcare delivery.
Defining and Paying for Value: Theory Becomes Reality, PwC Health Research Institute adults suggest health care organizations must demonstrate they are delivering better value; those that do not will be penalized. The survey findings reveal inconsistencies in attitudes toward health insurance offerings.
- 52 percent of respondents indicated they would be interested in a value-based insurance plan such as one in which treatments known to be effective would cost little but new treatments with unproven benefits would cost more.
- 65 percent of respondents believe health plans should offer a wide range of hospitals, doctors and treatment options from which to choose.
- However, 47 percent of respondents said they would rather have a health plan that costs less and offers fewer doctors and hospitals than a higher-cost plan with greater choice.
Refer to www.pwc.com/us/tophealthissues2012
Physicians’ Viewpoint
Physician Perspectives About Health Care Reform and the Future of the Medical Profession, Deloitte
A Deloitte survey of randomly selected members of the American Medical Association indicates physicians are skeptical about core promises associated with the Patient Protection and Affordable Care Act. For example, only 27 percent of physicians surveyed believe the act is likely to reduce costs by increasing efficiency, and only 33 percent feel it is likely to decrease disparities. Moreover, half say access to health care will decrease because of hospital closures.
The report also shows that the majority of doctors (73 percent) are not excited about the future of medicine and 69 percent believe the “best and brightest” who might consider a career in medicine will think otherwise.
The negativity is driven in part by concern over the pressure family practitioners will face when millions of newly insured consumers seek care. Another stumbling block for physicians is the view that reform will mean a loss of autonomy and more costs and administrative burdens in adopting processes and technologies.
Additional key findings from the study include:
- Nearly 75 percent of respondents think emergency rooms could be swamped if primary care physician offices are overbooked.
- • More than 80 percent believe it is likely that wait times for primary care appointments will increase.
- • More than half indicate that other medical professionals (physician assistants, nurse practitioners) will deliver primary care both independently and as an adjunct to physician services.
- • Surgical specialists (57 percent) are much more likely to support repeal of the health care reform act, compared to primary-care providers (38 percent) and non-surgical specialists (34 percent). They are also more likely to say the legislation is a step in the wrong direction and believe their net income will decrease as a result of reform.
- • There is a disparity among generations: 59 percent of physicians 50 to 59 years old feel the Affordable Care Act is a step in the wrong direction while only 36 percent of those ages 25 to 39 share this sentiment. Younger physicians (ages 25 to 39) are also more likely than older doctors (ages 40 to 59) to think the transition to evidence-based medicine will improve care.
Refer to www.deloitte.com/us/physiciansurvey
Workforce Management
Strategic Human Resources and Talent Management: Predictions for 2012 – Driving Organizational Performance Amidst an Imbalanced Global Workforce, Bersin & Associates
Predictions included in the human resources management firm’s 2012 report highlight radical changes in the economy and the workplace as they relate to social networking for talent acquisition, informal and on-demand learning, performance management, employee engagement, talent development and mobility, and career development. Additional changes highlighted in the report include new models and modalities for leadership development, changes in the talent management software market, and all things social– including recruiting, learning, rewards, performance management, and career management. Among the predictions:
- Talent acquisition goes social – forcing a reinvention of agencies and job boards.
- New models, diversity and “Girl Power” will drive leadership strategies. Research shows that companies with significant female board representation had a 26 percent greater return on capital invested.
- Performance management will continue to shift toward a “coaching and development” model.
