With the cost of healthcare growing, what does healthcare future look like?

Now covering more than 100 million people, the growth of Medicare (MCR) and Medicaid (MCD) is contributing to the long term rise in health-care cost. Although healthcare costs went down slightly in 2013, a very different picture is emerging for the future. The growth of MCR is aligned with an aging baby boomer population and MCD is growing as a result of states that opted into MCD via ACA. Together, they are the biggest challenge to healthcare providers we have ever seen. They represent a financial challenge and a clinical challenge.

Between declining reimbursements, the cost of technology and the government mandates (including ICD 10) along with a decline in the number of available providers; the future does not look bright.

Not only are reimbursements declining, the payment models are changing and no one knows for sure how that’s going to work. On the payer side, networks are narrowing; providers are being dropped from networks and the cost of offering wellness programs requires providers to do more with less.

So is there any good news? There are plenty of opportunities for Primary Care to assert its leadership and influence. The role of primary care must become the hub of the wheel. PC can find opportunity in ancillary services, wellness programs and new direct pay models that will increase revenue and contribute to patients’ well-being. Comprehensive care of the whole person offered via primary care is the future of well-done primary care. Not only will PC be gatekeepers, they will build the super-highways of healthcare options.

Communication between patients and providers will be changing as well as how that communication takes place. Talking to a doctor may be one of the most important conversations people can have. Making sure patients have access to the right information, in the language they can understand and at a cost they can afford will be the key to effective communication. Several options Are available to physicians; but the one with the most prospect for multiple possibilities of communication is the practice web site. Information can be distributed, entrance to patient portal facilitated, necessary forms offered, direction for pre and post procedures easily captured and e mail opportunities abound.

Physicians have long communicated difficult news to patients, but talking about money has almost been taboo. With so much out-of-pocket existing, these difficult conversations must take place. Options for payment of these out of pocket expenses must be offered in ways that while uncomfortable, are manageable by patients.

Some practices will quickly and easily adjust (OK, maybe there will be just a couple that find an easy and smooth path). Others will struggle and find only discouragement, but some, knowing their commitment to patients and wellness, will find right combinations of technology, clinical resources, and patient engagement that will bring success to both providers and patients.