Health care has always been a key point of discussion for policy makers. Now, following the 2016 election, many businesses and employees are wondering what kind of changes the health care industry could see over the next four years.
Andrew Croshaw, co-chair of the Salt Lake Chamber’s Health Systems Reform Committee and president of the health care consulting group, Leavitt Partners, provides Chamber members with 12 scenarios to watch for in the first years of the new administration:
- The Affordable Care Act (ACA) is repealed and replaced: substance of the replacement legislation could retain some elements of ACA. The extent of bipartisanship in the replace vote will be a signal of the durability of change.
- Health information sharing increases: a number of bills have been introduced in the last year to increase the availability and accuracy of health sharing methods. President-elect Trump has been asked to act on the Electronic Health Record Regulatory Relief which seeks to ease requirements of providers and hospitals operating under the meaningful use program.
- Value-based payment models continue but at a slower pace: reforms that aim to promote quality and value of health care services will continue to grow but only some existing payment models will remain safe.
- Medicaid becomes more flexible and reduces overall spending: flexibility and reduced spending will occur not through a block grant in the short term as most are focused on – waivers and budget channels will be used and will send early signals of new administration policy. Block grant approaches will take time to mature.
- The individual market gets a makeover or spirals: the individual insurance marketplace is not stable and will require policy attention or will begin to spiral.
- Private sector value collaborations fill the vacuum left by outgoing administration: the Obama administration initiated dozens of mandatory and nonmandatory value-based payment arrangements in primary care, specialty care, acute care, and post-acute care. These programs were rolled out fast and furiously under broad authorities of the ACA. The vacuum created by an incoming administration that will not exert the same level of market-driving control creates both a need and an opportunity for the private sector to lead through organizing multi-stakeholder alliances to advance the imperative of lower cost health care.
- Partisan overreach or bipartisan compromise: passage of a bill replacing ACA will define political ownership of the replace legislation. As an important indicator of sustainability, keep an eye on how partisan the process becomes.
- Drug and device industry price pressure continues: pricing pressure on drug and device makers will occur more through transparency pressure than through price controls.
- Political alliances are sliced and diced: governors, partisans, and the private sector will vocally assert their interests in varied combinations. This is not simply a blue and red issue.
- Insurance cost and coverage requirements loosen: refundable premium tax credits and the individual mandate are likely to see major changes.
- No Medicare reform occurs before congressional elections: reforms in this area will, at the earliest, only occur after marketplace changes and ACA are addressed.
- FDA drug/device reviews become slightly faster and less burdensome: this could include shortening the timeframe for drug and device development, allowing treatments to enter the market faster.
While these scenarios will take shape in various ways over the next few years, change is inevitably coming. Because a healthy workforce is necessary for a productive business community, all employers should proactively understand health care reforms and consider the impacts such changes pose to their company and employees.
As the voice of Utah business, the Salt Lake Chamber is committed to continuing our efforts to inform and educate businesses on public policy issues like health care reform. Our efforts will also include actively engaging in the stakeholder process with Utah’s federal delegation.
If you would like to become more engaged in health care issues like these, we invite you to become a member of the Chamber’s Health Systems Reform Committee, which tackles complex legislative issues and promotes business friendly public policy surrounding health care.
The Salt Lake Chamber’s committees are designed to identify current and emerging problems, provide support on policy analysis and communication efforts, and counsel on issues to recommend to the Salt Lake Chamber Executive Board. Learn more at: slchamber.com/policy-committees.