2016: More antitrust actions, Medicare expansion tussles likely

The year 2015 featured a number of momentous events in the business of healthcare delivery, including the King v. Burwell decision. Here are our predictions of what the industry can expect in 2016:

1. More antitrust actions. In the closing days of 2015, federal regulators took action to block hospital mergers in West Virginia and Illinois. There were also some pretty big settlements in ancillary businesses, with laboratories Pharmasan and Pathway Genomics agreeing to pay hefty fines to settle qui tam lawsuits in December. The Federal Trade Commission and U.S. Department of Justice have appeared to have hit their stride on such suits, so expect to see more in 2016.

2. More tug-of-wars regarding Medicaid expansion. Bill Walker, Alaska's newly elected independent governor, decided to expand Medicaid eligibility under the Affordable Care Act on his own. Mat Bevin, the newly elected Republican governor of Kentucky, wants to roll back Medicaid expansion in the Blue Grass State. Expect to see more such battles as 20 states still have yet to expand their program, but the waning days of the Obama administration are giving them fewer political reasons to object.

3. More accountable care organizations (ACOs). There are hundreds of existing ACOs, and given the continuing pressure on providers to furnish more value-based care, expect to see more. But don't expect to see results that are little more than incremental at best.

4. More promises to repeal healthcare reform. Nearly six years in, the political promises to "repeal and replace" the Affordable Care Act have faded in recent months. But as the 2016 Presidential campaign heats up, expect to see those promises to flare anew. Whether anything comes of them remains to be seen.

5. More price transparency websites. Expect to see more states offering some prices on their websites, and more startups promising consumers to actually find out what their healthcare costs. But do not expect to see any of these services come close to actually providing price transparency.

6. More price increases. Given there is no device in place to constrain healthcare prices, expect them to continue to rise.

The one area where we are likely to see less rather than more:

7. Hospital job production. Hospitals had a blockbuster 2015 in creating new jobs, followed up by a pretty strong 2014 and overcoming several years prior of stagnant job growth. But continued mergers and acquisitions among hospitals and the maturing of the ACA makes it likely that this trend will slow down. Hospitals will still create jobs, but don't expect the 15,000-20,000 monthly clip we have seen of late.

 

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