In many ways, healthcare executives will end 2017 the way they began it: with continued uncertainty over the future of the Affordable Care Act.
Indeed, the drama over whether lawmakers would repeal the healthcare reform law dominated headlines for much of the year. And President Donald Trump’s recent tweets indicate he expects more of the same in 2018.
Based on the fact that the very unfair and unpopular Individual Mandate has been terminated as part of our Tax Cut Bill, which essentially Repeals (over time) ObamaCare, the Democrats & Republicans will eventually come together and develop a great new HealthCare plan!— Donald J. Trump (@realDonaldTrump) December 26, 2017
While it may seem like the plot of “Groundhog Day,” the “will-they, won’t-they” push and pull over former President Barack Obama’s signature legislation wasn’t the only news in 2017.
Tom Price’s wild ride as HHS Secretary comes to a sudden end
Despite Democrat concerns about his potential ethics violations and conflicts of interest while a congressman, Tom Price, M.D., was confirmed as secretary of the Department of Health and Human Services in early February and soon began his push to defend a GOP health bill to replace the ACA.
But his ethics ended up being his downfall.
A Politico investigation found Price spent nearly $1 million of taxpayers’ money on chartered flights and military planes for government and personal trips instead of less expensive commercial flights.
Price resigned seven months into his tenure due to the controversy and wrote a check to the U.S. Treasury Department for $51,887 to reimburse the government for his seat on the chartered flights.
But Trump’s pick to replace Price is also controversial.
Alex Azar, former head of pharmaceutical giant Eli Lilly’s U.S. operations, promised during his hearing before a Senate panel that lowering drug prices will be his top priority. Some senators questioned him on how he could follow through on that promise when, under his leadership, Eli Lilly raised the prices of insulin and test strips for diabetes by 200%.
His confirmation has been stalled by Democrats, who recently blocked the nomination and have called on the White House to resubmit the nomination if Trump wants him in the position, according to Politico.
Opioid crisis becomes a national public health emergency, but funds still lacking
The nation’s problem with opioid addiction reached crisis levels in 2017, leading to the death of 175 Americans each day. The epidemic has caused a spike in the number of deaths from opioid-related hospitalizations, cost the nation billions of dollars and led to an increase in infectious diseases among intravenous drug users. In response, the Joint Commission issued new pain standards for hospitals to help reduce dangerous prescribing practices of opioids.
Trump vowed to take action to end the crisis, declaring the problem a national public health emergency in October. But he still hasn’t designated funds or specified where the additional funds to implement programs will come from.
Earlier this month, Trump donated his third-quarter salary of $100,000 to plan and design a large-scale media campaign that highlights the dangers of opioid addiction. But Congress remains divided on how much is needed to truly reverse the epidemic. A House bill included roughly $15 billion and the Senate version had $45 billion.
But perhaps the funding issue will be resolved in early 2018: This month, a bipartisan group of senators called on leadership to ensure that substantial and sustained funding for the opioid epidemic is included in any legislative package.
Hospitals face unprecedented turnover amid baby boomer retirements
High turnover within hospitals has been a problem for years but now is on pace to reach record levels. Indeed, hospitals are losing critical employees, including clinical administrators, physicians, nurses and members of the C-suite, faster than they can replace them, according to a report issued in May 20 17.
The problem will lead to hospitals replacing virtually half of their staff every five years, noted the report, conducted by Leaders for Today, a national healthcare interim and permanent staffing company.
And it will only get worse amid the national physician and nursing shortage and the number of baby boomers preparing to retire. Nearly 50% of the 852 hospital personnel surveyed told the company that they plan to stop working within the next 10 years and 22% will retire in five years.
The financial impact is staggering.
Hospitals pay billions to recruit and retain nurses—offering higher salaries and signing bonuses—to address the nationwide nurse shortage. The issue is among the top concerns of chief nursing officers, and some hospitals are trying new initiatives to recruit staff.
Cedars-Sinai Medical Center, for instance, aims to hire veterans to fill open positions at its 958-bed hospital in Los Angeles, and other hospital executives surveyed last year say they are boosting retirement plans and repaying student loans as incentives to recruit staff and get them to stay.
Hospitals experiment with new approaches to care
As healthcare transitions from fee-for-service to payment for value-based care, some hospitals decided to shake up their traditional approaches to care.
Intermountain Healthcare, for instance, abandoned its regional approach to care to focus on how patients actually use the organization’s healthcare system.
The Salt Lake City-based nonprofit system revamped its leadership structure and in December began to focus on community care and specialty care to provide faster, more direct care to patients. The move, according to CEO Marc Harrison, M.D., is meant to disrupt the organization so it can be a model of healthcare in the years ahead.
Geisinger Health System launched a population health initiative early in 2017 that targeted patients' chronic conditions and the community’s overall socioeconomic health.
The Danville, Pennsylvania-based system’s new program aims to make Scranton a nationwide model of health by providing residents to healthy food options and also launching a precision medicine initiative for Scranton residents, using DNA to gather information on genetic conditions to which they may be predisposed, helping with prevention, early diagnosis and intervention.
Providers are also collaborating with payers to help move away from traditional business models and improve care, lower costs and engage patients in their care.
For example, this year Penn State Health and Highmark Health signed a $1 billion deal to form a value-based community care network to improve population health and protect market share by keeping more patients in the region, especially for complex care.
Other deals in the works: United Health’s Optum Unit will acquire DaVita Medical Group, McLaren Health Care will take over the nonprofit HMO MDwise and Cleveland Clinic will partner with Humana to offer two new health plans.