By Dr. Rod Hochman

Leaders at Providence St. Joseph Health, the nation’s third largest nonprofit health system that operates Kadlec Regional Medical Center in Richland, predict no let-up in the massive changes in American health care, which will be defined in 2018 by continued debate in Washington, D.C., intensified efforts to address mental health and broad leaps in genomics, population health management and consumer-focused innovation.

Dr. Rod Hochman,

There will be continued critical policy discussions at the federal and local levels that will dramatically impact health care in this country. This means that health care providers will become much more proactive, taking the future into our own hands on behalf of the communities we serve.

Together we’ll drive toward better, more affordable services for everyone. This will require a continued focus on innovation, personalized medicine, collaboration among diverse partners, and stability and support for not-for-profit health care, which serves as a vital resource for communities across America.

What are the major health care predictions for 2018?

We foresee these developments ahead:

• Policy and politics: Health providers will lead a push to preserve Medicare and Medicaid.

As lawmakers consider shrinking Medicare and Medicaid spending to help manage the national deficit, the country’s health care providers will take the lead in speaking out about the critical role these programs play for millions of Americans. This year will see increased national dialogue to ensure awareness about these safety net programs, the wide range of beneficiaries, the serious implications of program reduction and new and ongoing solutions to make care more cost-effective for taxpayers while also improving quality and access to care.

• New revenue streams: Digital health will create revenue diversification opportunities and speed value-added health care technology to consumers.

Expect more hospitals and health systems to make innovative digital offerings a new source of revenue to offset declining reimbursements from traditional payers. Look for health systems to get directly involved in developing new technologies and ultimately be quicker in bringing new capabilities to the primary care setting. Also, there are many new opportunities to offer value-added products and services directly to the consumer to keep them healthy and enhance their care. And, as health systems innovate, they will offer new platforms to other health care organizations so that they, too, can achieve solutions to health care delivery issues.

• Technology: Empowering patients to become more involved in their care.

Tech giants like Google, Microsoft, Apple and Amazon will leverage their investments in cloud computing, AI/machine learning, supply chain, and consumer engagement platforms in health care. Technology startups will leverage these scaled cloud computing and AI/machine learning platforms into health care specific innovations as well. With cloud computing and regulatory changes making it easier for patients to access and share medical information, we can expect to see more apps and technologies that help patients track everyday health habits and share them with their care teams.  All of this is good news for patients, especially millennials, who continue to be frustrated by old-school processes for accessing care and their health information. Finally, creating an ongoing dialogue between physicians and patients using real-time data will lead to better managed and preventive care and more effective, customized health regimens.

• Personalized medicine: Leveraging DNA and other personal data will improve wellness and prevent disease.

Integrating genomic data with clinical labs and other personal health information will take center stage as the key to solving many global – and personal – health care mysteries. Discovering the secrets of the genome, proteome and microbiome will help providers realize the promise of precision medicine. And advances in technology such as direct-to-consumer tests are enabling people to delve into their genetic makeup and even wearable data-collection devices have now made more data retrieval possible – all of which is helping secure a much better reading of a patient’s health and wellness. Integrating this data into clinical care in innovative ways is also enabling a more personalized approach to medicine and moving us to the verge of preventing, delaying or curing diseases that confounded medical experts just a decade ago.

• Population health: Providers will step up efforts to address the social determinants of health.

Health systems help entire communities stay healthy and population health management will soar in importance this year. Ongoing improvements in analytics and care management are making it easier to prevent illness and care for those with chronic conditions, but declining revenues will challenge providers to be more effective than ever. Taking on an even broader platform, the social determinants of health – including access to care and services, reliable transportation, housing, education, and nutrition – will become the focus of many more health care systems and social service providers. For those providers truly committed to improving population health, we’ll see more partnerships that involve care management, housing (especially for the homeless), community services and increased access – particularly in ambulatory care, home, and virtual settings. More emphasis will also be placed on the measurable outcomes achieved through these important alliances.

• Innovation: New partners will team up to address the growing mental health and substance abuse crisis.

With mental illness and substance abuse now the leading cause of death for Americans under 50, it will be harder to ignore the problem hitting almost every community country-wide.

We’ll see more community collaboration with health providers to help people get access to care and resources, and there will be more effort to get help earlier. Collaboration will take place across many sectors – including health care, schools, the criminal justice system, churches, businesses, social service agencies and veterans’ groups. This is the year the stigma of mental health all but vanishes as efforts gain to find a realistic and effective solution.

• Work force: Providers will invest in work force pipelines, and leadership diversity will increase .

Finding a wide base of health care talent – especially nurses – who are prepared to meet the challenge of providing cost-effective and high-quality care is a challenge. With high demand for well-prepared new employees, providers will look to developing their own work force pipelines through partnerships with universities, medical schools and forming their own education programs, like the unique partnership PSJH just formed in Great Falls, Montana. This strategy allows for greater influence on training and expediting the hiring process, which creates a steady stream of employees ready to tackle next-generation challenges.

• Ambulatory and home health: Care goes everywhere.

Bringing care where people live and work isn’t new; however, CVS’s proposed purchase of Aetna will amplify this model on a national scale. Providers will follow suit by expanding their reach to places where people make choices that affect their health such as retail pharmacies, neighborhood wellness centers, grocery stores, and brick and mortar retailers. And convenient at-home services like telehealth via video, email, chat or text will finally go mainstream, especially as reimbursement policies push these capabilities into every day uses.  Accessible services like these positively encourage patients to pay consistent attention to their health and wellness – and that’s good news for everyone.

• Partnership: Health care will explore non-traditional partnerships to help establish greater stability.

Look for traditional but also non-traditional pairings which can bring care to more people and improve the efficiency of delivery. With the threat of reimbursement deteriorating and more people losing coverage, health care organizations will need to shore up their ability to care for communities, especially those patients who are more financially vulnerable. Benefits for organizations that find the right partners will include lower costs for medical supplies and pharmaceuticals to help stabilize what has been a skyrocketing expense.

[panel title="About Rod Hochman:" style="info"]

Dr. Rod Hochman is president and CEO of Providence St. Joseph Health, a health system of 50 hospitals, including Kadlec Regional Medical Center in Richland, and 829 health clinics and a comprehensive range of services in Washington, Alaska, California, Montana and Oregon.