Is it 2018 Already

In the blink of an eye it will be 2018! Will organizations be ready for what healthcare demands? Will YOU be ready? Will your systems be ready to analyze, report and predict required outcomes? Now is the time to think about this and not wait until the day reporting is required for reimbursement. The Centers for Medicare and Medicaid have made some bold statements and goals for 2018. New targets call for Medicare to use accountable care or other new payment contracts for 30% of spending outside of managed care by 2016. That would increase to 50% by 2018. More broadly, Medicare would require some incentive for quality or value to be tied to 85% of spending by 2016 and 90% by 2018 under the new targets. This not a proposal! These are not options!

The next question is, “How do I prepare for the inevitable?” It is time to put your CIO, CMIO and CMO to work to understand and determine where your data exist and how you will use this data in the future to demonstrate outcomes. Although there has been a lot of talk about the “death” of meaningful use, the essence of stage 3 to “meaningful outcomes” is still a reality. When you look at the trend to increasing risk with the Next Generation ACOs, it is clear that healthcare organizations may increasingly bear the responsibility of appropriateness of care, overutilization and disease prevention and management. Movement from fee for service to capitation is the future. Metrics exist for ACOs and reimbursement will depend on meeting those benchmarks.

Moving to the new reimbursement system and meeting the quality and cost demands will not occur in a single leap. However, putting a roadmap together to move from one system to another is something that you can and must do now. The path will require coordination among all parts of an organization. Technology, although not alone, will be part of the solution. Executive, Quality and IT leadership are essential for an organization to be ready. Time to get going with the roadmap.

Dr. Wesp is currently the Executive Clinical Strategist for Jacobus Consulting based in Irvine, CA. and adjunct professor at USC Sol Price School of Public Policy.

Dr. Wesp graduated from Rutgers University-NJ Medical School, completed residency at Children’s Hospital Los Angeles, holds a Master’s degree in Organizational Management, and is a lifetime member of the American Association for Physician Leadership.