How the AHCA Could Impact Provider Technology Efforts

Healthcare reform has taken center stage thus far in the 115th Congress, with the House of Representatives very narrowly passing the American Health Care Act (AHCA) in May as part of a promised three-step overhaul. Senators and a 13-member healthcare working group now are considering proposals to overhaul everything from the current insurance marketplace to Medicaid.

These conversations are generating uncertainty in the marketplace, with concerns about reform timelines, hospital budgets and, according to the Congressional Budget Office, as many as 23 million more uninsured Americans. As a result, technology budgets, already a small portion of a care organization’s overall budget, may very well remain stagnant, if not risk cuts, as reimbursements and revenues face limbo.

Shift to Value-Based Care

Healthcare cost concerns are paramount for policymakers on Capitol Hill and in the Trump administration, as many provider organizations shift to value-based models through participation in accountable care organizations or other alternative payment models (APMs). The industry recognizes that cost savings will come with the use of technology and the free flow of healthcare information. Enabling informed clinical decision-making through an interoperable ecosystem will be absolutely imperative.

Congress has indicated a willingness to expand options for APMs to design their care delivery programs to include technologies like telehealth and remote patient monitoring, while ensuring providers assume enough financial risk. Both Health and Human Services Secretary Tom Price and Seema Verma, the Centers for Medicare & Medicaid Services administrator, confirmed their interest and belief in telehealth, in particular, as a means to expand access and improve health outcomes.

Real-Time Data Collection Is the Next Step

Going forward, it will be critical to ensure recognition of the variety of healthcare technologies that will enable real-time data collection and allow for immediate interventions by care providers. Robust information sharing, combined with the ubiquitous nature of electronic health records and the growth in collection of patient-generated data of all kinds, will aid in making population health and community-based care a reality.

Improving the accuracy of the data generated and shared will enable outcome measurement, which is increasingly how providers are paid. Price and senior leaders at the Office of the National Coordinator for Health IT have cited the need to allow physicians to be more efficient by reducing the documentation burden. The newly established Office of Clinician Engagement, coupled with the charge to reduce the regulatory burdens on healthcare providers, suggests revisiting how providers interact with and use technology, at least in their efforts to satisfy government regulations.

As the era of uncertainty continues, it will be efficiencies that attract interest from providers and hospitals. Is it worth building your business model around telehealth and serving as a hub for your community? Can you improve the efficiency of the doctor-patient interaction by leveraging synchronous or asynchronous technologies? How can you improve outcomes based on community factors according to your new population health software?

Technology and high-quality data will determine both the future of care delivery and the payments clinicians and hospitals receive for that care.