With the healthcare industry in a state of unrest (due to shrinking reimbursement rates, skills shortages, cost pressures, pending regulatory changes, and unprecedented demand) healthcare organizations must find ways to eliminate, automate and standardize operations (at the admin, business, and clinical levels) to drive down the long-term cost curve and realize near-term profits.
The most popular healthcare cost containment strategies and tactics have been discussed by administrators and consultants for a number of years (simply Google “2010 healthcare trends” and then compare to a Google search for “2007 healthcare trends”) however a few new healthcare trends are emerging including:
- Eliminating Fraud,
- Implementing controls,
- Seeking innovation, and
- Outsourcing to a better breed of vendors that can truly deliver the full promise and value of outsourcing.
Read more about these emerging trends here:
- In an article titled “10 Ways to Cut HealthCare Costs” from November BusinessWeek speaks to many of the oft-repeated tactics such as developing a healthy workforce, moving more aggressively to adopt CDH plans, but one new trend is the emergence of “CRACKING DOWN ON FRAUD AND ABUSE.”
- From the article: “Crime pays big when it comes to health care. This huge industry is run pretty much on the honor system. The FBI figures that fraudulent billings to Medicare, Medicaid, and private insurers account for 3% to 10% of total health spending, and the bureau concedes its estimates may be low. "Everywhere we look, we see evidence of fraud," says Lewis Morris, chief counsel for the Office of the Inspector General at the U.S. Health & Human Services Dept.”
- “Open Enrollment: Six Benefit Trends for 2010 from SHRM” discuses the utilization of wellness and disease management programs, changing value-based plan designs, dependent eligibility audits, and seeking more competitive vendor terms through bids and other innovative strategies all in an effort to curb rising health care costs,
- A closer eye on spousal and dependent coverage. Employers are increasingly revisiting spousal and dependent coverage in their efforts to control rising costs. Some employers are requiring spouses to complete health-risk assessments, while others are charging higher premiums for working spouses who have access to other health care coverage. More employers are also expected to audit their workers to eliminate dependents who are not eligible for coverage (i.e. dependent eligibility audit and eligibility verification).