Paul Keckley Ph.D.
Health Care Entrepreneur, Policy Analyst and Trend Spotter
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Paul Keckley Ph.D.
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Health Reform 2.0
What to Expect in Round Two
• The intersections of cost containment pressures, competition from new entrants, clinical innovation, politics and the Affordable Care Act’s implementation through 2020: how will each sector respond, and what factors will determine winners and losers
• The status of the ACA’s implementation
• Two catalysts for disruptive change: employers seeking value and consumers forced to engage directly
• Speed traps for providers—physicians, hospitals, long term care providers: fraud and adherence to evidence-based medicine; business relationship transparency
• Realities for health insurers: new customers, consolidation, scrutiny, diversification
Megatrends impacting the US Health Care Industry
• Health and Entitlement Reforms (Regulatory)
• Clinical Innovations that Disrupt Traditional Modes of Care
• Data-driven health care: the convergence of financial and clinical data
• Employer activism: the relentless pursuit of value and exit from ESI
• Plan Growth and Consolidation: new customers, new realities
• Consumerism: the buck stops at home
• New Competitors: Taking Advantage of the Industry’s Disruption
Consumerism in Health Care
Is the Industry Ready?
• Expenditures
• Attitudes and Beliefs
• Expectations and Trade-Offs
• Opportunities
Industry Restructuring
‘Go Big or Get Out’
• Physician-Hospital Alignment
• Acute-Long-Term Care Integration
• Plan-Plan Consolidation
• Plan-Hospital Strategic Partnerships
• Emergent Niche Sectors
• OWAs (Other Weird Arrangements)