The year 2015 marks the five-year anniversary of the Affordable Care Act (ACA).
The landmark legislation has fundamentally changed the country’s health care landscape, according to a new report from PricewaterhouseCoopers’ Health Research Institute.
The ACA has had “a profound, and likely irreversible, impact on the business of health care,” according to the report, and has altered the way health care is delivered, paid for and marketed to patients.
The report documents the changes since the ACA took effect in the way doctors, hospitals, pharmacies and clinics deliver patient care; the way public and private health plans and patients pay for care; and how insurers and pharmaceutical companies market themselves.
Here are five new trends in health care related to the passage of the ACA, according to the report.
1. New payment models shift risk
The ACA’s pay-for-performance and rewarding outcome payment models have shifted risk among hospitals, physician groups, pharmacies and other health stakeholders.
The report claims that the ACA has hastened the shift of risk away from insurers (the traditional risk holders,) and placed it on providers, pharmaceutical companies and consumers. Providers will now, or soon, have to demonstrate patient care results for reimbursement.
2. Focus on primary care
The ACA has spurred a renewed focus on the basics, including preventative and primary care.
The report cites the elevated role of primary care physicians, pharmacists and retail clinicians as evidence of the renewed focus on primary care, and the health care professionals supplementing and extending primary care services.
These health care providers are working in more team-based, collaborate networks of primary and preventative care predicated on value as a result of the ACA.
3. Emerging health care companies
The report claims that the ACA has created an increased demand for lower-cost and consumer-oriented health care options, and new companies are emerging to meet this need.
Ninety new health companies have been created since 2010, according to the report, including 29 telehealth companies, 15 consumer education companies and 14 process improvement companies.
4. Retail approach to insurance
The ACA is causing a shift away from business-to-business insurance wholesale, to a more retail-centered, direct-to-consumer approach.
Insurance options are becoming more transparent with this menu-driven, market-style approach, on public and private health exchange options.
This trend is projected to continue to grow in order to meet the demands of consumers, federal and state health administrators, and employer-sponsored health plans.
5. States claim key role
States have emerged as key players in the health care landscape under the ACA.
The ACA gives states control over Medicaid expansion, management of the marketplace and oversight of exchanges, which imparts states with enormous influence over how health care reform is implemented.
Expect these five trends to expand as the ACA continues to shape the health care industry in the future.
