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Medicaid Expansion, Medicare Reimbursement And The Next Level Of Healthcare Information Technology: U.S. Managed Markets Continue Titanic Shifts In 2014

Decision Resources Group's team of subject matter experts have analyzed the market forces affecting U.S. Healthcare in 2014, and outlined forward-thinking insight for each major market driver in a new Executive Briefing. Healthcare reform, which touched every part of the nation's healthcare industry in 2013, will remain at the core of continuing, unparalleled change throughout 2014.

Decision Resources Group's newest Executive Briefing, entitled "2014 In Focus: Seven Market Drivers to Watch in U.S. Managed Markets," discusses seven key market drivers that will force further evolution of the U.S. healthcare industry:

* Telehealth and telemedicine capabilities will expand to provide routine care in rural or underserved areas.
* Pressure from hospitals and providers, as well as the enticing federal match, will drive more states to expand Medicaid.
* Star ratings will take on even more prominence, as the average rating for all Medicare Advantage plans increases.
* Accountable Care Organizations (ACOs) will consolidate to form "Super ACOs."
* Prospective bundled payments, with their potential for cost savings, will be pushed by payers.
* More rural area physicians will seek hospital employment to share risk, access resources and avoid burnout.

The full Executive Briefing can be downloaded here.

Quotes:

Ric Gross, Senior Analyst for Decision Resources Group, said: "The question of whether to expand Medicaid is one of the key decisions states face in 2014. It impacts all players in the industry, but hospitals have the most to lose. Hospitals in non-expansion states are in the awkward position of continuing to treat large numbers of uninsured while receiving fewer dollars for charity care. In states that have expanded Medicaid, managed care plans have the potential to access significantly larger numbers of covered lives. For example, LA Care and Health Net in California are both positioned well to gain lives, while in Ohio, local players CareSource and Paramount Health could be big winners."

Renee Burnham, Director of Market Access Insights for Decision Resources Group, adds: "Members of Congress negotiated a framework to end the way physicians have been paid for Medicare since 1997, in what would create a shift toward quality-based reimbursement by 2018. State lawmakers that have not expanded Medicaid have another year to change their minds before significant cuts to disproportionate share hospital payments occur. Organizations that can poise their resources to cater to population-based health and tightly coordinated care will see a wealth of new opportunities to capture lives, market share and cost savings."

About Decision Resources Group

Decision Resources Group offers best-in-class, high-value information and insights on critical issues within the healthcare industry. DRG insights and analysis on the U.S. managed care market are powered by HealthLeaders-InterStudy. Clients rely on this analysis and data to make informed decisions. Find out more at www.hl-isy.com and www.DecisionResourcesGroup.com.

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