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Healthcare Uncertainties to Intensify in 2014

John Commins, for HealthLeaders Media, January 2, 2014

Many providers who've been on the forefront of the movement away from fee-for-service may find themselves at a disadvantage with payers as healthcare transitions into value-based payment models such as bundled payments and gain sharing, says one analyst.

Uncertainty and rapid change were hallmarks of the healthcare landscape in 2013, and there is no indication that things will be much different in 2014. In all probability, many analysts believe this historic transitional period could accelerate and get even rockier as the healthcare sector continues to undergo profound changes in how healthcare is delivered and paid for.

Curt Whelan, managing director at Huron Healthcare consultants, says that many providers who've been on the forefront of the movement away from fee-for-service may find themselves at a disadvantage with payers as the healthcare sector transitions into value-based payment models such as bundled payments and gain sharing.

"It is going to be more of the same in '14 than it was in '13," Whelan says. "The key questions are how much traction are the exchanges going to get and how much more robust and aggressive are the payers going to get on not allowing even the bigger market share leaders to get markedly more fees? If they can't at least get enough, because they are still cost-shifting, expenses are going to still outpace revenues and that is going to pinch margins. Success in this market is so much more difficult because you have to find the pockets of growth in a non-growth revenue market and go after them."

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