With less than a week until the deadline to buy individual health insurance that begins Jan. 1, experts say sign-ups are on course to hit or exceed the Obama administration's projection of about 9 million enrollees in 2015. Several weeks into the second year of the Affordable Care Act's insurance exchanges, about 1.5 million people have enrolled in coverage, according to data from state and federal exchanges. As of Dec. 5, almost 1.4 million had enrolled through the federal insurance exchange, which serves 37 states, the Centers for Medicare & Medicaid Services reported Wednesday.
On-demand. One-stop shopping. What you need, when you need it. These phrases are more than just slogans. They are today's models for how leading companies are winning customers and revolutionizing the marketplace.
Businesses that provide a wide array of high-quality products easily, quickly—if not instantaneously—and at reasonable price points are rising to the top. These companies will stay at the top if they can nimbly respond to ongoing changes in their respective industries, including technological innovation and customer needs and wants. This can certainly be said for the healthcare industry.
Inpatient stays are dropping while outpatient visits are on the rise thanks to medical advances and new reimbursement rules and payment models. This is good news. Outpatient care is being provided efficiently, economically, and thanks to new technology, safely.
Urgent care centers are one of the fastest-growing segments in the ambulatory sector. For those who are well-positioned, there is huge potential as millions of Americans newly insured under the Affordable Care Act, many on high-deductible plans, look for less expensive primary care options. These centers are also a critical part of the solution for managing our nation's healthcare costs. Nineteen percent of healthcare leaders responding to the HealthLeaders Media Ambulatory/Outpatient Care Survey expect to acquire urgent care centers to expand their primary care network, and 18% will partner with urgent care centers. In addition, 93% of providers expect ambulatory/outpatient care net patient revenue for their organization to grow within three years, with 56% estimating that growth at 10% or more.
What does all of this mean? To thrive amidst all this change, providers must move away from the outdated hospital-centric care model and evolve into integrated healthcare networks. And, indeed, the survey indicates that within three years, the ratio of capital budget investment for new program development will be dominated by ambulatory/outpatient care spending (64%) rather than inpatient acute care (36%).
At Jupiter Medical Center, we are offering a wider and wider array of services and operating as a regional system of integrated care. We will open our second urgent care facility in early 2015 and in the coming years will expand to five centers. We have made great strides in strengthening our entire ambulatory care network and creating new opportunities for effective physician alignment.
As we succeed at treating patients in more accessible settings, we have to be strategic in our response to the downward trend in inpatient volume. At Jupiter Medical Center we've diversified our inpatient services and increased the intensity of care we provide on an inpatient basis. Our strategic vision is to create a set of world-class clinical services, and develop a network of facilities and access points within our community.
Reforms to payment and changes in delivery models are driven by a common goal: to provide better coordinated care, improved outcomes, and lower costs. Delivering the right care in the right place at the right time—that's what today's healthcare is all about.
As healthcare delivery continues to evolve and change, those who both facilitate and respond to this change will rise (and remain) at the top.
John D. Couris
President and CEO
Jupiter (Florida) Medical Center
Lead Advisor for this Intelligence Report
Obamacare customers shook off their Thanksgiving food comas last week and began signing up at a much quicker pace on HealthCare.gov, which has now sold 1.38 million insurance plans. The upsurge in enrollment comes in advance of next Monday's deadline to sign up for health insurance that goes into effect by Jan. 1, 2015. That federal Obamacare marketplace had 618,548 people pick an insurance plan from Nov. 29 through last Friday, the third week of the ongoing open enrollment season, according to data released Wednesday by federal officials.
The health insurance industry is firing back at Republicans' decision to cut government payments that could help plans struggling under the healthcare law. America's Health Insurance Plans (AHIP) blasted legislation changing ObamaCare's "risk corridors" program and predicted that it would raise healthcare costs for families. "American budgets are already strained by healthcare costs, and this change will lead to higher premiums for consumers and make it more difficult to achieve affordability," said Clare Krusing, AHIP spokeswoman. "Our focus should be on changes to the law that will lower costs — like repealing the health insurance tax — not those that drive premiums higher."
The federal government has recovered nearly $5 billion in misspent healthcare dollars over the last fiscal year, about 15 percent less than the same period last year. Investigations within the Department of Health and Human Services (HHS) led to roughly 1,000 criminal charges and 500 civil charges, according to a report Wednesday. The department also barred more than 4,000 people from federal healthcare programs. The wasted money was found across 100 departments in HHS, which is one of the largest spenders of federal dollars. It is also the government's largest distributor of grants.
When Anna Duleep went shopping recently for 2015 health coverage on the Connecticut insurance exchange, she was pleasantly surprised to find a less expensive plan. To get the savings, the substitute math teacher had to change from for-profit giant Anthem Blue Cross and Blue Shield to a fledgling carrier she'd never heard of. Still, Duleep, 37, liked saving $10 on her monthly premium of about $400 and knowing that her new plan, HealthyCT, is a nonprofit governed by consumers. She also liked that all her doctors participate. "I just figured, 'why not change?'" she said.