2011 Predictions: MU Goes Tactical, ACO Strategic

In the Healthcare IT (HIT) market, 2010 was the year of meaningful use (MU). Healthcare organizations (HCOs) of all sizes developed plans, began making IT modifications and began adopting the technology they needed to meet Stage One MU requirements and subsequently receive incentive payments, some of which began being disbursed in late 2010. As we move into 2011, we will continue to see an extreme amount of activity and turmoil in the HIT market with the biggest elephant in the room being what will actually happen to the healthcare reform bill that was passed at the beginning of 2010.

Against this backdrop, we once again have prepared our annual top ten (actually we have 11 for after all it is 2011) predictions for 2011 which are as follows:

1) MU Initiatives Move to Tactical. Meaningful use is no longer of great concern to the executive suite, well except for maybe the CIO and his counterpart, CMIO. It has moved to the tactical implementation stage for enterprises insuring that systems are in place, clinicians trained and MU requirements met to reap incentive payments.

2) C-Suite Strategy Focuses on New Payment Models. Despite the turmoil swirling around healthcare reform, one thing that is unlikely to change is the move to bundled payment models and the migration to Accountable Care Organizations (ACOs). The train has already left the station on this one and this train does not have reverse. The repercussions of these new payment models have the potential to make or break a HCO and the C-suite knows this thus are focusing all of their attention on what is the most appropriate strategy for their organization. Strategy service firms such as CSC, Dell, Deloitte, PWC, etc. are going to make out like bandits.

3) RCM & Charge Capture Systems Require Overhaul. Moving from a fee for service (FFS) model to a bundled payment model will require a number of changes in current HIT systems but software that addresses payment, Revenue Cycle Management and Charge Capture software, are on the front line. Vendors providing these solutions will need to invest heavily in R&D in response. This will likely push some of the weaker players out of the market are into the hands of an acquirer for relatively low multiples.

4) Mergers & Acquisitions Continue Unabated. We had this prediction down for 2010 and it certainly came true with one of the more recent mind-blowing acquisitions/valuations that being Aetna

4 replies »

  1. Because David Cameron’s Big Society idea is apparently falling apart already because of government cuts, he’s lining it up to get government funding. I mean, why make the cuts in the first place?

  2. John,
    Excellent thoughts. And, contrary to some political mindsets, we do not believe that healthcare reform 2010 will dramatically reduce healthcare costs, increase access, or improve quality for at least ten reasons:
    1. Doctors and their patients voraciously use new technologies and pharmaceuticals.
    2. Quality is hard to define and most medical mistakes are due to human frailty.
    3. Cloud computing, eMRs and internet grid collaboration for all stakeholders is exploding.
    4. Traditional top-down leadership and medical bureaucracy is collapsing.
    5. Transparent provider fees and healthcare institutional pricing promotes accountability.
    6. Consumer directed health plans and medical tourism a growing trend.
    7. Abandoning non-profitable medical treatments is anathema to practitioners.
    8. Aging baby-boomer populations and demographics are against it.
    9. A perfectly competitive or capitalistic healthcare free-market does not exist.
    10. The push for continuous medical research and development is in our DNA.
    Above all else, medicine is a uniquely personal experience, and society is not ready for the brutal efficiencies of rationing, or an intrusive governmental system.
    On the other hand, we are pragmatic and realize that medical providers of all independent degree designations (allopathic, osteopathic, podiatric physicians, dentists, optometrists, chiropractors, psychologists, and nurse practitioners), must learn to better compete, collaborate and appropriately use health information technology in the next decade.
    Ultimately – physicians that are clinically, technically and managerially responsible will be future leaders of medicine.
    Hope R. Hetico RN MHA
    [Managing Editor]