The continues its slow journey towards providing better outcomes and ensuring equitable opportunities for healthcare to all, whether through bottom up market innovations or top-down government regulations. The unstable political landscape continues to be the main challenge facing the US healthcare system. Another challenge is the multitude of players within the healthcare system having competing interests, such as hospitals, doctors, payers, pharmaceuticals, and governments. This paper touches on the developments in the healthcare system and the current active debates within it.
It sheds light on some of the market innovations and trends for the coming period and how they may contribute to the overall healthcare system as well as the continued political debate, and legal challenges, around the Affordable Care Act, which was passed a decade ago.
The United States healthcare system continues to struggle under increasing costs, relatively poorer outcomes, and inequitable opportunities to access healthcare. The changing dynamics of healthcare financing, whether through public or private funding, mixed with the competing interests of the players in the system, create complex dynamics under which change becomes slow and difficult.
Yet change continues to happen. Technological or entrepreneurial innovations on the ground level continue to drive the market forward, while government regulations and policies continue to play a critical role in setting the larger playing field. The University of Mississippi Medical Center (UMMC) TelEmergency network stands as a shining example of the work intrapreneurs like Kristi Henderson can achieve.
The TelEmergency network was established to link the rural critical care centers in Mississippi to the advanced UMMC in Jackson to reduce the transfer costs rural patients incurred and to reduce the load on UMMC.
Introducing the telehealth network program was not a simple task. Kristi Henderson faced financial and regulatory challenges in every step, but more difficult were the people and processes changes needed to be made to make the program a success. The UMMC TelEmergency network program was named one of only two telehealth centers of excellence in the country and continues to stand as a successful model to be replicated . Effective bottom-up changes, such as the TelEmergency network, are a critical ingredient in changing the US healthcare system. Kristi Henderson had to lobby Mississippi state legislatures to enact legislation that requires payers to pay an equal fee for telehealth consults as is paid for face-to-face services.
On the national level, consumers are beginning to play a larger role in changing the landscape of healthcare services. New generations of healthcare consumers are pushing for more convenience and ease of access, and are seeking reduced costs services. Hospitals and health systems are beginning to adjust to meet these demands and are seeking to engage consumers more actively. This focus on consumer engagement and convenience may finally begin an era of consumer-driven healthcare. The current main players, including government, payers, and providers, have been the core drivers of the system thus far.
The Affordable Care Act (ACA), passed by Congress a decade ago, still remains at the forefront of the healthcare debate. Challenges to the law in Congress and the courts still continue, although the final outcome still remains uncertain. The ACA succeeded in reducing the number of uninsured Americans and has pushed to improve access and delivery to healthcare. More important for the healthcare policy future is the changing public opinion on the government role in healthcare. The percentage of Americans who see a larger role for government in ensuring healthcare coverage has increased from 42% in 2013 to 60% in 2017.