When we look back at healthcare news from 2016, what will we remember? Uncertainty, anxiety, and continued pressure on frontline providers.
Here are some of the stories that roiled the healthcare industry this year — with links to athenaInsight's related coverage.
Fear of Zika
The mosquito-borne virus, which can cause severe birth defects, reached crisis proportions in Central and South America last summer, and caused deep anxiety around the Olympics in Brazil. Whether it would spread to the United States was an open question for much of the summer.
Then, the first positive report came out of Florida.
athenaInsight tracked Zika testing across Florida and the U.S. during the height of the season — and found that, at one point, more than 600 Zika tests were administered in a week on the athenahealth national network — more than half of them from providers in Florida. It was a sign of anxiety for an epidemic that, thankfully, never materialized — though public health officials are still on alert as winter travelers return from the Caribbean.
In its MACRA final rule, announced this fall, the Centers for Medicare and Medicaid Services held firm to its commitment to fully implement the value-based payment program in future years. The agency gave assurance that it would leave no providers behind, so long as they make the effort to participate in this massive shift in payment models.
Eventually, though, everyone will be expected to make the shift to value-based care — which could become especially onerous for independent physicians who don't have the scale to succeed under value. Here's an infographic guide to the MACRA basics — and a recommendation for health organizations from Stephanie Zaremba, athenahealth's director of government affairs.
The opioid crisis
The continued impact of the opioid epidemic on American lives was of the most tragic stories of 2016. Opioid-related emergency department visits nationwide have almost doubled since 2005, abuse of the drug costs the country $20 billion annually, and according to the CDC, opioid-related deaths now outnumber deaths from firearms in the United States.
athenaInsight spent the year digging into data from the athenahealth network to highlight prescribing patterns, policy trends, and innovative, data-driven clinical practices. Here's an overview of our ongoing coverage, which ranged from an infographic about the effects of opioid regulations to a story about an orthopedic practice that reduced prescribing rates without government intervention.
The problem of physician burnout
Physicians working 30 hours straight without sleep, showing signs of high rates of depression, and ultimately a large majority are now solidly disengaged from their chosen profession — with a particular burden on primary care physicians.
Our opinion writers weighed in on the problem and highlighted potential solutions. Rushika Fernandopulle, CEO of Iora Health, called out the problem of viewing healthcare through a transactional lens. And Steve Adelman, M.D., a psychiatrist and director of Physician Health Services, Inc., lamented that in “the same way mining is unsafe for workers, healthcare is becoming an unsafe work environment" — and called for increased support for the work of primary care providers.
The passage of 21st Century Cures
Though it had been in the works since 2014, the passage of the 21st Century Cures Act seemed to come out of the blue in mid-December. The $6.3 billion package has a lot inside: It funds the National Institutes of Health, reforms the FDA drug and device review process, provides an update to mental healthcare policy, dedicates $1 billion in funding for opioid prevention and treatment programs, and grants $1.8 billion to the cancer initiative renamed for Beau Biden.
Deep in the bill were some important provisions related to health IT, including language to spur on interoperability amongst electronic health reacords — something provider organizations need in order to succeed under value-based reimbursement. It's a promising sign, wrote athenahealth technology standards and policy manager Greg Carey, that the bill allows this effort to come from the private sector, and not from a framework mandated by the Office of the National Coordinator for Health Information Technology.
The Trump era begins
The biggest unknown, heading into 2017, is the future of the Affordable Care Act. As President-elect Donald Trump takes office, and the Republican Party controls the House and Senate, many assume the law will be repealed. But it's truly anybody's guess as to what will happen next.
The ACA has been credited with expanding coverage to nearly 20 million Americans and reducing the uninsured rate to about 9 percent in 2016. Despite that success, healthcare costs are still increasing: Two weeks before the election, the Department of Health and Human Services announced that premiums for individual-market plans on the federal exchange would rise by 22 percent on average across the country. That should be no surprise, wrote Paul Levy, former CEO of Beth Israel Deaconess Medical Center: The law focused on access and choice, and didn't create enough government structures or market incentives to control costs.
Will the law be repealed and replaced entirely, or will it merely be amended and improved upon to deal with rising costs now that the access issue has been solved for? Time will tell.
James Furbush is the managing editor of athenaInsight.