Here are the five trends addressed in the article:
1. Ms. DeVore predicts ACA repeal will be forthcoming, but there are several proposals from Republican lawmakers and think tanks for its replacement. If lawmakers aren’t able to settle on a solid plan, insurance companies will have difficulty deciding whether to participate in exchanges and setting rates and premiums. The replacement will likely feature customization and encourage state-led innovation.
2. Alternative payment models to promote value-based care are likely to stay, according to Ms. DeVore. The ACA replacement could target physician-led approaches for expansion or be turned over to the private sector, but Ms. DeVore thinks Republicans will build on the current system as well as create new options for greater physician choice.
3. The ACA replacement will likely give states more control over the Medicaid expansion and promote innovation for care delivery to Medicaid recipients. Ms. DeVore sees more providers creating provider-sponsored, Medicaid managed health plans contracting with the states and aligning financial risk with performance.
4. As high pharmaceutical drug costs remain an issue, Ms. DeVore expects Congress and states to focus on “closing loopholes and market anomalies” that prevent competitive pricing instead of price controls. There could be legislation fast tracking new generic drug applications and more cases addressing anti-competitiveness in the field.
5. More consumers are exposed to direct healthcare costs with health savings accounts and high deductibles, and laws protecting patients against “surprise billing” have passed in a four states. Five states have healthcare cost comparison websites and transparency could become a major factor in healthcare going forward.
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