THINK TANK | Looking Back to Inform Our Future

Thoughts from Foothold Technology’s Senior Advisor

It is hard to believe 2018 is already well underway. I have never been one to dwell on the past, but a little review before thinking about the future helps keep us grounded. Reflecting on 2017, I remember the turmoil that played out in the world of healthcare. This past year was filled with action and mobilization to preserve the progress that had been made to provide adequate and equal access to quality healthcare for those most in need. At the government level, it was a year of unprecedented State Plan revisions and Waiver activities which resulted in major changes across the country, most apparent in program service delivery models and approaches to funding.

In 2017, discussions on topics like quality measures, integrated care, interoperability, alternative payment models–and the individual’s role in managing their own healthcare experience–moved from behind-the-scenes, industry-specific settings to a wider national audience. These themes have become more common among government, providers, and people receiving services. With all the ups and downs of 2017, and changes on the horizon, here are a couple of reflections I’d like to share:

1. For those in the healthcare arena, it’s important to remember the sun will rise every morning. Regardless of the noise around you, you are expected to, and will continue to, provide the best possible care to the individuals you serve.
2. I believe the most empowering takeaway from the year was seeing that although single voices can often get lost in the wind, voices joined together can shift the wind to create movement in a more positive direction. This became very apparent when we witnessed the strength of many voices opposing the threats to the additional benefits and growth we achieved as a result of the Affordable Care Act.

So what do we have to look forward to in the future? We can predict there will be new battles in Congress and within State legislative bodies regarding Medicaid and the Affordable Care Act. We also know many states are awaiting approval of their State Plan Amendments or Waivers which will affect service providers and individuals. We can be sure the continued shift from government funded grant and fee-for-service models to independently operated Managed Care systems will continue in 2018. In addition, there are three areas we should all keep our eyes on:

1. The first trend is the concept of Value-Based Payments. It is going to become more of a reality for more providers in the coming year. I also believe it will have a greater impact on how your agency operates. Although Value-Based Payments and alternative payment models have been topics of discussion for the past few years, the Federal Government has not wavered in its plans to shift the vast majority of federal reimbursement to a value-based payment structure. For some agencies, this is going to be a major shift in how to approach care, while other agencies will simply need some tweaking of models and a change here or there in processes. Regardless, it will require all agencies to find and use more efficiencies in their operations and will warrant the use of data in very strategic ways. To be successful, the use of data will need to shift from supporting decisions to driving decisions. How you use your data captured in an electronic record or Electronic Health Record (EHR) like AWARDS will be key.
2. I suspect we’ll see additional headlines about Social Determinants of Health. This concept has been creeping its way into the healthcare scene for many years. The concept of Social Determinants of Health is often misinterpreted and misunderstood. To learn more about the concepts, I recommend this discussion paper by Sanne Magnan. Said simply, knowing the social and physical conditions of one’s environment and then addressing those conditions is the only way we can start to deal with the inequalities of today’s healthcare system. Nationally, we are seeing a greater shift and pivot to a true population health approach, one focused on health equality. A few years ago Foothold Technology hosted Dr. Rishi Manchanda to speak with our customers at our annual User’s Conference. As an “upstreamist” he explained how social and environmental factors of our everyday lives can affect health.
3. The opioid epidemic. This crisis is not going away and it’s only getting worse. SAMSHA has shared some important tools and guidance and other national associations like NASADAD are also providing ongoing updates on the crisis. Many Foothold Technology partners and customers are actively involved with supporting individuals and families dealing with this epidemic in their own communities. I’m grateful to represent Foothold Technology on a national EHR association taskforce to help examine how electronic health records can support providers in addressing this epidemic. I’ll be sharing updates from the taskforce as we move along this path together.

I’m sure you and your agency will experience both stress and opportunity in the coming months, but if you can remember to base your decision-making by using data and remain focused on the needs of the individual, you will be successful. Lean on each other, learn from each other. And, as we move forward, please feel free to use me as a resource.