Ten Health Care Forecasts 2012

The most reliable way to forecast the future is to try to understand the present.

John Naisbitt

Weather forecast for tonight: dark.

George Carlin

December 29, 2011 - Here we are at the end of the year. It is time for my annual health care forecast.

• One, it all depends on the election - If we have a Democratic President and Congress, it’s Obamacare, full-speed ahead. If Obama wins and has a Republican Senate, it’s slow go – with reduced funding and slow implementation. If its Republican government at all levels, it’s Obamacare repeal and time for alternative plan.

• Two, it depends on the June Supreme Court announcement of its decision on the individual mandate, the whole plan, and Medicaid implementation. My forecast is that the mandate will be overturned 5-4.

• Three, it’s beginning to look like Romney. I think he stands a 50:50 chance of beating Obama. If he does, each state may have its own approach to care , can handle its Medicaid population as it sees fit, and can have its individual mandate if it wants.

• Four, hospitals, doctors, and health plan will continue to rapidly consolidate, with some owning each other, with dominance of local and regional markets, with negotiating power, with higher prices, and with anti-trust issues.

• Five, as new revenue models offering “free” EHRs, computing off-site in “the Cloud,” and hand-holding facilitating “meaningful use” bonuses, EHR use will take off like wild-fire.

• Six, more and more physicians will exit from practices depending on 3rd party revenues and will go to concierge, retainer, and direct-cash practices.

• Seven, hospitals, physicians, and insurers will enter retail markets to snare business from individual consumers, who will become an increasingly larger part of insurance market.

• Eight, primary care shortages will grow, concern about their future will escalate, and more nurses and physician assistants will be trained and recruited to fill the gap.

• Nine, accountable care organizations will be very much in the news as the ten “pioneer” ACOs hit the streets on January 1, 2012, and other providers wait and see if outcomes improve and savings eventuate.

• Ten, venture capitalists, sensing openings in the vast health care industry, will be actively searching to find entrepreneurs, including physicians, who have marketable ideas on how to make care cheaper, better, more convenient, and more “disruptive,” i.e., useable for less sophisticated folk below the specialist level.

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