In the News: July 6–12
Sg2 is dedicated to helping our clients interpret the latest news and trends in health care. Below you’ll find our analysis of this week’s key industry headlines, along with links to related Sg2 resources.
Narrow Networks May Limit Access to High-Quality Cancer Care
A Journal of Clinical Oncology study examined narrow provider networks offered on the 2014 individual insurance exchanges in markets with National Cancer Institute (NCI)–Designated Cancer Centers, finding that narrower provider networks had a higher likelihood of excluding oncologists affiliated with one of the 69 NCI-Designated Centers, which are associated with higher-quality care and lower-mortality outcomes.
Changing market forces (eg, ongoing uncertainty in the individual insurance exchanges, narrow provider networks) are prompting providers to maintain their relevancy in their local market. Sg2 believes providers should focus on the fundamental factors that underpin their relevancy to local market payers, partners and consumers. For further insights on remaining relevant in your market amid uncertainty, read the January 2016 Sg2 Letter: The Fight for Market Relevance.
End-of-Life Care Patterns Evolve
A Health Affairs article identifies 3 key trends in end-of-life care: (1) increasing diversity in primary diagnoses, (2) an increase in comorbidity and illness, and (3) shifts in patterns of care and sites of death. As the patient population and care patterns for palliative care patients continue to evolve, it is crucial for health care organizations to provide accessible options to deliver high-quality care.
Sg2 experts highlight outpatient palliative care as a strategic opportunity to provide continuity of care from the inpatient to the outpatient setting. To learn more about best practice models for outpatient palliative care, read the Sg2 FAQ: Community-Based Palliative Care.
Growth Continues Across Alternative Payment Models
As a recent Health Affairs article highlights, participation continues to grow across alternative payment models. The authors identified 923 active public and private accountable care organizations (ACOs), covering 32 million lives in 2017. Beyond ACOs, the authors provide a snapshot of current participation in CMS payment models and the future outlook of payment reform.
While the pace at which US health care markets are becoming “accountability ready” is accelerating, the evolution varies widely across individual markets and institutions. Provider system leadership teams must anticipate the tipping points for value-based care and devise and accurately time their strategic response. To learn more, read the Sg2 Report: The Race to Risk—Tracking Markets’ Evolution Toward Value-Based Care, which categorizes the current risk readiness of hundreds of markets nationwide and delves into key trends to project future market evolution.