In , total spending on health amounted to approximately In , for the first time in our history, there were more seniors than children in Canada. The fact that more Canadians are living longer and healthier than ever before is surely a towering achievement for our society, but it presents some economic challenges. On average, it costs more to provide health care for older people. In addition, some provinces the Atlantic provinces, Quebec and British Columbia in particular are aging faster than the others.
This means that these provinces, some of which face the prospects of very modest economic growth, will be even more challenged to keep up with increasing health costs in the coming years. Canadians should have a health-care system that is truly worthy of their confidence and trust. There are four clear steps that could be taken to achieve this:.
Health-care stakeholders in Canada still function in silos. Hospitals, primary care, social care, home care and long-term care all function as entities unto themselves. There is poor information sharing and a general failure to serve common patients in a coordinated way. Ensuring that the patient is at the centre — regardless of where or by whom they are being served — will lead to better, safer, more effective and less expensive care.
Investments in information systems will be key to the success of these efforts. Those who serve Canadians for their health-care needs need to transition to accountability models focused on outcomes rather than outputs. Quality and effectiveness should be rewarded rather than the amount of service provided. Alignment of professional, patient and system goals ensures that everyone is pulling their oars in the same direction.
A plan that seeks health equity would distribute its public investment across a broader range of services.
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A push for universal pharmacare, for example, is currently under way in Canada. Better integration of health and social services would also serve to address more effectively the social determinants of health. Bold leadership from both government and the health sector is essential to bridge the gaps and break down the barriers that have entrenched the status quo. Canadians need to accept that seeking improvements and change does not mean sacrificing the noble ideals on which our system was founded. On the contrary, we must change to honour and maintain those ideals.
Our leaders should not be afraid to set aspirational goals. A contemporary Robinsonade — York, York. The polar oceans and global climate — Milton Keynes, Buckinghamshire. Edition: Available editions United Kingdom. Our rapidly aging society will place even greater pressure on the already expensive and mediocre Canadian health-care system.
Chris Simpson , David M. Insurers are taking on more healthcare costs than in prior years while receiving fewer premiums from healthier populations. For instance, according to a Blue Cross Blue Shield report , in and , the payer saw a rise in the number of enrollees with conditions like hypertension, diabetes, depression, coronary artery disease, human immunodeficiency virus HIV and Hepatitis C.
Removing the cap between young and old or at least expanding it to five or six times the premium cost could go a long way to bringing in younger adults to purchase coverage on the exchanges and providing payers with a low-risk pool, some stakeholders believe.
Payers and policymakers are seeking broader enrollment and more continuous enrollment in order to stabilize the market and keep payers profitable. These are shared goals between insurers and the Obama administration. At the end of , UnitedHealthcare announced it would drop out of the ACA health insurance exchanges.
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In August , Aetna also decided to pull back from a number of the regions it was serving through the health insurance exchanges. Instead of selling health plans in counties the payer had previously been operating, Aetna will be serving only counties in Payers have started to raise their premiums to compensate for the challenges inherent in the health insurance exchange environment. In response, patients are trying to choose plans that offer the lowest possible monthly premiums, even though these reduced costs are balanced by higher out-of-pocket deductibles payable when they receive care.
What we have are very high-deductible policies that are forcing people to pay for an awful lot of care out of pocket. The average premium rate on the exchanges rose by 2 percent in , 7. Medicaid has also been affected by the ACA. Thanks to the Supreme Court ruling that made state Medicaid expansion optional , a large number of states have declined federal funding to expand their low-income insurance programs. Non-expansion states fear that the extra costs would strain their budgets.
However, Medicaid expansion may actually produce financial benefits for state governments. Medicaid costs rose 6. And states may be able to pay for Medicaid expansion out of existing programs, like free clinics, that would be reduced or eliminated if more low-income patients had insurance coverage, added a report from the Center on Budget and Policy Priorities.
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Medicaid expansion in more states may also help to address the coverage gap produced by the ACA. While the health insurance exchanges offer tax subsidies for some low-income families, those that were meant to be eligible for Medicaid under the ACA do not currently receive financial aid. This gap is problematic for commercial payers, as well.
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If patients who are supposed to be eligible for Medicaid sign up for plans on the insurance exchanges instead, commercial payers will be responsible for paying for their care. However, these individuals may have greater health spending needs than the rest of the population, which would put greater financial pressures on payers. According to the report from the Center on Budget and Policy Priorities, it would behoove payers to align with advocates and urge the remaining 19 states to expand their Medicaid programs.
When considering some of the difficulties of operating under the Affordable Care Act, healthcare payers can take steps to succeed in the new environment the ACA brought. First, commercial payers could be more competitive in the public marketplace by being the first to meet consumer needs and securing loyalty from their customers. One method for improving patient satisfaction is to invest in price transparency and the development of user-friendly payment and price comparison strategies.
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Where does this leave providers? This session will discuss how strategic partnerships between retail healthcare and providers can improve overall patient care. How can you ease the bumps of disruption, mergers and demands of new policies? Hear tips on how to lead effective change, while navigating an organization through disruption and build relationships across external organizations.
Given the shifting environment of payment models, technology and business relationships across the healthcare ecosystem, what are key factors to focus on to thrive in the current and future healthcare reality. Insight on how to separate hype from reality in technology and business model adoption and impact on healthcare delivery Examples of areas of investment and organizational change to succeed in an increasingly competitive healthcare environment Framework of where some organizations are lagging and what the impact might be for slow followers.
Zone 1. Zone 2. Payors and Providers strive for the same goals — to encourage their customers to lead healthier lives while providing the best possible experience for their customers members or patients.
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The intentions to provide a good Patient Experience can be negated by an interruption in the life-cycle such as a denied or delayed claim. This interactive session will examine the claims process from both payor and provider viewpoints. Success factors — tips on how payers can think like providers, and providers can think like payers Insight on technology and processes to make claims more accurate and expedient. Zone 3. We are on the edge of a digital revolution allowing us to deliver care to patients in their own homes. However, while this presents a massive opportunity there are significant challenges that must be overcome to provide an integrated technology-supported model of in-home care.
This session will explore the translation of evidenced based, innovative, homecare delivery models for chronic health conditions into a US health system framework. Key Take-Aways: Framework of an innovative and integrated home care delivery model Insight into the challenges in delivering home-based chronic disease care Guide to delivering outcomes in a value based health system Putting the patient first — new approaches to patient engagement and empowerment.
As hospitals, payors, and subspecialty groups continue to merge and expand across the healthcare industry, what is the likely end state we are headed towards? Key Take-Aways: Drivers of consolidation across both payor and provider organizations Examples of the benefits of scale for health systems, payors, members and patients Insight on the challenges these organizations face in achieving the benefits of scale.
Hosted by:. Choose one of the following concurrent sessions:. Tired of admiring the problem? Key Take-Aways: Blueprint specific data elements necessary for population health analytics Identify 3 techniques for making data actionable Metrics to determine successful analytics. Automating and streamlining provider workflow is essential to improving care for patients as well as lowering costs. EHRs are a great starting point to accomplish this, but understanding how to accurately interpret the data and communicate with multiple stakeholders is vital in the clinician workflow process.
http://stuntmomfilm.com/uploads/guam/3767-home-depot-coupon.php As more of the U. Use to date has proven remote care effective at successfully driving better care quality, access and cost across a diverse range of diagnostic and treatment modalities and conditions. Now with critical elements aligned and proof of efficacy in hand, remote care is ready to scale for use as a peer complement to clinical care in new standard of care requirements. Key Take-Aways: Insight on the major challenges to acceptance and adoption of mobile and wearable solutions Examples of how remote care is ready and able to scale for chronic conditions Framework for the greatest impact and highest leverage solutions to these challenges.
Consumer organizations are creating new levels of intimacy with your patients, members and care providers through cloud analytics and cognitive services which threaten your established relationships. Convenience is becoming the new battleground requiring new tools and techniques. Key Take-Aways: Insight on integrated analytic and cognitive services available in the cloud Fresh perspective on solution approaches emerging based on automated communication techniques Examples of ideation resulting in real solutions at the speed of cloud.
Prepayment models and greater financial accountability over a patient population whether capitation or other variations could create the right incentives to support building out additional care programs and capabilities to allow patients to be cared for in more efficient ways. Learn More. In this ever changing cyber risk landscape driven by geo-political and financial trends across the globe, the data that is managed generated, collected, processed and transmitted by healthcare entities, both payers and providers, is a very valuable commodity.