ERDMAN E-News – Healthcare Trends



Q&A: Lessons for Organizations Interested in Community Paramedicine
Advisory Board, January 14, 2016


In light of widespread efforts among hospitals and health systems to implement population health strategies, community health initiatives will be increasingly affecting service line offerings and deployment strategies. Community paramedicine (CP) is an example that has gotten attention in recent months.  According to the California Emergency Medical Services Authority, CP is a new and evolving model of community-based healthcare in which paramedics function outside their customary emergency response and transport roles in ways that facilitate more appropriate use of emergency care resources and/or enhance access to primary care for medically underserved populations.   CP programs vary in nature because they are tailored around community needs and relationships between emergency medical services (EMS) and other health care and social service providers.

The “Resource Access Program,”  implemented by the City of San Diego, has paramedics meet with identified frequent ED utilizers at home and connects them with a variety of resources such as homeless shelters and food pantries. In California, state mandates that requires EMS to transport 911 patients to the hospital can be lifted for approved participants in a community paramedicine program to divert them to other settings or follow up post-discharge.

Whether it’s a call for spaces within facilities to accommodate community partners, increased coordination with city and regional development planners, or referrals from providers for wellness and social services outside of health systems, community health coordination is a key part reducing costs in population-based care.

An Overview of Continued Healthcare Trends
ERDMAN, April 2016


Successful health systems in the coming few years will being paying special attention to leveraging partnerships and creating efficiency as they transition to value-based care. Beyond that, patients must be addressed as increasingly savvy, motivated consumers with options to seek health services through competitors. Special attention to a consistent patient experience and convenient access to care will differentiate successful healthcare organizations.  Look for the following trends to continue and impact your marketspace.

Mergers and Acquisitions
Healthcare organization merger and acquisition activity show no sign of letting up in 2016 as providers seek to access the needed information technology infrastructure and provide value-based care, two objectives that are best achieved at scale. Improving profitability and staying efficient in light of shrinking margins is crucial for health systems. Indeed for rural and community hospitals, partnering on some level is increasingly being seen as a key to survival. While some M&A deals are facing scrutiny, it has been suggested that vertical integration via payors and medical groups may be one way of achieving the volume being sought. (Kurt Salmon, 2015) All of the aforementioned healthcare organization types are watching which types of deals are being allowed by regulatory agencies at the state and federal level and we can expect the precedents established to inspire further M&A activity in the coming few years. As market disruptors continue to emerge, we can also expect to see new types of partnerships and affiliations. Wearable technology providers and beacon technology that will aid patients in facilities are examples of partners that are entering the healthcare market.

The Continuum of Care
The continuum of care will continue to be coordinated by health systems seeking to address population health, beginning with employed physician groups. Greater focus on system branding, the patient experience, and competition with retail providers will spur greater standardization of care across the services and facilities that are being acquired. Also across the continuum, post-acute care will continue to be integrated, with behavioral health and senior living and skilled nursing partners being evaluated for long-term partnerships with health systems. Behavioral health holds special importance in the care continuum, due to greater funding, large unmet patient needs, and greater recent attention to the need to treat mental health as part of achieving wellness for both employee and newly insured populations. Conversely, we can expect specific hospitals to shed service lines that are creating drags on efficiency and bottom lines.

Underutilized Inpatient Capacity
Strategizing across the health system in regard to service deployment will also have an effect on the newer facilities that are opening. We can expect replacement projects to be closely scrutinized relative to any new inpatient capacity that is being created. The emergence of bedless and microhospitals with few inpatient beds and greater observation capacity is one expected response to the current underutilized capacity that exists. Specialty centers at highly populated centers, community hospitals, and then hospitals with observation capacity to treat emergency and scheduled surgery patients will be strategically deployed to create highly coordinated systems of care. Further, viewing the patient as a consumer and providing convenient wellness services and retail-style points of car will help systems shore up market share and also provide downstream care needed to prevent costly inpatient episodes of care that may affect value-based care reimbursements.

Virtual Care
Finally, virtual care and patient facing technologies will continue to explode in the next year and beyond. The International Data Corporation reports that clinical mobility spending was forecasted to grow from $2.9B in 2011 to $5.4B in 2016 at a compound growth rate of 12.7%. Patients are very open to the concept of virtual visits, particularly in the millennial demographic. Patients are also increasingly willing to share their own data with their doctors, gleaned from wearable and smartphone devices, which is occurring simultaneously with a greater number of wearable devices being approved by the Food and Drug Administration for providers to use for patient monitoring.


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