Predictions: 2019 will be "the year of coalitions in health care"

January 2, 2019 Rod Hochman

As we start 2019, Providence St. Joseph Health is gearing up for another big year in health care. What are the key industry trends we’ll be tracking closely? We’ve outlined them in our second annual list of New Year’s predictions.

We’re calling this “the year of coalitions in health care” because we anticipate many diverse organizations will come together to collaborate on key issues. A great example of this is Civica Rx, the not-for-profit coalition that formed last year to address the national crisis around surging drug prices and frequent medication shortages.

Here are our top 10 predictions for the year ahead.



PSJH executives release their annual list of New Year’s predictions.

RENTON, Wash., Jan. 2, 2019 – Disruptive trends that have been building for several years, including momentum around new health care coalitions, will bring significant change to the U.S. health care system in 2019, according to president and CEO Rod Hochman, M.D., and other executives at Providence St. Joseph Health (PSJH), the nation's third largest health system.

"The formation of new coalitions will make 2019 an inflection point in health care. We expect many diverse organizations to come together to collaborate on key issues,” said Dr. Hochman. “We’ve been talking about ‘disruption’ in health care for some time, but 2019 will be the year we see real change that measurably improves health, affordability and transparency.”

PSJH has a track record of accurate predictions for the health care industry. Last year’s top predictions, issued in a news release in January 2018, anticipated a trend in “non-traditional partnerships.” Later that month, Amazon, Berkshire Hathaway and JPMorgan Chase announced the formation of an independent health care company for their employees.  What will be the major health care trends in 2019? Here are PSJH’s top 10 predictions for the year.

1.    Diverse coalitions will form to tackle the toughest issues in health care.

When seven major health care systems, including PSJH, banded together in 2018 to form Civica Rx, a not-for-profit generic drug company to address the national crisis around surging drug prices and shortages, it was a sign of things to come. Watch more nontraditional coalitions among health care organizations and others lift off in 2019 as providers, in particular, assert stronger leadership in areas such as big data, digital innovation and advocacy.

2.    Health system mega-mergers will cool down in 2019.

After several years of high-profile mega-mergers among health systems, there will be a slowdown in 2019 as newly merged organizations focus on integration and delivering quality and value across scale. Smaller alliances, such as the recent partnership between PSJH and Adventist Health in Northern California, will continue to form at the local level, where community partnerships remain critical.

3.    A potential recession will have a significant impact on health care.

If warnings of an economic downturn are realized, the impact on health care will be significant. Hospitals already operate on very narrow margins, and a recession could decrease revenue even further. Downgrades by the ratings agencies are likely, and more hospitals may be forced to close, especially smaller, rural facilities.

4.    In the move to the cloud, data security will be the top concern for providers.

Cloud computing will make it easier for providers to aggregate and leverage data to support more informed clinical decision making and enable predictive analytics in medicine. This fundamental shift will require new partnerships between providers and big tech companies. In these new relationships, providers will serve as leading advocates for ensuring patient data is secure and confidential.

5.    More tech industry talent will join health care.

More tech experts will choose to make the leap to health care to help develop innovative solutions that will improve health and the delivery of care. PSJH has been a leader in recruiting talent from outside industry, including the recent hiring of Microsoft’s B.J. Moore to serve as PSJH’s new chief information officer. Expect more personnel movement from tech to health care in the year ahead.

6.    Traditional provider roles will blur as drugstores, insurers offer direct patient care.

The recent mergers between CVS and Aetna, as well as Cigna and the retail pharmacy Express Scripts, are the latest examples of nontraditional partners coming together to deliver direct patient care. While some consider this a threat to traditional providers, close observers will notice disruption happening in both directions. Providers are also reinventing themselves for the future by expanding into retail, and health and wellness.

7.    The pharmaceutical industry will come under heightened public scrutiny.

With soaring drug prices and frequent shortages, pharmaceutical companies will feel the heat from consumers, legislators and regulators in 2019. They will be scrutinized, oftentimes publicly and aggressively, on the efficacy of new, high cost medications and biologics the industry is promoting and will face tough questions on the role of Big Pharma in the proliferation of opioids.

8.    Homelessness, suicide and opioids will be strategic priorities for improving health.

The social factors that affect health will take on greater strategic significance for the major health systems. Expect providers to ramp up community partnerships that address the nation’s mental health and addiction crisis, which led to an alarming 117,000 deaths in 2017 due to suicide and opioid misuse. Providers will also partner with communities to tackle homelessness with more urgency and invest in affordable long-term housing options, especially for complex patient populations.

9.    Improving quality and reducing costs in the Medicaid program will be a key focus.

Medicaid is a critical program and vital safety net for one in five Americans. Recognizing the important role this program plays for a large population, not-for-profit providers will continue to be a strong voice for preserving Medicaid expansion. Providers will also make it a strategic priority to improve the health of the Medicaid population, which will also help reduce the cost of the program.

10.     Uncertainty and volatility in health care policy and regulation will continue.

After a federal judge in Texas ruled the Affordable Care Act unconstitutional, the law will continue to be a hot topic of debate as the case makes its way through the appeals process. Meanwhile, providers will be faced with uncertainty about the future of the ACA, programs like 340B drug pricing, Medicaid and Medicare.

About the Author

Rod Hochman

Rod Hochman is president and CEO of Providence St. Joseph Health, a national, Catholic, not-for-profit health system, comprising a diverse family of organizations serving Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.

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