Five Big Healthcare Business Trends For 2019


By Jonathan Ford Hughes

With 2018 in the rearview mirror, it’s worth taking a look ahead to 2019. The new year is shaping up to be another exciting and somewhat volatile chapter in the history of the healthcare business. Policy debates, emerging research, and new technologies will have direct impact on the frontline of care. Here are the healthcare business trends doctors will likely be hearing a great deal about in the new year.

1. CMS Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) has modified its decision on evaluation and management (E&M) codes. Earlier this year, CMS had proposed condensing eight rates into two, which sparked blowback from American physician groups.

Under the initial proposal, the second of the two new rates, which generally applies to very ill patients seen by specialists, came with lower reimbursement. CMS has since pivoted, but only slightly. Now, level 2-4 codes will be combined into one rate in 2021.

So, is this the final word on CMS fees? Not really. The American Medical Association will use the two-year reprieve to scrutinize the proposal. It’s safe to assume there will be future requests for changes, making this one of the healthcare business trends worth following.

2. 5G

Move over, 4G LTE. Make way for 5G. Remember Nokia, the company that made the rad 3310 phone that you used to play Snake on, back in the ‘90s? They’re alive and well, and apparently pumping out 5G infrastructure in Finland. Since 2016, they’ve been testing 5G functionality at a small hospital there.

5G has massive implications for the Internet of Things (IoT). With faster download and upload speeds, less lag, and higher capacity, breakthroughs will take place in American healthcare. A surgeon could one day operate, using the da Vinci system, on a patient in another state while receiving live video and audio feeds, in addition to haptic feedback.

A recent Nokia white paper projects mainstream 5G use by 2020, making it one of the healthcare business trends worth watching.

3. Artificial Intelligence (AI)

Is 2019 the year AI in healthcare becomes something more than a topic hospital CEOs discuss at the golf course to impress their friends? Forbes seems to think so.

In their annual roundup of healthcare predictions for the year ahead, Forbes thinks that the AI healthcare IT application market will exceed $1.7 billion, with breakthroughs in medical imaging analysis, pharmaceutical development, and risk reduction. Forbes was 98 percent accurate in its predictions last year.

The Cleveland Clinic also put AI on its list of Top 10 Medical Innovations for 2019. AI is already having an impact on healthcare, as recently highlighted by the Harvard Business Review. A study published in 2017 in The Spine Journal highlighted how AI assistance during robotic surgery reduced complications by a factor of five. A separate Harvard Business Review analysis showed a potential 21 percent reduction in length of stay for orthopedic patients.

4. Cannabis and Psychedelics

Marijuana and psychedelics haven’t been this big a part of the cultural discussion since the Summer of Love. Michael Pollan’s latest book, How to Change Your Mind, may have brought medical use of consciousness-altering drugs into the mainstream. Similarly, the widening trend of legalization and decriminalization of cannabis have raised its profile.

On the psychedelic front, the Multidisciplinary Association for Psychedelic Studies (MAPS) has been looking into therapeutic uses of MDMA in conjunction with psychotherapy for PTSD. MAPS will apply to the FDA for expanded access in 2019, hoping to open the experimental therapy to PTSD patients who are running out of options.

More than a dozen medicinal cannabis studies are underway. One standout is a Phase 1 trial looking at optimal non-psychoactive CBD dosage in pediatric patients with drug-resistant epilepsy, brought on by Dravet Syndrome. It’s slated to wrap up in 2019. A second study, conducted by Yale researchers, is looking at the effects of cannabinoids on the pain response. That study is slated to conclude in December.

5. Prescription Drug Costs

President Trump has made it clear that he wants to lower prescription drug costs for Medicare patients. He recently announced proposed changes for some drugs that are covered through Medicare Part D. One proposal would make out-of-pocket costs for patients known to doctors as they are prescribing.

What remains to be seen is how the administration will proceed on these and other drug changes in 2019, and how the pharmaceutical industry will respond. As a recent FiercePharma report indicates, we may see the U.S. share of global pharmaceutical spending decline. Could that mean less innovation — and consequently fewer new drugs — in the American market? Only time will tell.

Here are the healthcare business trends you’ll be hearing about in 2019:

1. The ongoing debate over the CMS fee schedule.

2. The implications of 5G wireless technology for healthcare and healthcare devices.

3. The rise of artificial intelligence in healthcare.

4. Medical uses for psychedelics and cannabis.

5. Policy debates over prescription drug costs.


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