ORLANDO — When we talk about the ripple effects of the Patient Protection and Affordable Care Act, we do so primarily within the context of the broker community.
Sure, we also speculate about carriers, employers and to a smaller degree, all the third-party players in the benefits business, whether they're straight-up TPAs, enrollers or the techies touting ben admin systems. But we always seem to do so from the broker perspective.
But providers — and by extension, consumers — face as dramatically different a future as the rest of us.
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As a matter of fact, One Place 2015 headliner Jeffrey Bauer fully expects more than a third of today's health care providers to "cease to exist" within the next decade. The author, health futurist and medical economist makes that dire forecast based on his belief that the health care spending market has finally peaked and is probably headed toward stagnation, if not outright collapse.
He points to CBO and OMB numbers — the ones used to sell us all on PPACA six years ago —that wildly missed the mark. At the time, Peter Orszag told Congress that by 2015 — this year — health care spending would consume 20 percent of the gross domestic product. It stalled, however, and has yet to hit 18 percent.
And that, Bauer insists, is the problem with making predictions based on little, incomplete or just plain bad data. It's also a problem that stems from confusing predicting with forecasting, something Bauer claims is all too common in the Beltway today.
In short, based on this slowed spending, Bauer's forecast is a chilling one.
"Thirty-five percent of today's providers will cease to exist," Bauer says, "40 percent will continue to do business as they are organized today and 25 percent will change the way health care is delivered."
Obviously, I'm generalizing a bit, boiling down some pretty complex thoughts into something more easily digested. But we're already an explosion of standalone emergency rooms, urgent care clinics and a health care economy slowly shifting away from third-party payers. It was only a matter of time before consumers began acting more responsibly, and spending more prudently.
It's naive to think the market won't respond in kind.
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