When healthcare execs think of a way to sum up 2014's best and worst moments, so many things come to mind. From innovative start-ups like Theranos to hospitals successfully treating Ebola patients (but badly managing them), this year was definitely filled with plenty of newsworthy highs and lows.
Here, we offer the biggest success stories and tales of failure in healthcare this year.
5 Biggest Successes
1. Mega health mergers
A number of big-name healthcare organizations proved successful in aligning themselves for the goal of better population health management in 2014. The impetus behind many of these partnerships—to improve quality, care coordination and efficiency—are noble and important goals for the industry. However, as mergers continue, concerns over monopolies will need to be addressed, and already the Federal Trade Commission has begun to challenge some of the many hospital mergers and physician practice acquisitions taking place. And while there are valid concerns over the costs of partnerships, there is growing evidence that the mergers are helping clinicians do a better job of coordinating care and pooling resources. Still, no matter where you stand philosophically on the success of mergers, there is no question that the trend marches on, with deals like Kindred's purchase of Gentiva for $719 million leading headlines. And according to a new survey by KPMG, M&A in the healthcare and life sciences markets is likely to keep up its brisk clip and even gain momentum in 2015.
In a year filled with a fair amount of dismal health news, from the breakout of Ebola to financial troubles of hospitals, innovation was a bright spot in 2014. One company that is quickly getting investors' attention is Theranos, Inc., a lab diagnostics firm that markets tests that cost less than what independent labs charge (and a quarter to a tenth of what hospital labs bill), according to Fortune. The Silicon Valley firm is valued at $9 billion, has raked in more than $400 million in venture capital from investors such as Oracle co-founder Larry Ellison, and is run by a woman in her early 30s.
3. Hospitals successfully treating Ebola patients
The panic over Ebola hit fever pitch in early fall, after the first person to bring the disease to US soil died from it—but not before transmitting it to two healthcare workers. Since then, the workers, of Texas Health Presbyterian in Dallas, have recovered from the virus, and the hospital is back in in the swing of things after a near-$10 million loss in October. While a lot has been said about the devastating impact of the Ebola virus on West Africa and the work of healthcare professionals to halt its progress, less ink has been given to hospitals like Bellevue Hospital in New York, which cared for Ebola-stricken physician Craig Spencer. Hospitals have increased training, invested in protective gear and most importantly, offered care—and patients have recovered.
4. Big data
The momentum toward population health is in full swing, and big data is the talk of the town, as anything that offers business intelligence and insights into trends is catching the eye of C-suite executives. In October, the National Institutes of Health (NIH) announced grants to develop new strategies to "analyze and leverage" the explosion of increasingly complex biomedical data sets. These NIH multi-institute awards constitute an initial investment of nearly $32 million in fiscal year 2014 by NIH's Big Data to Knowledge (BD2K) initiative.
5. Obamacare 2.0
The first go-round of Obamacare was certainly less than smooth sailing, and healthcare.gov technical glitches were nothing less than the butt of jokes. When the Affordable Care Act's second enrollment period began Saturday, Nov. 15, 100,000 Americans signed up for coverage that day, with many qualifying for federal subsidies that kept their premiums under $100 a month. Within the first month, 2.5 million Americans had enrolled. So it looks like the government is on track to meeting its enrollment goals.
5 Biggest Failures
1. The Pioneer ACO program
Much to the dismay of regulators, healthcare providers aren't running over each other to enter Medicare ACOs. And over the last few months, several Pioneer ACOs have dropped out. To its credit, CMS proposed a new rule that addresses program challenges, and offers providers more options and flexibility in an attempt to encourage them to take risks. Specifically, CMS said it hopes to strengthen the ACO shared savings program through "a greater emphasis on primary-care services and promoting transitions to performance-based risk arrangements." Many ACOs have made the jump to the less-risky Medicare Shared Savings Program, and on December 22, the agency announced that it had added 89 new ACOs to the program.
2. ICD-10's failure to launch
After all the hoopla over getting ready for ICD-10—and healthcare providers' lack of readiness—Congress delayed implementation of the upgraded, granular code set again. While this was good news for physician practices, it was a eye-roll-worthy moment for hospitals, which have invested millions of dollars into infrastructure and training efforts. Now, healthcare organizations must transition from ICD-9 to ICD-10 by October 1, 2015. Recently, a group of healthcare organizations—including the American Health Information Management Association, America's Health Insurance Plans and the Healthcare Financial Management Association—sent a letter to Congressional leaders urging them to make sure there are no further delays to ICD-10 implementation.
3. Attesting for Stage 2 of meaningful use
Buying an EHR is seems easy enough (if expensive), and the idea of using it to improve care quality and coordination is well-intentioned. That, and there are plenty of certified EHRs to choose from now that the Incentive Program has a few years under its belt. However, overhauling your medical practice to meet CMS' rigid "meaningful use" requirements—which are much more challenging in the second phase of the EHR Incentive program—isn't quite so easy. CMS announcing earlier this month that it would penalize more than 257,000 physicians and other healthcare providers 1% of their pay next year for failing to achieve meaningful use of an EHR. The penalties incensed the American Medical Association, among others. "The American Medical Association is appalled by news from the Centers for Medicare and Medicaid Services that more than 50% of eligible professionals will face penalties under the Meaningful Use program in 2015, a number that is even worse than we anticipated," AMA president Steven J. Sack, MD, said in a statement.
4. No SGR fix in sight
The $1.1-trillion Omnibus Appropriations bill that passed before Christmas has many physicians up in arms because it lacks any fix to the sustainable growth rate (SGR) formula for physician reimbursement under Medicare. What's more, there's no sign of an extension to the current pay bump for primary-care physicians who see Medicaid patients. While last-minute legislation could change this, 2015 is looking more financially stressful than encouraging for physicians who serve Medicare and Medicaid patients, and could lead to physicians dropping these patients.
5. Uber's flu shot delivery
Transportation service Uber ran an edgy pilot program to offer free, on-demand flu shot delivery in big cities, and it was a good idea—in theory. Through a partnership with Vaccine Finder, Uber users would be able to order up to 10 shots in one location, and the company's drivers would bring registered nurses to the site to administer the shots. However, while some shots were administered, many consumers faced hurdles. For example, healthcare writer Dan Diamond wrote in Forbes that he didn't receive the email alerting him of the promotion until 1 PM. He tried the site, but was unable to order the shot. Still, there's hope that Uber and others who try this flu-shot-on-call idea will be able to work out the technological kinks for future flu seasons.