The coming year will likely continue to be a tumultuous year for 必威官网bethealth care providers,供应商,和付款人,as they adapt to meet new challenges and market forces,尤其是考虑到关于《负担得起的医疗法案》(ACA)的可行性和持续存在的公开问题,以及近期评论made by members of the incoming Trump administration.以下是2017年需要注意的10件事情,可能会影响2017年医疗保健破产的数量和进展。必威官网bet

不断变化和挑战的偿付格局

必威官网bet医疗保健系统正在努力适应基于价值的采购,这就要求从以量为基础的支付以及结构上的改变转向补偿,甚至影响临床护理的提供方式。医疗保险是导致报销率下降的主要原因,它已经开始将传统的医疗保险支付与质量挂钩,结果,以及通过其他支付模式实现的价值。Financial resources are further stretched as Medicare enrollments are projected to continue to increase as the population ages.Medicare has already achieved its initial milestone of tying 30 percent of all traditional Medicare payments to quality or value through alternative支付模式到2016点。This trend is expected to continue as Medicare plans to increase this到2018年达到50%.虽然这些改变的方法仍然相对较新,供应商和供应商继续适应,这一趋势对一些医疗保险业务的利润率产生了负面影响。必威官网betHealth care businesses that rely heavily on Medicare will need to be nimble in adapting their business model in 2017.有些人可能会发现破产提供了诱人的选择,在备案或收购不良实体中。

《负担得起的医疗法案》前景不明

With the forthcoming Trump administration,it is likely that there will be a broad effort to roll back the ACA,全部或部分。Exactly what impact this will have on profitability for 必威官网bethealth care providers and suppliers remains to be seen,但是,对当前模式的任何重大影响肯定会在整个市场上引起反响,并可能对医疗保健提供者(可能必须治疗没有覆盖范围的患者)以及可能难以获得其他覆盖范围的患者造成困扰。必威官网bet2017年,医疗保健提供者通过保必威官网bet险提供者获得补偿的能力也可能下降,由于几家大型保险公司在权衡是否继续参与必威官网bethealth care exchanges.

Acquisitions of Distressed 必威官网betHealth Care Assets

必威官网betHealth care providers and suppliers in bankruptcy may offer an interesting扩张的机会希望进必威官网bet入新地理位置的卫生系统,扩大市场份额,或者利用规模经济。必威官网bet卫生保健系统无法迅速适应ACA带来的结构性变化和其他变化,或者现金流不健康,必威官网betmay find that bankruptcy is the most cost-effective way to market and sell their assets through a process provided by 11 U.S.C.第363节,债务人可以出售其部分或全部资产。”free and clear"经破产法院批准。医疗资产市场很可能会继续充满有必威官网bet兴趣的买家,他们希望扩大到新的和现有的市场。

管辖权和 破产事项的行政终局性

必威官网bet与医疗保险或医疗补助有关其提供方协议状态的争议的医疗保健提供者将有额外的理由在2017年与项目的管理过程进行谈判和密切合作。2016年的两个案例表明,美国正在积极采取措施,通过为此类争议设立的行政程序,引导处理医疗保险或医疗补助计划的所有问题。在破产程序之外,医疗保险或医疗补助提供者必须在联邦法院裁定涉及提供者协议的争议之前耗尽程序的行政程序。However,两例,,在河口海岸,有限责任公司护士注册和家庭健康公司必威官网bet.,分别提出了自动中止是否会影响供应商协议的终止,或在存在超额支付问题的情况下要求持续偿还的问题。Ultimately,in在河口海岸,第十一巡回法院认为,破产法院缺乏司法管辖权来中止供应商协议的终止。有趣的是,in护士登记处,,肯塔基州东部地区的破产法院最初认为它有管辖权,并下令医疗保险支付被扣留的款项,但后来在达成和解并经债务人和美国共同动议后撤销了这项命令。这两个案件为其他法院提供了说服力,破产管辖权的争论不太可能像2016年那样在2017年引起争议。

Government Deals and Prepackaged Reorganization Plans

我们可能会继续看到与美国政府达成和解,其中包括预先打包的破产计划。An example of this type of settlement was seen in the bankruptcy filing of Millennium 必威官网betHealth,LLC美国最大的药物检测实验室之一。千禧年同意支付超过$200 million in settling allegations它违反了医疗保险和医疗补助不必要的医疗检查收费的虚假索赔法。司法部是千禧年最大的无担保债权人,该计划还为放款人成为新的所有者提供了条件。

必威官网betHealth Information and Technology Continues to Create Costs and Risks

The focus on care management and enhanced quality capabilities may require investment in additional personnel and technology that may be beyond what smaller 必威官网bethealth systems can afford.Delivering high-quality clinical care is impossible without the support of strategic and integrated IT systems.However,同样的技术会带来隐私和安全风险,以及requires substantial investment.尽管过去有政府补贴,实施电子健康记录可能会在短期内增加健康提供者和供必威官网bet应商的成本和减少收入。此外,maintaining compliance with regulations like the 必威官网betHealth Insurance Portability and Accountability Act and Health Information Technology for Economic and Clinical Health Act is becoming increasingly complex as health care providers retain and provide more information electronically and are subject to audits,potential fines,以及黑客带来的风险。We may see increasing appointments of ombudsman to oversee the privacy and security of patient information throughout the bankruptcy process in 2017.

必威官网betHealth Care-Related Debt Continues to Be a Major Factor in Consumer Bankruptcies

The ACA helped to reduce the number of people without insurance,然而,many Americans still lack insurance and many of the plans available do not provide robust coverage.由此产生的医疗债务是导致消费者破产的一个主要原因。这种趋势正在放缓,但是医疗必威官网bet债务很可能continue to feature prominently in consumer bankruptcies2017。If an"Obamacare“coverage option is eliminated,与医疗保健费用有关的消费者破产可能会增加。必威官网bet

护理费用

医院面临着费用的增加hire more employeesand invest in technology,可能导致expenses outpacing revenuefor some hospitals.员工和用品的成本将是2017年需要关注的一个额外因素,as other financial pressures mount on distressed 必威官网bethealth care providers.Ultimately,护理成本加上补偿减少和应收账款回收困难,可能会继续增加2017年的医疗保健破产申请。必威官网bet

Increasing Cost of Drug Prescriptions

在过去的两年里,来自药房福利管理公司的保险报销没有跟上处方药成本上升.这就导致了更大药店能够更好地弥补的损失,并且lead to increasing consolidation在市场上。Large purchasers have pushed back against increasing drug costs,但迄今为止,还没有确定一种有效的方法来控制成本,但继续提供足够的药物覆盖和供应。例如,加利福尼亚recently proposed限制某些人群的药品价格,但这个提议最终失败了。继续关注处方价格上涨,表明进一步削减这些成本的方法将继续是一个有争议的话题,并可能导致进一步的整合,获取,以及制药行业的结构变化。供应商将受到影响,因为他们继续与供应商进行自己的谈判,并试图控制自己与必要药物相关的成本。

疗养院的痛苦在上升

养老院行业也面临压力,这可能会增加2017年养老院的财务困境,作为该行业面临着停滞不前的医疗补助率。以及越来越多的疗养院居民。While there is still investment in skilled nursing facilities,,一些市场参与者正在削减风险敞口以及出售资产。此外,a ban on mandatory arbitration clauses for nursing homes may result in a诉讼的兴起风险和成本。