Ten Predictions for 2011

The Disease Management Care Blog was interviewed today on blogradio by Gregg Masters of ACOWatch. If you missed it, the podcast is linked below. The audio can be accessed by clicking the "play" arrow button toward the left side of the badge. Think of it as informative background talk complimenting that extra cup of caffeine as you clean out your email inbox.

In the podcast, the DMCB makes a brazen prediction:

1. CMS will delay the targeted January 1, 2012 start date for Accountable Care Organizations. Note that none of the proposed enabling regulations have been released as of this writing. The DMCB calculates that the a) time required by CMS to solicit, digest and respond to the follow-on public commentary to the proposed rules, plus b) the the inability of most ACO wannabes to plan and organize in the time remaining, makes the current ten month window a daunting proposition. Toss in hostile Congressional meddling as well as growing uncertainty over the fate of the ACA and the deadline has now become practically impossible.

While it is at it, the prescient DMCB has some other audacious predictions for 2011:

2. While healthcare-based social media will continue to expand, its full potential as a catalyst of personalized patient behavior change will be hampered not only by the uncertainty imposed by the privacy restrictions of HIPAA, but "no you can't" Homeland Security concerns over Twitter encryption.

3. Donald Berwick will be confirmed by the U.S. Senate as Administrator for CMS. Republicans will use Dr. Berwick as the poster boy for their newfound - if cynically opportunistic - bipartisanship because a) it's just a matter of time until the Administrator's independent streak begins to vex the Obama Administration, b) the shrewdly targeted use of CMS' grants will curry favor with key individual Senators and c) health care reform is enough of a target rich environment without picking on Dr. Berwick.

4. Reality will not only continue to intrude into the naive enthusiasm over the electronic health record but rear its ugly head in the emerging evaluations of the Patient Centered Medical Home. Both will disappoint when stakeholders seek "proof" of increased quality and lower costs.

5. Speaking of health care costs, they will continue to go up a rate that exceeds the general rate of inflation. That's because, despite health reform, the twin inconvenient truths of our advancing age and voracious appetite for technology refuse to go away. That being said, opportunists will continue to blame the health insurance industry.

6. The population health management (PHM) née disease management industry will continue to hold its own thanks to the grudging acceptance of nurse-based care management as part of the suite of services required to manage insurance risk. Vendors will also have the advantage of being able to couple or decouple PHM with other sophisticated wellness, prevention and health promotion programs.

7. The term "disease management", despite the DMCB's vast supportive readership, will not be resurrected in policy parlance. It will, however, also refuse to die.

8. A political stalemate will prevail as socially-minded progressives and market-minded conservatives battle for the hearts and minds of the body politic. Conflicting public opinion surveys, a divided government and the slow march of the ACA through the appeals process will not lead to any winners or losers. Deciding that will have to wait until 2012.

9. Ours is a time of "Black Swans." Despite our scientific modernism, our worldwide interconnectedness has ironically made us ever more vulnerable to unknown unknowns like pandemics (H1N1), economic dislocations (mortgage meltdowns) and political revolutions (Egypt). Compounding our budgetary travails, another **Big Event** is going to further distract the Administration and Congress from taking constructive action on health reform.

10. The Disease Management Care Blog will not achieve the popularity or the revenue potential of the Huffington Post, leading to further DMCB spousal skepticism over the merits of this whole blogging thingy. She will be unimpressed by the hundreds of thousands of hits, the thousands of return readers, the growing number of links to media outlets such as New York Times, The Washington Post and the Wall Street Journal and vast blogging income amounting to the tens of dollars.

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