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Healthcare in 2009 focused mainly on the three "Rs" — reform, reimbursement and readmissions — and wrapped up with a 2,000-page reform bill on the table. Looking ahead, will this new healthcare year toss out old cost reimbursement concepts and ring in an evidence- and value-based vision of reimbursement? After a year of income inertia, which areas hold the most promise for profits this year? What influence do employers really wield in benefit and reimbursement design, and how will the consumer era change the dynamics of provider performance measurement and rewards?

In Healthcare Trends & Forecasts in 2010: Performance Expectations for the Healthcare Industry, two key thought leaders take on these issues and more, predicting likely winners and losers from the pending healthcare reform legislation and describing its implications for key stakeholders in the year ahead.

In HIN's sixth annual healthcare industry forecast, William DeMarco, president and CEO of DeMarco and Associates and Jim Knutson, risk manager and human resources director, Aircraft Gear Corporation, analyze the changing reimbursement conversation and suggest ways to rethink payment and benefit design to reflect today's healthcare delivery systems.

DeMarco forecasts the 2010 industry climate for physicians, hospitals and health plans, including strategies to close care and business gaps, and suggests likely areas for new products. Addressing the current status of health reform, he shares late-breaking developments from Capitol Hill that affect key industry sectors.

Focusing on payment reform, Knutson outlines the PROMETHEUS payment method, an alternative to traditional fee-for-service reimbursement that uses episodes of care as the basis for payment and aligns provider payment incentives with risk and rewards. Aircraft Gear Corporation participated in the PROMETHEUS payment pilot, allowing them to negotiate the purchase of high-quality, evidence-based care from providers and incentivize them to avoid potentially avoidable complications.

This report also analyzes the responses of nearly 100 healthcare organizations to the sixth annual HIN Healthcare Trends and Forecasts survey, in which respondents ranked top-of-mind concerns for the year ahead and reported their organization's best and worst business decisions in 2009.

In this forward-looking special report, you'll get details on:

• Barriers and limitations to implementing a fairly radical payment reform proposal such as PROMETHEUS;
• Coverage with evidence development (CED) — a way to apply comparative effectiveness research;
• Employer boardroom decisions driving the healthcare agenda;
• What lifestyle analytics tell us about future healthcare utilization and cost;
• Suggestions to reduce hospital fragmentation of services, revenue and expenses;
• Opportunities for growth in specific healthcare markets;
• The rise of the accountable health plan — the secret to creating "medical groups without walls," the economies of scale they deliver and how to leverage their power during the reimbursement discussion;
• How the current consumer era in healthcare is impacting providers and hospitals;
• Healthcare reform buzz from a Washington, D.C., insider: straight talk on taxes on the physician, employer, health plan and medical devices and the latest on the pharmacy fix;
• The top 20 healthcare innovations as reported by HIN e-survey respondents;

In an expanded Q&A section, Demarco and Knutson analyze the demise of CMS's planned Medicare Medical Home Pilot and suggest ways to encourage the technology-shy provider and engage the medical staff in new initiatives.

This 40-page special report, "Healthcare Trends & Forecasts in 2010: Performance Expectations for the Healthcare Industry," showcases the topics that will continue to consume the healthcare executive, and new challenges that await the industry this year.

Table of Contents

• Healthcare Payment and Coverage Reform
  • Payment Reform and Prometheus
  • How to Become Certified ‘Trend-Benders’
  • Prometheus: Realigning Payment Incentives with Risks and Rewards
  • Defining PACS, HACs and ECRs
  • The Prometheus Filter, Navigator and Accumulator
  • New Approach to Data and Data Analysis
  • Role of the Quality Score Card
  • Coverage for Evidence Development
• Health Reform and the Move Toward Value-Based Purchasing
  • What’s Ahead for Health Plans
  • Reasons for the Shifting Paradigm
  • Effects of Provider Reimbursement
  • Life Stage Health Plans
  • The Hospital Market
  • The New Industry of Reducing Readmissions
  • Risk Adjustment in Action
  • Emergence of the Accountable Health Organization
  • Following the Pay for Performance
  • Era of the Consumer
  • The Latest in Healthcare Reform
  • Breaking Down Obama’s Healthcare Savings
• Q&A: Ask the Experts
  • Outcome of Healthcare Reform
  • Content and Delivery Date of Healthcare Reform
  • Impact of CMS’s Shelved Medicare Medical Home Pilot
  • When Providers Are Technology-Shy
  • Engaging Medical Staff in New Models of Care
• Glossary
• For More Information
• About the Authors