Legacy of Excellence Digital Flipbook

THE NEXT 125 YEARS IN OTOLARYNGOLOGY-HEAD AND NECK SURGERY

in the decades ahead. Declining reimbursements from Medicare and Medicaid have led to softening in operational performance with a pronounced rise in annual expense growth coupled with a slowed rate of commercial payer revenue growth. Other continuing trends include a shift of inpatient services to outpatient settings, “site neutrality” for facility reimbursement, competition from niche providers (nontraditional competition), and the increasing role of medical consumerism. These factors have contributed to the recent wave of consolidation in healthcare, exacerbated by the novel coronavirus pandemic. Health systems and practitioners, at all levels, are being pushed either to compete as their own integrated (horizontal or vertical) high-value networks or to be rolled up into a larger organization. This trend has clinicians and executives searching for opportunities to influence their market share and sustainability in the regional, national, and now international healthcare marketplace—in an era of medical consumerism and medical tourism. The recent CVS-Aetna merger; collaboration among Amazon, Berkshire Hathaway, and JP Morgan; and heightened interest shown by Apple, Google, and other tech giants in transforming (and controlling) healthcare

Originally published in the Bulletin , Special Edition, 125th Anniversary, January 2021 commemorative issue

Gavin Setzen, MD, AAO-HNS/F, 2017-2018 President and Chair of the AAO-HNS Future of Otolaryngology Task Force T he United States

healthcare system is poised for significant change in the coming years as we continue to strive toward

the creation of a viable system that truly works for everyone. While the U.S. healthcare system has been moving toward a more consumer-focused experience, progress has been slow and cost-containment efforts have been largely ineffective. For decades, regulatory barriers and competition within the provider community have made it difficult to create a transparent, consumer friendly, efficient, cost-effective, and physician-friendly healthcare delivery system. Otolaryngology practices (independent, employed, and academic) will, in the absence of change, likely experience continued downward economic pressure

The AAO-HNS will advocate for and protect members and the patients we care for in negotiating with health policy makers, payers, consultants, regulators, the public, pharma, medical device companies, hospital systems, and the myriad other entities vying for dominance, control, and relevance in the rapidly changing healthcare arena.”

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