More of the same and plenty of the new are on tap for health IT in 2018. Here are five trends to watch as the year unfolds.1. Value-based care will continue to grow.The Centers for Medicare and Medicaid Services (CMS), which has led the charge on value-based care (VBC) reimbursement, pulled back a bit last year. CMS eliminated two new bundled payment programs and excluded many physicians from its Merit-Based Incentive Payment System (MIPS). Nonetheless, MIPS continues to move forward, as does CMS Alternative Payment Model (APM) track for accountable care organizations (ACOs) and other risk-bearing groups.Private payers are also hustling down the VBC path. Aetna, which has long invested in ACOs and private label plans for large healthcare systems, forecasts that 75 percent of its spending will be in VBC arrangements by 2020. Cigna aims to increase VBC payments to 90 percent of its spending this year. Payers are already seeing results: Blue Shield of California, for example, attributes $325 million in savings from 2010 to 2015 to its ACO strategy, and other plans have seen reductions in hospital costs. The healthcare industry should expect more, not less, VBC reimbursement in 2018.2. Industry consolidation will continue.The transition to VBC has caused many hospitals and healthcare systems to invest extensively in health IT infrastructure. Meanwhile, as more procedures have moved to the outpatient side, acute care hospitals have felt pressure to grow their market share. The need to improve care delivery and increase access to capital and patients has motivated many healthcare systems to merge. While the government has blocked a few of these mergers, the overall pace of consolidation has quickened, doubling between 2011 and 2015. Last year, foreshadowing whats to come, hospital chains Dignity Health and Catholic Health Initiatives announced one of the biggest provider mergers ever.A similar development is happening on the payer side. The Justice Department stopped the proposed Humana-Aetna and Anthem-Cigna mergers last year, but Humana later agreed to buy home carelong-term care operator Kindred Healthcare, and Aetna was acquired by CVS Health. While some observers saw the latter deal as a defensive move by CVS against the potential entry of Amazon into the pharmacy business, the insurer and the pharmacy chain promised to use their combined clout to lower the cost and improve the quality of carethe definition of VBC. One certainty is that the consolidation of both providers and insurers, both among themselves and with other parties, will continue, with some novel arrangements in the forecast.

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