It has been a year full of twists and turns for the US healthcare system. Although many believed that Obamacare was the law of the land after the 2012 re-election of President Obama, it has proven to be anything but. Although the attempts to repeal and replace the ACA did not succeed, much has been done to undermine this law and consequently, the future shape of healthcare in America is very much in doubt. This has major implications for investments in digital health and the move to value-based care. Uncertainty about the regulatory environment, payment policy questions, and the number of the uninsured will all affect the pace of investment and progress.
At the core of what has happened, there are a series of executive actions that have taken away subsidies, de-funded various parts of the ACA, and rolled back regulations. This has resulted in a rise in the number of the uninsured and put the future of the law in question. As many of the business models for digital health companies have been based on the increasing number of the insured population, the move to value-based care, and other trends that were either created or super-charged by the ACA, the question now is whether this momentum will continue? So far, digital health investments have kept a record pace for 2017 but whether this will continue or that the recent developments will affect the ROI of these investments, it remains to be see.
One thing is for sure: the rise in the ranks of the uninsured after years of rapid drops is disappointing and moves us away from the ultimate goal of universal coverage; like all of the other developed nations in the world!!