Trilliant Health

The U.S. health economy is $4.5T – more than the entire GDP of any country in the world other than China – and is projected to grow to $7.7T by 2032 – more than the combined total GDP of Germany and India. What is society’s return on this massive investment? Not much, according to our latest report, the 2024 Trends Shaping the Health Economy.? The 2024 edition of our Trends Shaping the Health Economy Report explores the 8 macro trends that will define the emerging landscape of the U.S. healthcare system and concludes that the winners of healthcare’s negative-sum game will be those who deliver optimal value to their customers. ?? https://lnkd.in/eqEqsPX3

Only five years ago, the world celebrated the bravery and endurance of hospitals, physicians and nurses during the #pandemic. In many cities, hospitals weren’t just the provider of last resort — they were the only provider of care. How quickly the world has forgotten. Today, the Federal and state government knowingly reimburse hospitals below the cost of care while mandating they take unlimited financial risk. And now, policymakers want to impose price controls on hospitals across America; a move that will accelerate hospital closures. ? Our special edition of #Counterpoint examines the consequences of price controls on hospitals, and the people that rely on them.?

New Study: #Endometriosis affects roughly 6.5 million women in the U.S., yet it often goes undiagnosed or untreated for years. With expanding treatment options, what do the data reveal about trends in treatment and management of endometriosis? More in our latest Compass+ study ?? https://hubs.ly/Q03bWwJr0 #EndometriosisAwareness #womenshealth

The Trump Administration’s decision to roll back select #CMMI models highlights a critical issue: government innovation and regulation are failing to generate value in the health economy. #HHS has experimented with value-based care for almost 20 years, with limited reductions in spending or improvements in quality. Intended to generate savings, CMMI models are instead projected to increase #Medicare spending by $9.4 billion by 2026. Even the MSSP program, CMS’s most successful value-based initiative, has failed to generate more than $193 in per capita savings, which is almost enough for a year’s worth of Netflix.?

In game theory, a negative-sum game is characterized by a shrinking market. The only way to win a negative-sum game is to take something from a competitor. The U.S. healthcare system is a negative-sum game because the commercially insured population — its very lifeblood — is shrinking, and most stakeholders cannot generate positive operating margins from reimbursement for #Medicare and #Medicaid beneficiaries. As the total market shrinks, every organization faces the same fundamental reality: the status quo is no longer sustainable. Survival requires fierce and effective competition: winning key battles, cutting losses early, losing less frequently and losing by a smaller margin than the competition. Read the Field Guide to see how your organization can leverage data-driven insights to compete in healthcare’s negative-sum game. https://hubs.ly/Q03bKkLS0

New Report: How COVID-19 Reshaped U.S. Healthcare: 6 Structural Shifts Every Leader Needs To Know Five years after the COVID-19 Emergency Declaration, it has become clear that the #pandemic didn’t just disrupt the health economy — it permanently changed its trajectory. Our latest report examines 6 enduring shifts that continue to shape #healthcare delivery and financing, including: ?? Permanent demographic changes ?? A widening coverage divide ??The normalization of virtual care ?? An intensifying behavioral health crisis ?? The persistent workforce shortages ??? Increased politicization eroding patient trust While some pandemic-era adaptations have faded, these 6 structural changes represent the "new normal.” Is your organization prepared to navigate the post-pandemic health economy? ?? Upgrade to read the report, available exclusively to Compass+ Enterprise subscribers: https://lnkd.in/eKV2qeka

"Software is eating the world," Marc Andreessen famously observed in 2011. In 2025, specialty pharmacy is eating healthcare services. Demand for healthcare services has clearly flatlined nationally in the last decade, and specialty #pharmacy is a key reason. Even so, many healthcare providers continue to develop strategic plans based on a 40-year-old demand forecast model that ignores this reality. Is your strategic plan based on reality or wishful thinking? Our latest #Counterpoint examines the cold, hard fact that chronic disease burden is not correlated with the demand for healthcare services.?

?? New Research: Healthcare Transformation, Government Style: The Impact of Changes to the #IPOList For decades, hospitals have relied on #inpatient procedures for financial stability. But what would happen if the entire Medicare Inpatient Only (IPO) list is eliminated, as the prior Trump administration proposed? Our research reveals that the removal of procedures from the Medicare IPO list corresponds with notable – even catastrophic - declines in inpatient volume: ?? When total knee replacements came off the Medicare #IPOlist, inpatient volume declined by 17.9% in one year. ?? The same trend played out for total hip replacements after their removal in 2020, with inpatient cases dropping by 35.0%. ?? Three years after total knee replacements were removed from the Medicare IPO list, inpatient volumes had declined by 52.7% Every hospital must prepare for a future where the migration of procedures to #outpatient setting accelerates, whether because of site-neutral payment legislation or elimination of codes from the IPO list or employer demands – or all of the above. How could additional changes to the IPO list impact your organization? Compass+ provides in-depth scenario analysis and strategic guidance: https://hubs.ly/Q03962Yg0

We’re excited to formalize and expand our machine learning-driven approach with the introduction of our Machine Learning Team. The reality: Healthcare claims data contains countless variations and exceptions that simple rules-based systems cannot handle effectively. Our ML-first approach enables us to resolve many of the most complex challenges in claims data with: ??? Labeled data collection ?? Deployment pipelines ?? Performance monitoring frameworks ?? Data quality processes Our ML-first approach powers our ability to process raw, incomplete claims data and turn it into meaningful insights about longitudinal patient journeys and physician relationship networks. The outcome: Healthcare stakeholders gain unprecedented visibility into physician decisions that directly impact their market position. #HealthcareAnalytics #MachineLearning #DataScience

For #lifesciences companies, knowing which physicians prescribe your drugs and implant your devices — and those of your competitors — is table stakes to win healthcare’s negative-sum game. Our Provider Directory offers visibility not only into physician #referral patterns but also the financial relationships between those physicians and life sciences firms. How it works:? 1?? Search for any U.S. physician.? 2?? Analyze their procedure volumes and practice patterns.? 3?? Understand their existing relationships with life sciences companies through #SunshineAct data.? 4?? Refine your targeting and strategy with these insights. ?? Ready to gain a competitive edge? Start with our free provider directory. https://lnkd.in/epu2nvad