Washington, D.C. — A disparate panel of providers offered an array of opinions about who will “own” the patient in the post-reform world, including the government, the physician and the patients themselves. And although there was little agreement as to how the post-reform healthcare landscape will look in 2020, all of the panelists at “Provider Town Hall: Who Will ‘Own’ The Patient in 2020?” at the HCap Conference in Washington, D.C. in December, agreed that we are in the throes of a “transference of risk” that is moving healthcare away from the fee-for-service model.

“It's all about fee for outcome,” said Mark Heaney, President and CEO of Addus Healthcare. “Overwhelmingly, the payer is government, and government is going to take the financial risk, so they are going to have tremendous influence over the patient, and they are going to ask many providers to be great providers—create great outcomes—but also share in the risk.”

The increasing role of government in healthcare was undisputed by the panel, however few providers expressed enthusiasm about this development. For example, Paul Mastrapa, President, Walgreens Infusion Services, echoed many comments made by panelists throughout the Town Hall meeting when he said “the best coordinated care models will be the ones where the government has the least intervention.”

Despite the government's role in healthcare, the results of a live on-site survey of Town Hall attendees (using text messaging) showed that more people believe that when it comes to “owning” the patient, physicians will wield a greater influence than the government in 2020. Among those who feel this way is panelist Michael Kasper of DuPage Medical Group. As CEO of one of the leading independent physician groups, Kasper believes that as long as prescription-writing power lies in the hands of physicians, they will continue to control the core relationship with the patient.

Whoever is in control, however, it will serve that party well to master the flow of data. In fact, data manipulation and the ability to coordinate care through information technology is one point that all panelists universally agreed will be a critical component to patient-centered care in a post-reform world. It's one reason Town Hall moderator Dexter Braff, President of The Braff Group, called data “the ultimate issue of control.” Through data, Braff said, “the provider can direct care, coordinate care and take risks, because it gives them a better understanding of where a patient is likely to go within the system.”

It's not only the physician that benefits from data, however. When it comes to the role that patients themselves will play in influencing their care in the years to come, many providers believe that data and technology in general will position the patient to play a much more active role in their own care, and therefore take ownership in the process.

“If a patient is looking for a nursing home online, and a live chat line pops up and it's somebody they feel they can talk to about care options and where they should go, bang, that's going to grab and hold that patient,” said Stephen Winner, Co-Founder and Chief of Culture at Silverado Senior Living.

Similarly, technology is empowering patients to become more active in their own diagnoses, according to Kent Bottles M.D., a panelist and leading healthcare consultant and speaker. “Patients used to come to see me and say, I've got dizziness, What do I got, doc? Now they come and say, I Googled my symptoms and I've talked with patients all over the world, and I've got multiple sclerosis, oh, and I want that new drug from Switzerland and I want it in 5,000 milligrams.”

After more than 90 minutes of discussion, including comments and questions from an engaged audience, the provider panelists ultimately agreed to disagree. Who will own the patient in 2020 is still up for debate, with some seeing government taking a bigger role, others seeing managed care playing a bigger role, and still others believing the physician will have more influence than ever. But if the current, and pending, reform stands a fighting chance of getting everyone on the same page, it will take a lot of compromise. As DuPage Medical Group's Kasper pointed out: “If any of this is going to work, everyone on this panel needs to learn to work together, because if we don’t there’s going to be winners and losers, and the problem is that the losers are going to be the patients.”