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As presidential hopefuls jockey for position leading up to election day, healthcare is set to be perhaps the most hotly debated topic in 2020.

While last year didn’t present the type of industry overhaul that some may have been expecting, 2019 was full of new healthcare trends and legislative changes that helped reshape the operating landscape. Notably, the shift from fee-based to value-based payment systems continued to alter how physicians and other healthcare providers care for patients. This continued change even prompted the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS) to propose new regulations surrounding how physicians can make referrals. Mergers and acquisitions also dominated headlines in 2019 and shook up the competitive landscape. We also saw Amazon set its sights set on telemedicine and the healthcare industry with the launch of Amazon Care.

As the pool of presidential candidates continues to make headlines ahead of election day, there will be no shortage of conversation and new ideas about how to improve the current U.S. healthcare system. Everything from rural healthcare to opioids to cybersecurity will be debated at length by candidates up and down the ticket. A number of existing bills are also likely to come back into focus in the year ahead as both sides of the aisle in Washington push their agendas.

While there’s no way to predict exactly what will happen, we have our ears to the ground in Washington and see a number of issues to keep a close eye on in 2020. Here’s what we’ll be watching:

  1. Medical Bill Transparency: Many Americans who have made a trip to the emergency room or had surgery may have seen surprise charges on their bill. These unexpected medical charges tack on dollars and put additional financial pressure on not only patients but insurers as well. A bill aiming to eliminate surprise medical charges gained steam in 2019, but failed to get through both chambers of Congress before the end of the year. Given the bipartisan support behind it, resolving this issue will likely stay top of mind for President Donald Trump and all legislators, with possible passage in early 2020.
  2. Access to Healthcare in Rural America: Nearly 60 million Americans call rural areas home. Yet only 10 percent of physicians in the U.S. practice in these areas. These folks also earn lower incomes on average and face greater transportation difficulties in reaching healthcare providers. The expansion of telemedicine could help alleviate access issues. Senators Elizabeth Warren and Bernie Sanders say the answer to the affordability factor is Medicare for all, and they will continue to beat this drum well throughout their presidential campaigns. But no matter who wins the presidency, providing quality healthcare to rural America will remain a priority for Republicans and Democrats alike.
  3. Improving Mental Healthcare: Providing better quality and access to mental health has become a main issue of discussion and will continue to be a focus come election season. Mental health affects so many areas of society, from homelessness, gun violence, domestic abuse and more. A clear distinction has emerged in the White House between treated and untreated mentally ill individuals, as untreated mental illness presents a much higher risk to society. Providing better access and quality healthcare to untreated individuals has come into the spotlight for lawmakers and will remain a priority in 2020.
  4. “Cures 2.0”: A bipartisan pair of U.S. Representatives are pushing what they’re calling “Cures 2.0,” an expansion on 21st Century Cures Act aimed at speeding the time it takes to get FDA-approved drugs and devices covered by Medicare, Medicaid and private payers. The bill’s backers requested additional input by December 16, 2019, but skepticism remains as to whether the U.S. Senate has the appetite for passing Cures 2.0 legislation. If this movement picks up momentum, consumer and healthcare providers could benefit from an accelerated approval process.
  5. Battling Opioids: With the total number of Americans who have died of an opioid overdose eclipsing 400,000 and counting, legislators have no choice but to continue looking for solutions to the issue in 2020. The spotlight will likely shift onto healthcare providers and how they can better leverage federal and state funding to treat opioid-addicted patients. President Trump has taken steps to make it more financially viable to treat substance abuse disorders with federal money, but providers still need more guidance on how to address this health epidemic.
  6. New Democrat Healthcare Plans: There are 15 democratic candidates currently on the ticket, each with their own plans for what the U.S. healthcare system should look like. So far, their plans vary widely. But healthcare organizations today are wise to begin thinking about how these new plans could affect their business models. While it’s far too early to begin making any actual changes, the potential for a plan set forth by a candidate, like Sanders or Warren, or even less industry-altering plans from Joe Biden and others, to truly shake up the landscape warrants some early-stage discussions.
  7. Cybersecurity Spotlight: Cyber criminals continue to target healthcare providers with cyberattacks, ransomware, distributed denial-of-service (DDoS) attacks and fraud scams that lead to millions of dollars in damages. On average, a cyberattack costs healthcare providers $1.4 million in lost productivity, reputational damage and service disruptions. This December, a New Jersey health system opted to pay a ransom following a cyberattack in order to protect patient health information. As providers continue to lean on electronic health records and other technology , they will need to invest in the next wave of cybersecurity technology to ensure their systems and sensitive patient information are protected.
  8. Continued Fight for Lower Drug Prices: President Trump has continued to pound the pavement for lower pharmaceutical drug prices. He even recently announced he would allow states to import drugs to fight climbing prices and has repeatedly blasted Democrats for failing to do enough to support his mission. Regardless of who’s responsible, U.S. drug prices today remain some of the highest in the world, and this issue won’t stop being discussed any time soon.
  9. Medicinal Marijuana Mania: The mania over medical marijuana and cannabidiol (CBD) is showing no signs of slowing down. However, the FDA has been extremely slow in offering guidance on this budding industry. As more states legalize medicinal use and medical marijuana and CBD-related companies push for greater access to their products in 2020, regulators will look to do better in weeding out bad actors and providing a framework for greater safety.
  10. Immigration and Healthcare: Immigration touches every industry, and healthcare is no exception. The U.S. Department of State expects some Employment-Based permanent residence categories may become oversubscribed in early 2020 – including some foreign national nurses – leading to a backlog. As one might imagine, this is just the tip of the immigration iceberg. We’ll have even more insights from our immigration experts in an upcoming article.

With the presidential election in sight, 2020 is looking like another transformative year for the U.S. healthcare industry. With big new ideas and impending change on the horizon, the need for strong partnerships and advocates in Washington and at the state level has never been greater.