Finding Certainty In Uncertain Times

Written by Mike Pukszta | Cannon Design

Regardless of one’s political beliefs, everyone can agree 2017 promises to be full of uncertainty regarding healthcare. On President Trump’s first day in the Oval Office, he signed his first executive order aimed at dismantling the Affordable Care Act (ACA). While the proposed American Health Care Act failed to gain enough support to become law in late March, House Speaker Paul Ryan has said that continuing to push for an overhaul of the nation’s healthcare system remains a priority.
Most agree a full-scale replacement will take time, and new legislation wouldn’t have much impact this year as government rules for 2017 have already been incorporated into contracts with insurance companies. Furthermore, since the Trump administration has always positioned any potential replacement as a significant departure from the ACA, it could be many years before anything far-reaching is implemented.

Long story short: there are still a lot of unknowns about what healthcare will look like in the future under President Trump. But even with all this uncertainty, we know there are a few ways the healthcare industry (and capital development within it) will change in the years ahead. Here are three trends driving that evolution:

1. Partnerships and moonshots

This past December, Congress overwhelmingly passed the 21st Century Cures Act, which boosts funding for medical research, eases the development and approval of experimental treatments, and reforms federal policy on mental healthcare. The bill, signed into law by President Obama, provides $4.8 billion in new funding for the National Institutes of Health, including $1.8 billion reserved for the Cancer Moonshot launched by Vice President Biden and another $1.6 billion earmarked for brain diseases.

As a result, one trend we’ll see continue this year and beyond is partnership. Specifically, we’ll see silos torn down between biomedical companies and academic medical centers and new alliances emerge. For example, last year, Vice President Biden visited the Novartis-Penn Center for Advanced Cellular Therapies in Philadelphia. The facility is designed for global pharmaceutical company Novartis and Penn Medicine to explore Chimeric Antigen Receptor (CAR) technology, which enables a patient’s own immune cells to be reprogrammed outside of their body and re-infused to hunt for and potentially destroy tumors. The partnership between the two organizations is fueled by a mutual goal of finding more effective treatments for cancer.

2. Micro-health on the rise

Outpatient care in convenient settings, such as MinuteClinics and urgent care centers, continues to be a successful strategy in providing accessible healthcare. Based on the achievement of these models and the overall growth of the ambulatory care market, we’re now seeing a rise in the business case for microhospitals. These facilities are full-service hospitals that are “micro” in their number of inpatient beds (typically less than 12) and their compact size. They’re convenient for patients and provide healthcare systems with affordable settings to deliver care, test demand in new communities, or provide enhanced services in established markets without an extensive investment.

The ability to reduce costs and risk by testing a market before going all in is extremely attractive amid ACA-repeal talks. Although microhospitals usually require more upfront costs than ambulatory care and urgent care centers, they’re significantly more affordable than entering a market with a full-service hospital and they currently experience a much higher reimbursement than ambulatory care facilities due to their inpatient facility classification. Microhospitals are already being built across the U.S., and with a growing body of research emerging on this new facility type, we anticipate that growth to continue

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Michael Pukszta, AIA, is healthcare practice leader at CannonDesign (St. Louis office). He can be reached at


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