If there was a book, movie, or Netflix series on the U.S. healthcare industry today, it would aptly start with the Charles Dickens quote:
“It was the best of times … ”
“COVID was an accelerator for us,” according to the senior vice president and chief information officer of Sentara Healthcare. Since the start of the pandemic, the transformation and digitization of healthcare organizations (HCOs) accelerated at unprecedented rates to usher in consumer centrism, increased accessibility, and enhancements in continuous care. Ryan Smith, vice president and chief information officer of Intermountain Healthcare, said, “We did more in the last year than the 10 years prior.” Unprecedented demand for virtual care forced providers to pivot, and within days and weeks, they enabled telehealth. There were more applications of AI-powered clinical decision-making than ever before. We saw new bots, virtual waiting rooms, self-triage tools, the digital front door, remote patient monitoring — and the list goes on — all being stood up in weeks and months, not years. The proverbial reboot is happening.
“ … it was the worst of times.”
Life expectancy dropped to 77.3 years, equaling the life expectancy from 2003, which was 18 years ago. Eighty percent of US patients reported that their clinician was burnt out in a recent visit. Collection agencies held $140 billion in unpaid medical bills last year — it was $81B five years ago. Sixteen thousand clinics closed in 2020, and care facilities continue to be under extreme cost pressures.
The Decisions Made Over The Next 10 Years Will Determine The Next 50 In Healthcare
In the second half of 2021, Forrester kicked off its “future of healthcare” research and conducted over 50 interviews with executives from health systems, insurers, integrated delivery networks, health tech vendors, retail pharmacies, the National Institutes of Health, medical doctors, and other industry experts to paint the picture of healthcare in 2030. From the interviews, the following came up as some of the most impacted areas in healthcare over the next decade:
- Value-based care. It will be the dominant reimbursement method. The confluence of preemptive care, home-based care, and labor force transformation will enable HCOs to embrace fee-for-value or value-based care (VBC) and absorb greater downside risk. Cost transparency pressure from consumers will also push HCOs to embrace episodic-based care, which proactively sets budgets for the cost of a service, thereby allowing HCOs to inform consumers of their out-of-pocket costs. But a prerequisite for success in VBC is metrics that hold all stakeholders accountable, including both patients and clinicians.
- Hospital-at-home. It will become the principal care setting. The dialogue around patient centricity will finally give way to action, as care is received by the patient in their home and only in a traditional, clinical setting when absolutely necessary. Hospital care will be reserved for invasive procedures or when the home is not safe for care, but the corresponding decrease in physical hospital asset utilization will expedite clinic closures. As such, health insurers will be positioned to purchase these assets and manage member care costs. In 2029, 29% of evaluation and management visits will be delivered in a virtual care setting.
- Consumer-led data sharing. It will grow in popularity and push HCOs to evolve as democratization sets in. In 2030, consumers will hold the rights to their health data, which they will increasingly generate, and set the terms on provisioning and revoking access to their health data. Driven by the Office of the National Coordinator for Health Information Technology’s Cures Act Final Rule, healthcare data must become more portable across the healthcare ecosystem, including consumer-facing mobile applications. The future of healthcare is data-driven, and institutions that endeavor to block data will be displaced.
- Health equity. It will improve as greater distribution of best-in-class care vastly increases. Reaching health equity means attaining the highest possible level of health for all people. Driven by an expansion of representative data sets, the use of analytics, and VBC, best-practice care protocols can be applied equitably across all populations and geographies. By 2030, HCOs must actively dismantle the inequities that affect marginalized communities. As the industry reckons with this inequity, HCOs must use their mission and values to guide decision-making rather than hard ROI.
To set your organization up for success in 2030, Forrester recommends that HCOs:
- Embed cybersecurity into all decisions. A connected healthcare ecosystem means the threat level for cybersecurity attacks will remain high. Adopting a Zero Trust eXtended architecture and appropriate segmentation for hospital assets such as medical devices and employee endpoints that require access to patient data means it must be continuously authenticated. Quantum computers will also present an imminent threat to breaking encryption.
- Understand the shifting value of data and protect it at all costs. The value of data collected today and in the future will grow exponentially by 2030, but this collection is based upon customer trust. HCOs that fail to protect security and privacy will not be competitive. Ask the following questions to enable a data economy that improves patient outcomes: How will data be used, who will use this data, how will data be protected, and how will meaningful value be delivered?
- Establish new revenue streams that embrace low-acuity care settings. Leverage new care settings, establish new revenue streams and dismantle barriers to technology adoption. Remote patient monitoring can improve financial outcomes in fee-for-service (FFS) and VBC models, but devices must become more affordable for all. To offset the cost of these devices, embed capabilities into care plans for chronic care and post-acute monitoring with aligned incentives that drive FFS or VBC.
The stakes are as high as ever in healthcare, as the decisions made through the end of the decade will determine an organization’s success for the next 50 years. Being informed and getting in front of the industry shifts provides a much-needed injection to fuel success for HCOs in the future.
The Forrester analysts who wrote this article include Daniel Hong, vice president and research director; Natalie Schibell, senior analyst; Eric Bellomo, researcher; and Paul-Julien Giraud. The original article is here.
The views and opinions expressed in this article are those of the author and do not necessarily reflect those of CDOTrends. Image credit: iStockphoto/sdecoret