Chelsea Youngquist
Director of Marketing
Patient experience is paramount
Patients are increasingly demanding the same consumer-centric experience they receive in retail settings. To understand this shift toward consumer-based care, you must first understand your population and patient personalization channels. How do they like to receive care? How do they like to communicate with providers? Who are their preferred doctors? Once you know the answers to these questions, you can start to build technology and other solutions to customize the care you provide.
Most providers offer patient portals for viewing lab results and upcoming appointments. Many patients find these portals frustrating to access and don’t find them to be user-friendly. Many patients also want online appointment scheduling and cancellation. They want to be placed on waiting lists in case of an earlier canceled appointment. They want convenient extended hours, and they want to contact providers through real-time video and/or email tools.
Improving communication and delivering a more retail-focused experience will go a long way toward developing patient loyalty.
Lower costs
Lowering the cost of healthcare is imperative not only for providers facing budget pressures but also for consumers — who are shouldering more and more of their own healthcare costs — and for payers who are looking to minimize reimbursements for unnecessary procedures.
The goal for providers is delivering the best results while keeping costs down. In fact, 41 percent name financial constraints as the force that they think will cause the greatest disruption in healthcare this year. Increased budget pressure should increase innovation in the delivery of quality care.
A report published in Health Affairs in January 2019 found that the cost of brand-name oral prescription drugs rose more than 9 percent per year from 2008 to 2016, whereas the cost of injectables rose more than 15 percent.
Consumers are increasingly struggling with rising drug prices and more cost responsibility due to high-deductible insurance plans. It’s likely that we will soon see new pricing models including paying for prescriptions over time rather than all at once. We can also expect to see increased governmental regulation to curb rising prices.
In addition to this, the FDA has rolled out new initiatives designed to unleash more competition to moderate drug price trends. These include encouraging new market entrants to rapidly start developing generics in classes where there is no competition, streamlining the generic drug approval process, promoting biosimilars and taking steps to prevent branded drug-makers from exploiting existing programs.
We predict an increase in consumer-focused medical plans. Consumers want convenience and value. To achieve that goal, we will likely see bundled finance offerings with plans, loyalty programs similar to frequent-flyer miles and professionals (similar to financial planners) who manage clients’ health spending.
Payers will continue to become more involved in the provider side as a way of controlling costs. They will continue to create policies, design plans and narrow provider networks.
Changing government regulations impact healthcare technology
Investments by health IT startups were worth more than a staggering $7 billion in 2018, much higher than they were in 2017. These huge investments will continue to be impacted by tax reform, healthcare reform and governmental requirements as well as other ways in which the industry provides and pays for care.
With the probable reduction of the corporate tax rate, we will also see changes in the ways companies invest, structure and hold profits.
Efforts continue to loosen Affordable Care Act consumer protections and mandates, cut Medicaid spending and expand access to lower-premium health insurance. Continuing shifts in regulatory and reimbursement requirements are causing providers to worry about their bottom lines, morale and workflow.
For the foreseeable future, the healthcare industry will continue to see inconsistency in government policies and funding. This is especially dangerous for hospitals in underserved communities that rely almost exclusively on Medicaid and Medicare funding. Unless they are supported in some way, many of these providers will sink deeper into debt.
The shift from inpatient to outpatient care
In 2017, according to the American Hospital Association’s “2019 Hospital Statistics Report” (the most recent data available), hospitals’ net outpatient revenue was $472 billion and net inpatient revenue was nearly $498 billion.
The industry will continue to shift away from inpatient care, which will benefit patients who are looking for quicker and more convenient care. Ambulatory surgery centers are increasingly used for low-risk patients who require surgeries. Care is moving from hospital settings into the community, giving consumers the quick and convenient access they desire.
These days, telemedicine and virtual care are offered by most healthcare organizations, and the prevalence of these tools is expected to continue to rise. This growth is driven by patients’ desire for more convenient care. Reimbursement is currently the main barrier to expanding these offerings.
Consolidations, partnerships and mergers, oh my!
More and more, providers and payers are organizing themselves into vertically integrated, high-value care and financing networks. Many insurers, physician groups, health systems and even retail organizations are seeking to compete as high-value care and financing networks.
Payer–provider partnerships vary in type, size, location and model. There are 50/50 joint ventures with co-branding as well as less-intensive partnerships like pay-for-performance models, accountable care organizations, patient-centered medical homes and bundled payment plans.
Employers are getting into the game, too. Amazon, Berkshire Hathaway and JPMorgan Chase are partnering to cut costs and improve benefits for their employees. This could be a game changer, especially as these major companies target tech solutions to simplify the healthcare system. We expect to see the industry become increasingly hybridized with more and more partnerships, consolidations and mergers.
