22 Sep A Landscape of Possibilities – 4 Themes Currently Shaping the Healthcare Industry
Post written by Tamara StClaire
We can all agree that we’re in one of the largest transformations that healthcare has ever seen, perhaps since the inception of Medicare. We’ve often heard it referred to as the perfect storm – aging boomers, high costs of care, physician shortages, and the Affordable Care Act. I see this as a landscape of possibilities – possibilities to change the way healthcare is delivered and the way the patient is engaged.
There are four trends shaping the industry today: consumerism, personalization, wellness, and a new definition of value.
We’re moving from wholesale to retail. The patient – or should I say consumer, now expects the same experience in healthcare that they’re receiving in all other parts of their “consumer life.” This is a radical change. Patients are taking advantage of connected technologies, social tools, and information resources to take a more active role in their own health, and it extends further into the payer market. Consumers are no longer limited to the single plan offered by their employer – they have more options than ever on the open insurance market.
To compete in this new marketplace, payers and providers need to rethink their offerings to consider plans that include performance incentives, transparency, and flexibility.
Our industry has historically treated patients en masse. But we’re seeing a move now from the group to the individual. Today’s healthcare consumers expect to be able to engage in a highly individualized, personalized manner, whether it’s in the services and treatments they receive, or the way they pay for that treatment afterwards.
Deploying advanced analytics will enable us to better understand which treatments deliver the best -outcomes and to tailor treatment, messages, and services, as well as provide early alerts. And an increased emphasis from payers on branding themselves and sharing personalized, engaging content will help to differentiate them and build loyal relationships with consumers who have more choice than ever.
We’re beginning to move from “sick care” to healthcare. Instead of treating people episodically – when they are sick – we are beginning to engage in healthcare before there is an acute need. The focus is on wellness and prevention. New devices allow consumers to track their exercise and nutrition and even receive prophylactic genetic testing – and to take action based on those results. There are also devices that remind us when it’s time to take our prescriptions, making sure we adhere to our medication plans and stay healthy.
Even retailers are getting in the game. In a significant move last year, CVS rebranded as CVS Health and even took cigarettes off of their store shelves. With retail clinics, access to flu shots and other vaccinations has never been greater.
New Definition of Value
There is an increased expectation for price transparency, particularly as high-deductible health insurance plans rise in popularity. A study late last year from Mercer showed almost half of the nation’s large employers are offering high deductible plans, which are designed in part to encourage consumers to think twice and ask questions about all options before choosing an expensive and potentially unnecessary treatment.
Payers are increasingly focused on value-based healthcare, or payment-for-outcome payment methods, in response to this call for increased transparency and improved outcomes.
In the provider world, there is a shift toward ACO structures and other alternative care and payment models. Digitization has taken center stage – data can now be mined across the entire business to create baselines to measure movement toward both financial and quality metrics. Additionally, payers and providers are now collaborating to realize that population health embraces defined quality metrics with the hopeful upside of financial payback.
Donald Berwick of the Institute for Healthcare Improvement sums it up as a triple aim – outcome, cost, and experience. And we now want it all.
A Landscape of Possibilities
The future of healthcare is bright and exciting. Enormous strides have been made to move to a more personalized, meaningful model of care. New consumer technologies and analytics are changing the way healthcare is delivered, and it’s important that we keep up this momentum to meet the needs of today’s patients.