This year four defining trends are set to keep healthcare industry decision-makers busy. Observers are keen to see whether headway in driving forward personalization will have any effect on medical costs, outcomes, and member experience in 2023. The industry landscape has been disrupted with non-native entrants, bringing in both added risk and fresh ways of approaching care delivery. The year ahead is also likely to see conversations around creating unified health ecosystems, and what this vision of the future entails from a regulatory perspective. With this backdrop in mind, here are four trends that will leave their mark on the U.S. health industry in 2023.
KNOW YOUR CUSTOMERS
Most consumers today are accustomed to personalized experiences from interactions with companies like Netflix and Amazon, and are expecting more from healthcare. Given the consumer imperative and expectations, personalized health is a topic that payers, providers, and pharma stakeholders are starting to explore, particularly, using personalized care delivery and engagement tactics to improve care outcomes and patient experience. For the healthcare organizations, delivering personalized experience means getting to know the consumers better, understanding their attitudes and preferences, and using that information to tailor content, messaging, channel and timing, in order to deliver hyper-personalized care offerings. To enable personalization at scale, health organizations are making significant investments in platform, technology, data, and integration.
Privacy and consent are big factors to account for to deliver a truly personalized experience. In the year ahead, healthcare organizations will continue discussing how far they can push the boundaries of personalized healthcare delivery and will be asking some hard-hitting questions around personalization, such as, what has this trend actually delivered?
It’s a harsh reality – nothing ignites the spirit of innovation quite like a pandemic. The increase in virtual/digital health, mental health, and lifestyle management solutions significantly picked up during the COVID-19 crisis. It has become clear that “care anywhere” is now imperative. This entails a combination of different components, including care at home, retail healthcare, digital health, telemedicine and virtual therapy. Whether it’s accessed at home, via retail or telehealth, a digital healthcare ecosystem unites resources together through technology and apps to merge different datasets gathered by clinics, labs or medical tests.
Given the change in how consumers and clinicians seek and provide healthcare services, this trend has supercharged digital health funding and there has been a proliferation of point solutions post-pandemic. Hundreds of point solutions companies are focused on solving various parts of members’ or a providers’ needs - e.g. telemedicine platforms, appointment services, disease-condition focused (diabetes, mental health), data clean-up, analytics. It is particularly tricky when none of these point solutions talk to each other or have no knowledge of the other health interactions. This can create a disjointed customer experience – from care delivery to leaving it up to members to find what is the right tool for them.
And speaking of telemedicine, in the post-pandemic world who doesn’t have telemedicine capabilities. It’s more about how consumers view virtual care now, after a big jump start in accessible digital healthcare solutions following Covid. Regulations go hand in hand with expanding telemedicine operations. For example, a physician who has a license to practice should, ideally, be able to talk to anyone in any geography, but licenses are not always valid from one geography to another. Additionally, virtual/digital care must be appropriately paid for. If digital services are less costly than in-person visits, how will that affect adoption of these services? Regulators are keeping busy with questions like these as consumers navigate care anywhere offerings.
Primary care, the day-to-day healthcare given by a healthcare provider or a focus on preventive care, is essential in prolonging people’s lives and achieving positive health outcomes for populations. The healthcare trend for primary care is growing due to consumer expectation of convenience, easy access, and quick response times regarding their healthcare needs. Given the increased focus in primary care, new entrants are making moves. Amazon and other retail companies like CVS and Walmart are providing or expanding their primary care services.
Digital has become an enabler for primary care. With primary care often entailing routine health checks and follow-up care, payers and healthcare providers are finding innovative ways of delivering these services. The idea behind virtual-first primary care is to have patients start their care journey with a digital interaction. Non-native health companies are often at the forefront of digital developments in the health ecosystem. For example, retailers like Walgreen Clinic and CVS MinuteClinics are disrupting primary care. Other examples include Amazon Care’s program Care Medical, a team of clinicians that support customers across their healthcare journey and help with primary care and urgent care needs. Amazon signed a $3.9 billion purchase of primary care provider One Medical in late July, signaling significant change ahead in the sector. Walmart Health expanded across Florida this year, with Walmart Health centers providing primary care services and other offerings such as labs, X-ray, behavioral health and counseling, dental, optical and hearing. In the year ahead, market observers will be interested to see whether these companies can change the health ecosystem as we know it.
Cost transparency is a convoluted topic in the U.S., where healthcare and insurance rates have not traditionally been visible to members and where they are, it can be very confusing. Price transparency can enable consumers to make more informed decisions and enable stakeholders to better assist consumers. Additionally, increased transparency can enhance competition in the marketplace leading to costs that are better controlled.
Regulations have been enacted in the last two years that mandate health plans and hospitals to disclose pricing for covered services and items. This can help healthcare consumers make better informed choices about their healthcare needs and provide a clear view on their share of the costs. However, current transparency efforts make it too difficult for the consumers to understand how to use it in their day-to-day care needs. Additionally, how accurate the information related to cost-transparency is as well as how much members and patients are aware of this and are using this to make healthcare decisions, is still something to be determined. Accuracy of cost transparency and regulation changes are therefore high on the health equity trend agenda. Current transparency efforts make it too difficult for the consumers to understand how to use transparency tools for their day-to-day care needs. Digital can simplify the process and provide information to consumers when they need it and where they need it.