The healthcare industry has been adapting to rapid changes especially since the COVID-19 pandemic started. The pandemic rapidly shifted the way providers deliver care, consumer expectations for care delivery and digital enablement. It also placed demands on antiquated technology. As the world has generally returned to the new normal, healthcare industry players are looking to a more proactive approach and to take advantage of the momentum the pandemic provided as they think forward about the future. In the coming year, we see a continued evolution in several areas across the healthcare spectrum that will be fueled advancements in data and technology.
1. Care Delivery Diversification
How care is delivered is rapidly changing with the expansion of retail health centers and continued advancement in the capabilities of digital health platforms. Department stores, pharmacies and urgent care centers continue to expand their retail health center footprint and the types of care they provide. These centers are competing for market share with the traditional doctor’s offices for primary care, urgent care, vaccinations, chronic condition management and some types of specialty care like dermatology, orthopedics and mental health.
Digital health platforms are advancing capabilities to deliver care through live video chat, asynchronous video and chat, remote patient monitoring, and mobile device integrations. The industry will expand use of these tools to reduce administrative costs, capture patient market share, and manage caregiver burn out. Hybrid care models that combine in person and digital care from the same provider will expand as customers expect continuity of care balanced with convenience.
Healthcare organization mergers and partnerships will continue, as they look to manage costs and maintain consumers within their ecosystem. Outside of acquisitions, payers are creating benefit design and network design that take advantage of these delivery innovations as another way to influence costs.
2. Whole Person Care and Inclusive Research
Across the industry, efforts to provide whole person care will continue to be a focus area. Driven by the CMS health equity framework, value-based reimbursement models and a general cultural focus on equity, care organizations will continue seeking ways to reduce health disparities and close gaps in care by addressing a person’s physical health, mental health and the socio-economic drivers that influence health outcomes.
Payers will add unique benefits to their plans to support reducing health inequities like food insecurity and transportation issues. Payers and providers will continue to explore ways to match patients to providers who can deliver culturally competent care with the goal of improved patient engagement. Pharmacies will use their frequent face-to-face interactions and consumer retail purchase data to provide consultative care and solutions that improve health habits like medication adherence and diet.
Providers looking to maximize reimbursement in value-based reimbursement arrangements will engage patients on socioeconomic factors that they can influence to help ensure the best possible health outcomes.
Life sciences organizations are focused on making clinical trials and research more inclusive across all aspects of possible patient health factors, demographics, and socio-economic conditions.
Digital health companies will continue to expand capabilities to personalize offerings based on a consumer’s unique identity, physical and mental health needs and social factors that influence overall health.
3. Technology Drivers
The industry is at the very early stages of figuring out how to use artificial intelligence, particularly generative AI solutions. All stakeholders will be looking for ways to harness the power of AI in new ways to support operational efficiencies, improve health outcomes, and reduce caregiver burnout. We are seeing rapid exploration of the use of AI in tasks like transcription of medical notes, automation of prior authorizations, empathetic customer support chatbots, patient triage, and summarizing vast amounts of medical history. These efforts will support faster care path decisions, manage claim costs and share digestible patient history with a patient’s care team.
Regulation and industry standards will continue to evolve as healthcare finds its way with AI. The ability to strike the balance of privacy, ethical use of data, patient safety and equity will be key for healthcare to successfully use data to support operational tasks and patient care.
4. Consumer Driven Marketplace
All players in the industry will need to adapt to the increasing demand from consumers for the healthcare experience to be on par with banking and retail experiences. Consumer choice in where they spend their healthcare dollar will continue to grow and become significantly more like a retail shopping decision. Consumer satisfaction with digital and in-person experiences will become a key driver for organizations to focus on as more options become available to the consumer for healthcare.
The number of people aging into Medicare daily is introducing a large group of consumers with the power to choose traditional Medicare or a plethora of Medicare Advantage plans. Those seniors are more digitally savvy than ever before, and those digital and customer experiences influence how they choose their benefit plan. The reduction in Medicaid eligible persons due to post pandemic redetermination activities is introducing more people to the option of healthcare marketplace plans. Employers are looking at ways to manage their healthcare costs by offering choice to their employees, moving to defined contribution benefits, and other ways to help control costs.
To support the demand for digital front doors and digital delivery, stakeholders will continue to invest in consumer data, cloud infrastructure and design solutions to modernize their customer experiences to match customer expectations that are largely formed by industries outside healthcare. These solutions will require investments in data to support personalization of messaging and consumer experience. Investment in modern security tools will be required to thwart bad actors who are increasingly attacking healthcare organizations because of the vast amount of data available on persons.
5. Data Enabled Healthcare
Data will be the essential enabler for all the trends we mentioned earlier. Accurate and unbiased consumer and health record data will be the way AI models learn and how we quickly advance medical research to develop new diagnostics and treatments. Consumer data will be imperative in delivering personalized care, member and patient retention strategies, provider and patient matching, and digital experiences that are secure and easy to use.
Lawmakers are grappling with the reality of the need to improve transparency and interoperability while balancing consumer privacy and security. Data about healthcare providers, consumers and the organizations that deliver and pay for care will become increasing important to organizations as they develop their business strategies to maintain market share and maximize value. The convergence of provider data, consumer data and healthcare claim data with regulation and AI advancements will create new opportunities for transparency and personalization in ways we have aspired for many years.
Conclusion
The healthcare industry has traditionally been slow to adopt new data and technology solutions. However, the COVID-19 pandemic, post pandemic policy changes and consumer expectations, and the public availability of generative AI solutions have created a platform for healthcare to advance quickly. Consumers are demanding more, and they want it faster and easier. Rising medical costs, provider shortages, and industry merger and acquisition activity are driving new opportunities for health systems, payers, and pharmacies to use data to improve their bottom line and deliver quality healthcare. Data is the great enabler that will underly all the advancement to come over the next few years.
If you would like to learn more about data trends, read our data briefs.
