There’s never a dull moment in healthcare, and 2019 was no exception. We saw trends continue, bills get shot down, costs rise, and consumer expectations shift. There’s no way to succinctly summarize a year of healthcare breakthroughs and frustrations, but here’s what interested us last year.
Peak Healthcare Consumerism … For Now
Interest in healthcare consumerism has risen steadily over the past couple years, but 2019 was the year it peaked. Having said that, 2020 will likely eclipse 2019 as the most healthcare-consumerist year on record. Why? Two reasons.
First, consumers continually expect greater convenience, higher quality, and lower costs. That’s the fuel that drives markets, and healthcare consumerism is a dominant force in the market. Amazon, Uber, Google, and the like have set a high bar for consumers’ expectations. Healthcare only recently began viewing patients as consumers, too. Now we’re catching up with the rapid innovation of the commercial and private sectors’ innovation when it comes to ways to engage customers.
Secondly, patients are paying more money. Between high-deductible health plans and the consequent increase in out-of-pocket costs, patients are more mindful of where their money goes. And they should be; that’s the same motor that accelerates the transition from volume to value. Last year, these concerns about cost made it to the federal level. Price transparency, which is needed for rational consumers to make educated decisions, received a great deal of attention in 2019; the Centers for Medicare and Medicaid Services (CMS) even proposed a rule requiring hospitals to show payer-specific rates. Legislators also examined ways to address surprise billing, cap drug costs, even import drugs from Canada.
Given the attention from big-name companies like Amazon as well as the federal government, it’s safe to say that consumers’ voices are making an impact on healthcare — and will only continue to do so!
Inching Toward Interoperability
Healthcare consumerism inspired a great deal of innovation, and not just around pricing. Privacy and convenience are central to the debate as well. These all coalesce in discussion of interoperability — who owns patient data and how easily accessible is it?
Interoperability talks were everywhere this year, especially at HIMSS19. As Chris Voigt pointed out, the discussion was often around the “Blue Button” app. This feature “would create health records at birth that include every appointment, test, diagnosis, and data from the Internet of Healthcare Things devices into a record, which could be blockchain-enabled to ensure accuracy and security.”
This Blue Button option is in line with what Secretary Alex Azar recently criticized as a “segmented, balkanized system.” Secretary Azar is keen on “putting patients at the center of American healthcare.” This means finding a way for all stakeholders — patients, providers, and payers — to seamlessly exchange data via application programming interfaces (APIs) while protecting patients’ privacy. As Privia Health CEO Shawn Morris noted on a podcast, with Oliver Wyman, this is a huge mountain to climb, but if we take it step by step, we can improve the patient experience exponentially.
Tangible Advances for Social Determinants of Health
Healthcare is local; data shows that zip codes affect health outcomes as genetic codes do. But these views were traditionally more the domain of sociologists rather than healthcare economists. However, the rise of value-based care has encouraged us to look at medicine in new, imaginative ways. Last year was perhaps the turning point in which social determinants of health moved from an intriguing — if not somewhat vague — buzzword to a meaningful, measurable, impactful concept. A major report from The National Academies of Sciences, Engineering, and Medicine’s report detailed ways of “addressing patients’ social risk factors and social needs with the aim of improving health outcomes.” Also, the American Medical Association teamed up with UnitedHealthcare to “address the social and environmental factors that affect patients’ health by standardizing data collection on their social determinants of health.”
Greater Federal Support of Value-Based Care
Last year we saw CMS signal their commitment to value-based care in many ways, but one in particular stood out: Primary Care First. Primary Care First is designed to foster independence and elevate outcomes through “voluntary five-year payment model options that reward value and quality by offering innovative payment model structures to support delivery of advanced primary care.” These aims are closely aligned with the Quadruple Aim, and that’s immediately apparent in the initiative’s goals: “prioritizing the doctor-patient relationship; enhancing care for patients with complex chronic needs and high need, seriously ill patients, reducing administrative burden, and focusing financial rewards on improved health outcomes.”
2019 gave us a lot to celebrate in healthcare. While every year is full of surprises, we’re optimistic that 2020 will expand on these exciting developments and keep 2019’s momentum going.