Belong Health is not in the prediction business. However, everywhere we turn there are signs of what is next for healthcare and how we can help our partners get ahead of and break the cost curve. In our first annual trends piece, we asked Belong team members where they see healthcare trending and what we need to do to be prepared. Coincidently, the insights fell in two buckets: care delivery and tailoring the healthcare experience. Take a look and let us know your take.
Hospitals and health systems need to drastically change their care delivery model to stay relevant and solvent
"While we'd like to think the days of the pandemic are behind us, from a patient experience standpoint, this is perhaps one of the worst times to seek out healthcare services. Hospitals and health systems, who have always struggled with razor thin margins, are finding it harder and harder to keep doors open. As government relief money is slowing down, labor costs are rising, and staffing shortages continue to create issues for the system. The impact is that hospitals and health systems are forced to focus on higher reimbursement services and are closing much needed outpatient services. Many of these services are desperately needed by patients who may have deferred care during the height of the pandemic. To keep the lights on, many systems are playing the shorter game to capture whatever they can in the way of revenue and margin."
"Hospitals are living dinosaurs. We will continue to challenge assumptions about what services are best managed in a hospital. Infectious disease treatment, remote robot-assisted surgery, virtual specialty consults, are all opportunities to shift care from an inpatient hospital setting to the home. Because of the unit economics this shift could happen very quickly, with opportunity for great innovation. This also provides risk for great inequity."
"While value-based care continues to drive innovation in healthcare, there are early signs of the next evolution in healthcare. This evolution will take a page from history and a page from the future, but most importantly will be born out of a desire for simplicity and patient experience. Healthcare financing of the future will look a bit like it did in the 1980s. Health insurance products will revert to the “major medical” type concepts and physician services will become a subscription-style service where you buy a subscription into a group/system of physicians and pharmacies for all your needs. This model simplifies the administrative complexities that exist today (no referrals/authorization for in-practice services) and will provide for a better overall patient experience (few delays in accessing care). A big advantage of this model is allowing doctors to focus on providing the best care at the right time. Key to executing this model will be adoption of existing and innovative technologies that accomplish the following:
- Bridge time and space
- Engage and allow caregivers and patients to manage their own care between visits
- Create a continuous monitoring of key physical health indicators that allows technology to triage patients into the right level of care
- Enhance access to care for those living in medically underserved communities."
Health plans will become more tailored to population needs
Vulnerable communities need even more resources to bring some level of parity to their healthcare experience. We are just scratching the surface on how customizable our healthcare system can be to address historic barriers to healthcare for the LGBTQ+ community, for example. Oftentimes, people who identify along this spectrum have been shunned by society in general, but by healthcare entities as well.
Because of this, payers are developing plans for the LGBTQ+ population. Specific care coordination with a vendor partner along with resources aligned to this community and virtual mental health services.
There are nuances in the care of our LGBTQ+ friends and family that cannot be solved by cookie cutter health plans. We need to develop plans to address their specific needs, not requiring them to adapt to whatever generic plan is offered.
Crafting these kinds of bespoke plan solutions is a blank slate right now. Our only limitation is our imagination and our willingness to change the status quo."
"Many health plans are looking to re-consolidate risk for complex populations. Complex populations are not served well by fragmented care. More comprehensive whole person care models and supportive financial models are leading to better patient outcomes.
For example, the proliferation of disease management apps works for simple populations where members often associate their medical care with a single condition or episode. However, complex populations don’t think of their care as one dimensional. They also don’t want five app logins. They do want and need accountable support for their comprehensive list of needs to maximize their health."
"Healthcare alone can’t fix the impacts of health disparities on the health of our communities. Poverty and stress take away any advances we make in addressing health disparities. We need to acknowledge that our food deserts and unwalkable cities make for unhealthy citizens. Instead of framing obesity and the increase in chronic conditions among Americans as a health crisis, we need to address the social, environmental, and educational issues that impact people’s access to healthcare. Health plans need to prioritize integration of social determinants of health assessments into member engagement, acknowledging the social and environmental factors that can impact our member’s health. It’s important for us to move beyond the “standards of care” and into tailored care for each member we serve.