The transformation of healthcare has been accelerating over recent years. In 2020, the COVID-19 pandemic altered the way healthcare is delivered, along with the expectations of patients. Simultaneously, significant technological advances offered innovative ways to provide more proactive, accessible and efficient care. Together these factors have created a prescription for fundamental change in the healthcare ecosystem.
The pace of transformation is not expected to slow down as we move into 2024. The healthcare industry must continue to address inefficiencies and inequities that have plagued it for years while also setting the foundation for the future of value-based care and meeting the needs of healthcare consumers. Looking ahead over the next 12 months, I see five key trends that will take center stage in this transformation:
#1 – Growing Shortage of Nurses and Physicians
Underlying any trends for the coming year is the elephant in the room – growing shortages in the healthcare workforce. According to the Association of American Medical Colleges, the U.S. is facing a projected shortage of somewhere between 37,800 and 124,000 physicians within 12 years. This physician shortage hampers efforts to remove barriers to care and demands new paradigms for care delivery.
Additionally, the rising cost of delivering care, which includes sustained cost increases for nursing post-pandemic, contributed to more than half of the health systems losing money in 2022. Combine that with an aging physician workforce and 10,000 baby boomers turning 65 every day and more people will need to be recruited into healthcare while simultaneously improving efficiency in care. These efficiencies will largely be powered by technology, especially artificial intelligence (AI) and remote patient monitoring (RPM).
#2 – The Rise of AI
While other industries have employed AI for years, healthcare has been slower to adopt it. But now healthcare companies are embracing AI for everything from helping practices become more efficient and reduce costs to clinical decision making on the frontlines.
AI was ranked as the most exciting emerging technology in a recent Center for Connected Medicine survey, for a number of reasons. AI can improve operational and financial challenges at the heart of healthcare delivery systems and potentially ease burdens on overworked providers. For example, AI chatbots can serve as a first point of contact for patients, improving the patient experience by guiding them quickly to relevant information or helping to schedule appointments. AI also can be employed to streamline documentation, improve communication between providers or to automate a variety of administrative tasks, such as billing or prior authorizations. On the clinical side, AI can help identify abnormalities in medical imaging that may not be easily detectable by the human eye or predict individual patient reactions to certain treatments, enabling precision medicine and personalized care at a scale the system has struggled to achieve.
Yet, despite the promise and potential of these advancements, trepidation remains about the use of AI. Concerns about data privacy, bias and the need for human oversight are rising as AI becomes more pervasive. As Futurescan 2023 noted, the next five years will be crucial for hospitals and health systems to build the infrastructure needed to support AI, not to mention putting policies in place to mitigate these concerns.
#3 – The GLP-1 Era
Obesity has become a public health epidemic, rising from 30.5% to 41.9% in the U.S. between 2000 and 2020. Glucagon-like peptide 1 (GLP-1) agonists – a category of medications historically prescribed to manage blood glucose levels in Type 2 diabetes – have demonstrated incredible efficacy for weight loss as well as initial benefit for cardiovascular risk reduction leading to huge increases in demand for these medications and staggering off-label use and supply chain challenges. This year alone, 1.7% of Americans have been prescribed this category of medications; 40 times more than 2018. And it’s only going to continue growing. By 2035, about 7% of the U.S. population will be using GLP-1 drugs, Morgan Stanley Research estimates.
The unparalleled efficacy for weight loss has resulted in skyrocketing demand for GLP-1 drugs, creating a shortage despite record sales and efforts to boost production. This has caused friction and frustration when combined with the high cost, limited insurance coverage and time-consuming prior authorization hurdles.
Adding to the concerns is the growing direct-to-consumer (DTC) market offering GLP-1s with less medical oversight than traditional medical practices. Several virtual care and telehealth companies, like Teladoc and Weight Watchers, through its acquisition of Sequence, are moving into the obesity drug market, offering GLP-1 drugs to qualified patients as part of weight management or chronic care programs. Regardless of whether it’s a traditional practice or a telehealth company, patients’ weight loss should be monitored and their prescriptions and comorbid conditions actively managed. Metrics like blood glucose and blood pressure should be monitored and medications adjusted as individuals lose weight, which requires more robust remote monitoring for patients to achieve optimal outcomes and avoid complications.
#4 DTC Disruptors
Plagued by long waits for in-person appointments, in part due to the previously mentioned physician shortages patients have become increasingly frustrated at the state of healthcare. The pandemic drove greater acceptance of virtual care, but pent-up demand for services and the continued shortage of healthcare professionals have prevented patients from getting the care they need, when they need it from their traditional providers.
These shortcomings presented a huge opportunity for non-traditional providers. Major retailers like Amazon and Walgreens have seized the opportunity to offer DTC telehealth services. And we’ve seen the rise of new niche telehealth companies offering digital care for specific conditions.
One question is if these services may ultimately cost more time and money. One analysis noted that more than 11% of telehealth visits nationally over the course of a year resulted in the patient having to follow up with an in-person visit for the same clinical issue within one week. DTC programs can lead to fragmentation of care between patients and their primary providers. Retail and niche offerings create data silos that make it difficult for a doctor to have a holistic picture of the patient’s health, which can potentially result in misdiagnosis, repeat testing or incorrect treatments over the long term.
The key for health systems is to find a way to innovate and move faster in deploying virtual care models. Many already started with telehealth during the pandemic, but they cannot stop there. Health systems need to add other virtual services, such as RPM, in order to compete and retain their patients in this rapidly evolving and increasingly competitive market.
#5 – Reimbursement Certainty to Expand Use of RPM
RPM has been a lifeline for patients in medically underserved communities who have been fortunate enough to receive these services. Yet, prior to 2024, there has been little to no reimbursement to support these valuable programs, even though they have proven to make a positive impact on the outcomes of many patients.
That changed this Fall when the Centers for Medicare and Medicaid Services (CMS) issued its 2024 Medicare Physician Fee Schedule Final Rule. For the first time, Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) – the primary organizations bringing care to medically underserved markets and patients – have a financially sustainable pathway to invest in remote patient care. While the number of those healthcare providers offering RPM is expected to reach about 76% by the beginning of 2024, it’s anticipated that with the changes in reimbursements, greater adoption of technology and expansion of existing programs, more than 70 million U.S. patients – 26.2% of the population – will benefit from some kind of RPM.
This is good news for the more than 67 million people who rely on FQHs and RHCs. The addition of more RPM offerings as a result of CMS reimbursements will provide underserved patients and their providers with the tools needed to proactively manage chronic diseases.
Lucienne Marie Ide, M.D., PH.D., is the Founder and Chief Executive Officer of Rimidi, a leading clinical management platform designed to optimize clinical workflows, enhance patient experiences and achieve quality objectives. She brings her diverse experiences in medicine, science, venture capital and technology to bear in leading Rimidi’s strategy and vision. Motivated by the belief that we can do so much better as individuals, in industry and society, Lucie left clinical medicine to join the ranks of healthcare entrepreneurs who are trying to revolutionize an industry.