In the healthcare landscape of 2024, the spotlight is predominantly on the transformative role of Artificial Intelligence (AI). Forecasts emphasize the real and imminent impact of AI, from patient data sharing to tailored treatment plans and cutting-edge innovations. While AI is set to reshape healthcare significantly, it’s crucial to recognize that 2024 won’t be the climax of its influence. Amidst the anticipation surrounding AI, noteworthy events shaping the future, including disruptive forces, are often overlooked.
Why Won’t AI Be the Main Health Care Story of 2024?
Artificial Intelligence will play a continuing, meaningful and supportive role in health care. It will even do some amazing things, like predict life expectancies for patients with some conditions. Diagnostics will continue to get better. Natural Language Processing (NLP) will be incorporated in major EHRs and reduce physician documentation workload. ChatGPT and others will facilitate technology development, communications, and other functions.
To look at this realistically, though, these improvements are just progress notes. AI will make a big stand in health care, but it isn’t ready to actually transform it, even if individual AI products go forward. Three missing elements need to be in place first.
- Actors in health care must be ready to adopt AI technology, with money and imperative. Physicians and groups, hospital systems, and other providers must have a business case for AI adoption. Only in diagnostics, robotic surgery or similar specific services have compelling business cases that tie revenue streams with provider differentiation. We see AI advances in radiology, ophthalmology, and plastics because there is a business case and capital to compel adoption, and groups with AI tools can ascend in the market and get returns on the investment.
- Slow AI adoption through Value-Based Care and risk-based payment models. In our economic reality, competition and payment models dictate providers’ financial viability and the pace of Value-Based Care adoption. The fact is that the cost of not participating doesn’t affect revenues enough currently. Payers can make it imperative for health systems and generalist providers to move toward risk, and risk-based reimbursement will create the backward chain of incentives to improve outcomes.
- Data necessary to fuel AI advancements must be present. Traditional providers have actively resisted the aggregation of data that could be used to deploy AI, and even large systems are just now beginning to build the data infrastructure necessary. While claims or billing data can provide a base of data, clinical data like laboratory values, condition staging information, and longitudinal outcomes is essential. More problematic, that data must be fed from a broad base of clinical providers serving any given patient. High quality demographic data, with social determinants of health, and financial and community sources will also be key to AI-enabled patient risk predictions.
Three Predictions for Continued Disruption in 2024, with Light Ahead
An exit from the disruption of the health care business of the past several years would be a happy next step. But it won’t happen until shifts in the balance of power and resources. These will gather steam during 2024, and advance the case for adoption of Artificial Intelligence to manage an increasingly complex health care environment.
- Corporate Health Care Expansion: Health care’s corporate surge continues in 2024, with Optum leading as the largest employer of physicians. The trend of corporate health care surpassing traditional providers in overall physician employment intensifies, driven by capital inflow into private-equity-backed practices and ACO enablers like Aledade. CVS Health and Amazon’s major physician group purchases in 2023 set the stage for continued escalation in 2024. These corporate giants, with business models grounded in Value-Based Care and risk, are poised to align with payers and invest in data and AI tools.
- Data Expansion for AI Adoption: The digitalization of healthcare data reaches maturity in 2024. Epic dominates the market, causing smaller EHR systems to decline. CMS policies, mandating certified systems for ACOs, fuel consolidation among providers. Major health systems recognize data as a crucial asset, experimenting with NLP to transform unstructured data into valuable sources for SDOH and other needs. With CMS requiring quality reporting for all patients, ACOs increasingly embrace AI opportunities, realizing the imperative of robust data.
- Physician Shortages and Changing Delivery: In 2024, physician shortages intensify, leading to longer patient wait times, even in historically well-served areas. Increased demand for specialties arises from larger patient populations with complex conditions. Wait times of up to 6 months, despite insurance benefits and large provider networks, become common. Consolidated health systems create bureaucratic barriers for patients, prompting a shift towards retail clinics and urgent care. This acceleration in patient behavior further strains the traditional bond with healthcare providers.
In 2023, the U.S. healthcare system witnessed widespread discontent, with low satisfaction levels reported by consumers, patients, physicians, and system executives. Conversely, there was great excitement on the outskirts of the healthcare system, as policymakers and technology companies anticipated a radically different future. That says something important about what that future is: It’s going to be a lot different.
Theresa Hush
CEO and Co-founder of Roji Health Intelligence, Theresa Hush is a health care strategist and change expert with experience across the health care spectrum, including public, non-profit and private sectors.
