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By Jordan Bazinsky
Though we don’t know when the COVID-19 pandemic will end, observers have been deliberating whether the U.S. healthcare system will eventually return to its pre-pandemic structure or if healthcare as we know it has fundamentally changed. In between those two poles resides our likely future, one where healthcare has been altered in substantial ways but today’s stakeholders still play an important role.
Here are 10 specific changes to the healthcare system brought about by the COVID-19 pandemic that are likely to persist far into the future:
- Reimbursement changes for less acute care settings. This evolution has been underway for years as reimbursement has shifted from favoring solely inpatient procedures to including outpatient care, ambulatory surgery centers, and other lower-cost care settings. Telehealth took the spotlight when CMS began reimbursing for virtual visits during the COVID-19 public health emergency, a move that one bipartisan group of lawmakers is looking to make permanent.
- Greater adoption of telehealth. Consumer demand for convenience and access, coupled with the rapid adoption of telehealth services and new diagnostic and management techniques, make telehealth a critical part of the United States’ healthcare future. Even for healthcare diagnostics and procedures that require in-person events, the related and ancillary services will be delivered remotely, such as rehabilitation and recovery. Already, we’ve seen several payers launch “virtual-first” health plans to accommodate growing demand for virtual care.
- The transition from building physical to building virtual infrastructure. Not long ago, the future of healthcare could be described as “a crane on every campus”. The next-generation corollary will be “a virtual platform for every patient,” as demonstrated by more than half of Medicare beneficiaries receiving telecare in 2020. No healthcare provider will be able to provide the full range of service to patients without a robust virtual delivery mechanism.
- Pricing transparency. Healthcare providers have somehow evaded all market norms by actively obfuscating prices, even as consumers have absorbed ever larger portions of the overall healthcare bill. This year, a new rule from CMS went into effect requiring hospitals to publish the prices they negotiate with insurers for various medical procedures. Prices are critical to the functioning of efficient markets, including the healthcare market. It will not be long before organizations compete on price alongside outcomes and patient experience.
- Diversity, equity, and inclusion (DEI) metrics. While the medical community has nodded to these priorities in the past, the pandemic further highlighted the disparities in access and outcomes for underrepresented populations. Expect to see healthcare organizations hiring, treating, and publicly reporting with a keen awareness of their DEI metrics.
- The resurgence of onshore biotech manufacturing. The oft-cited fact that American manufacturing has largely disappeared includes the healthcare sector. This became a point of national concern during the COVID-19 pandemic, when items as basic as medical-grade face masks could not be procured internationally, nor manufactured in large enough quantities domestically. National security concerns in the wake of the pandemic will shake up the medical manufacturing landscape.
- Centralized healthcare data. As with manufacturing, the lack of access to large-scale data sets with which to identify and model epidemics can have fatal consequences as we saw during the COVID-19 pandemic, with a lack of information leaving communities unprepared to handle surges in infections. Individual health plans, provider groups, and healthcare IT companies have maintained silos of data for decades. What was a steady rallying call among a smaller group of healthcare providers, policy makers, and business leaders has become a national outcry for ensuring our health and wellbeing. The fact that our national rollout of COVID-19 vaccines is being recorded on easily lost—not to mention easily forged—pieces of paper should give all of us pause.
- Medicaid programs leading the charge on policy innovation. With the amount of political conflict at a fever pitch in Washington, D.C., the federal government is unlikely to launch the next wave of healthcare innovation. Rather, individual states will reward ingenuity in healthcare delivery and technology through regionalized payment programs. Some of the most creative approaches to financing and delivering healthcare in the coming decade will be at the behest of state leaders.
- Gene therapy taking a prominent role in treating complex disease. Until now, gene therapies were primarily experimental, with huge price tags for small disease populations. However, the MRNA delivery mechanism commercialized by Pfizer and Moderna in their COVID-19 vaccines lends additional credence to novel methods of action in pharmaceuticals. When combined with new payment schemes, anticipate the acceleration of gene therapy drugs into the commercial marketplace.
- The eroding distinction between healthcare companies and “digital health” companies. For the last several years, digital health investment has been at record levels. These companies have held the promise of low-cost, high-impact activities across a range of populations and disease states. Yet, they were distinct from more traditional healthcare delivery routes. That will no longer be the case as legacy healthcare providers embrace digital health to extend and modify their care models for the post-pandemic era.
Any one of these changes could materially improve our national healthcare profile, but together they could revolutionize the healthcare system’s framework. That may be the lasting legacy of COVID-19: that out of great tragedy came a more resilient and patient-centered healthcare system than even the most optimistic among us would have imagined just a year ago.
Jordan Bazinsky is EVP of Operations at Cotiviti.
Healthcare Business Today is a leading online publication that covers the business of healthcare. Our stories are written from those who are entrenched in this field and helping to shape the future of this industry. Healthcare Business Today offers readers access to fresh developments in health, medicine, science, and technology as well as the latest in patient news, with an emphasis on how these developments affect our lives.