With headline after headline announcing a vaccine for COVID-19, many of us can begin to see the light at the end of a very dark tunnel. Although distribution and delivery of the vaccine present new challenges, they foreshadow a post-pandemic era.
Indeed, the post-pandemic era will surely not be without its unique difficulties. A recent survey from Xtelligent Healthcare Media found that only 20 percent of healthcare industry leaders believed their organization would definitely financially recover, and 58 percent of respondents estimate that revenue levels may not return to pre-pandemic levels for up to two years. Healthcare was not perfect before COVID-19 and we will have to contend with the consequences of the pandemic for years to come.
We should look back on 2020 critically and objectively to glean insights that can guide us through the unprecedented issues we face so that we may not only recover, but improve. A recent paper from PwC said it well: “While in 2020 many healthcare organizations saw their financial plans obliterated, patient behaviors radically shift and virtual care explode, in 2021 they will work to put the system back together. Not to how it always was—but in a way that reimagines healthcare delivery, reconnects broken pathways and makes a giant leap toward a consumer-centric healthcare system.”
So what are some trends to look for in 2021 as we seek to assemble a better healthcare system?
Embrace Digital Technology With Intention
While there are no “cure-alls” in healthcare, telehealth is one of the most powerful and promising tools we have. This technology can preserve connection between patients and providers, allowing patients to receive needed care and providers to partially maintain their revenue. As Megan Callahan, VP of Healthcare at Lyft, noted, “We’ve obviously seen the rise of new digital front doors with telehealth. We’re not going to go back from that.” Moreover, the use of telehealth for mental health conditions related to the pandemic will likely expand. Roughly one-third of U.S. consumers surveyed by PwC’s Health Research Institute experienced anxiety or depression as a result of the pandemic, and 58 percent of physician respondents will offer virtual visits for mental health and psychiatry in 2021.
Telehealth is just one of many digital tools growing in popularity: remote patient monitoring (RPM) wearables, a cornucopia of mobile apps, patient portals, devices connected through the Internet of Healthcare Things (IoHT), and more are now readily available. We should ensure that whichever technologies we use, they are well-integrated into clinical workflows. We must remember that healthcare providers are experiencing record-high rates of stress and exacerbated burnout. Adding the latest-and-greatest technologies without proper integration can complicate routines, impair care delivery, and increase non-clinical administrative work. Research from Deloitte shows that physicians believe much of their existing work can be performed by nonphysicians (30 percent), in nontraditional settings (30 percent) and/or can be automated (18 percent).
Taking a physician-oriented approach is also critical to advancing value-based care. Deloitte lists the following three considerations to make when equipping physicians to thrive in value-based care:
- Reorient physician compensation from volume to value and hold physicians accountable for outcomes.
- Give physicians easy-to-use tools for decision-making and performance improvement.
- Build care management capabilities, such as multidisciplinary coordinated care teams, risk stratification, care navigation, and site-of-care optimization
It is critical that organizations keep the provider experience top-of-mind when considering implementing new technological tools into workflows. This approach is considerate of physicians’ well-being, which in turn affects patient care, and can bolster physician retention. As Rae Woods noted on an Advisory Board podcast: “It’s just important to remember that loyalty among your physicians is not guaranteed. Especially right now when we’re seeing so many clinicians leave the workforce, because they’re going through something that none of us can possibly understand. They’re going through true trauma in this fight against COVID-19. And some of them are switching to an organization that perhaps did better, or has the perception of doing better, or they’re leaving. Physician loyalty is absolutely not guaranteed right now.”
Provider-Friendly Data to Succeed in Value-Based Care
Toward the end of 2020, the Centers for Medicare and Medicaid Services (CMS) announced its Geographic Direct Contracting Model. This ambitious payment and care delivery model uses a “geographic-based approach to value-based care [to] improve quality of care and reduce costs” and “build integrated relationships with healthcare providers and community organizations in a region to better coordinate care and address the clinical and social needs of Medicare beneficiaries.”
However, the model also highlights the difficulties found in many value-based programs leading to concerns being raised by groups such as the National Association of Accountable Care Organizations (NAACOS) around “key details on the financial methodology.” As the Association noted in an open letter, “These include specifics around benchmarking, risk adjustment and capitated payments. Without these details, it’s impossible for the healthcare community to make informed decisions about program participation.”
NAACOS’ reservations highlight the need for accurate, transparent, accessible data for providers in value-based contracts. Some organizations are even building data sharing conditions into value-based contracts. As Jamie Reedy, MD, MPH, Chief of Population Health at Summit CityMD, told RevCycleIntelligence, “If the physicians and care teams don’t know their quality scores, or they don’t know if they’re actually getting the right patients in for care … then they’re not going to be able to appropriately manage the outcome that we negotiate in our contracts.” It is crucial that the industry equips providers with the tools they need to understand and satisfy requirements of value-based contracts.
Tools to target and close care gaps are especially crucial post-pandemic. As Kaiser Health News found, nearly half of Americans delayed medical care due to the pandemic, which may lead to increased care gaps. The Advisory Board recommended care-gap closure as a key component of independent groups’ 2021 strategy. “To intervene early, independent groups are honing their methodology for identifying this specific subset of patients by reviewing care gap data that might signal low utilization and leveraging their population health staff to bring these patients in for care.”
Potential Increase in Direct-to-Employer Contracting
In addition to CMS’ Geographic Direct Contracting Model, another form of direct contracting may grow: namely, direct-to-employer contracting. With companies facing financial pressure, some may explore this option. According to healthgram, the benefits of direct-to-employer contracting may include:
- Establishing a more direct and financially advantageous relationship with the provider community
- Lowering costs without compromising quality
- Creating an aligned interest between employers and providers
- Improving price transparency
- Helping reference-based pricing plans run smoothly
- Potentially providing a direct link between cost and health outcomes
As Dave Willis, Vice President of Health System Strategy at the Advisory Board, mentioned on the company podcast. “There’s a lot of interesting data coming out this year about how employers are likely to behave, and it suggests that employers are going to approach what’s happened this year differently than they did the global financial crisis of 2008. Specifically, they’re almost certainly not going to be as aggressive about pushing cost onto their employees, but they are going to consider being more aggressive about things like steerage and reference pricing.” Additionally, employers considering direct contracting should focus on high-performance narrow networks and tools to engage and empower patient-employees.
If 2020 has taught us anything, it’s that unexpected, external forces can threaten even the best-laid plans. Healthcare organizations must continue to adapt and remain resilient to confront whatever challenges 2021 may bring.