Heading into 2020, healthcare is at a crossroads. With national health expenditures slated to outpace GDP growth by the year 2027, there is an urgent need for science, technology and policy to converge toward a better, more efficient healthcare system.
While there is undoubtedly a lot of work to be done, in many ways, we’re moving in the right direction by building the infrastructure upon which real progress can be realized. And with the right combination of innovation, collaboration and momentum, we’ll be able to continue on this trajectory well into the new decade. Here are 10 of the biggest trends we’re predicting will influence the healthcare landscape, starting in 2020.
1. From Emerging Tech to Industry Standard
The year 2020 has long been a marker for what some theorists envisioned would be the pinnacle of technological advancement — the year humans finally made it Mars, mail is sent by rocket and therapists have been replaced by robots, to name a few of the most amusing predictions compiled by Best Life.
While these then-outlandish predictions didn’t exactly take shape the way we anticipated, largely speaking, we’ve done much better. Data is transmitted instantaneously not by missile, but electronically, by way of email, and, in the case of healthcare, by electronic health records (EHRs). Artificial intelligence and robotics, while not taking on the role of the clinician, are substantially augmenting and enhancing clinical workflows.
In 2020, we’re likely to hear less about the potential of artificial intelligence and machine learning to “disrupt” healthcare — that is, because they already have. What we can expect is rapid progress in how these technologies are being used beyond the radiology lab to improve the whole healthcare spectrum, including payment accuracy, consumer experience and, in turn, population health. Although, if it’s anything like the rapid progress we’ve seen over, say, the last 10 years, we might not even realize the extent of the impact until we’re looking back 10 years from now.
2. Data Interoperability Coming Into Focus
Interoperability has been the aspirational buzzword of 21st-century healthcare. This is a real issue, given that many of our most promising quality improvement initiatives hinge on the ability to seamlessly and securely exchange health data across organizational boundaries. But with strides being made in data analytics and policy innovation, the stars are aligning to transform interoperability from pipedream to reality.
A proposed set of rules from the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) is one such regulatory push to accelerate interoperability through improved access to and transfer of patient data. The rules require health insurers — including Medicaid, CHIP, Medicare Advantage and Exchanges — to provide consumers with “immediate electronic access” to their personal health information by 2020. Additionally, these health plans and providers must adopt “open data sharing technologies” to allow consumers to transition their care when switching plan types.
3. The Internet of Medical Things (IoMT)
IoMT devices like wearables, heart and diabetes monitors and mobile health apps will become more important and widespread in the coming years. According to Forbes, 1.2 billion of the world’s 8 billion people will be elderly by 2025, making the level of connectivity the IoMT provides vital to monitoring and engaging this population, as well as other vulnerable populations.
The ability to seamlessly transmit critical health data from patient to provider allows care teams to identify and address health risks outside of the acute care setting. And with the emergence of 5G, healthcare professionals are poised to be able to do this with unprecedented efficiency and response time, opening the door to improved population health outcomes and reduced healthcare spending.
4. Patient Centricity Will Redefine the Care Setting
From virtual and home-based clinical trials to personalized care management programs, the healthcare value chain will continue to adapt to the needs of the patient at the center. But in the coming decade, we should see a tangible, evidence-based impact of how bringing care to the patient can improve cost and outcomes, particularly for those with a complex set of medical, behavioral and social determinants of health.
With mounting evidence supporting proactive, home-based care as a means of reducing hospitalizations, mortality rates and costs, CMS recently announced its Emergency Triage, Treat, and Transport (ET3) Model affording ambulance care teams greater flexibility around where and how they deliver emergency care to Medicare beneficiaries. Scheduled to launch in January 2020, the voluntary model will expand payment for emergency ambulatory services beyond direct transport to hospitals, skilled nursing facilities and dialysis centers to include alternative destinations, such as primary or urgent care centers, as well as treatment in place options.
5. Downward-Trending Life Expectancy to Drive Greater Urgency Around Population Health
Achieving the healthcare triple aim has long been a priority for healthcare stakeholders; however, alarming new statistics showing a steady decrease in life expectancy in the U.S. — and an increase in mortality rates among relatively young individuals aged 25 to 64 — suggest profound and systemic shortcomings.
The report, published in the Journal of the American Medical Association, examines how, despite a progressive increase in life expectancy over the better part of the past 60 years, the U.S. has fallen behind other high-income nations in this critical area, naming drug overdoses, suicides and organ system diseases as underlying factors. This phenomenon casts a glaring light on the need to better understand and address behavioral and social health across populations, and in 2020, we expect it to be an urgent priority for policymakers, healthcare professionals and all stakeholders across the care continuum.
6. Amid Uncertainty, Profitability Will Be a Challenge — Albeit a Manageable One
Although pressure on profitability is expected to continue into 2020, it’s nothing healthcare organizations haven’t successfully managed in years past, according to a new forecast from Fitch Ratings. However, Fitch notes that the emergence of value-based payment arrangements, opioid-related legal proceedings and political discord surrounding key healthcare issues could create susceptibility to headline risk, especially during an election year.
7. Analytics to Drive Action
Last year, we predicted there would be an increased focus on applied analytics as a means of turning data into actionable insights — and with more than 2,300 exabytes of new healthcare data projected to be generated in 2020, analytics must become exponentially more sophisticated in order to actually apply all this data. (For scale, an exabyte is equal to 1 billion gigabytes.)
In the ongoing effort to treat the whole person and improve health outcomes on a large scale, advanced analytical capabilities like predictive and comparative analytics will be key forces in putting healthcare data to use in identifying and addressing health disparities across populations.
8. The Continued Retailization of Healthcare
Patients and health plan members have more choices and purchasing power than ever, which has led to the recognition of today’s healthcare consumers as just that — consumers. And with national and big box retailers continuing to make their way into the healthcare arena, there’s a lot of discussion about their potential in facilitating greater access to care.
Expect retail clinics and urgent care practices to continue to grow in popularity among discerning consumers, while keeping an eye on the evolution of the various partnerships forged between retailers and healthcare organizations in recent years. And as Harvard Business School Professor Robert S. Huckman notes for HBR, interestingly, Best Buy is particularly well positioned to disrupt the telehealth market.
9. Medicare (Advantage?) for All
Healthcare has taken center stage as one of the most important issues among U.S. voters in the 2020 presidential election — particularly, universal access to healthcare. As we’ve outlined extensively in our Health Ideas series on the impacts of a single-payer system, the Medicare-for-All platform being touted by Democratic candidates would have profound implications for the healthcare system and the economy as a whole.
The idea of expanding Medicare Advantage has surfaced as a means of expanding access to health insurance, while still giving Americans the ability to choose their own health plan. Medicare Advantage plans have grown increasingly popular among the senior market, and some experts suggest that Medicare Advantage for All could fill current gaps in healthcare without the need to overhaul the system. Whether it gains traction as a viable solution or not, we’re predicting it will be part of the healthcare conversation, at least leading up to November.
10. The Shift Toward Value-Based, Patient-Centric Care Continues
The year 2020 marks a pivotal moment in healthcare — a moment when the urgency, momentum and capacity to drive meaningful reform are equally strong. As we reflect on the past 20 years and speculate about what the future will hold, we must continue to work together as an industry to develop the ideas and technologies that will facilitate a truly patient-centric healthcare environment, and the health and cost benefits that come with it.
What do you think will be the key to moving healthcare forward in 2020?
HMS advances the healthcare system by helping healthcare organizations reduce costs and improve health outcomes. Through our industry-leading technology, analytics and engagement solutions, we save billions of dollars annually while helping consumers lead healthier lives. HMS provides a broad range of coordination of benefits, payment integrity, care management and member engagement solutions that help move the healthcare system forward. Visit us at www.hms.com or follow us on Twitter at @HMSHealthcare.