Healthcare Is Changing By: Monte Regier, MS

Health systems continue the fight to save our lives but will likely emerge from the fight facing a whole new world. After the COVID-19 emergency passes, the healthcare industry will not return to business as usual. Here are some ways things are changing:

1. Health systems loosing significant market share.

It is not a secret that for profit health has been gaining market share for some time. Companies like Optum and CVS have been buying provider groups and opening new clinics nationwide. And who can blame them, they are for profit companies and it is their goal to find profit in the 3.5 trillion healthcare industry. COVID-19 is accelerating the growth of for-profit healthcare with hundreds of new companies taking advantage of new opportunities created by the pandemic.

Companies like Teledoc have seen significant growth in online appointments with consumer friendly Apps and video. Amazon Care continues to organize a patient centered care model to make healthcare consumer friendly.

Companies engaging in this new "gold rush" all share an advantage when competing with traditional health systems. They can pick and choose the most profitable services to gain revenue and leave the care of very sick and dying people to traditional health systems, who are obligated to provide care. They can avoid the non-paying patients and send the high cost patients to traditional health systems. For new healthcare companies providing high profit low cost models of care is very profitable. For traditional health systems profit margins will continue to shrink with a rise in non-reimbursed care.

2. Digital care is here to stay

The COVID-19 pandemic has put the spotlight on digital health tools like telehealth, text-based care and remote monitoring as healthcare providers and new emerging companies scramble to meet the new demands of consumers who now believe staying away from the health system will keep them healthy.

Digital health has emerged so quickly that normal monitoring of quality and outcomes of care has not caught up. We are really running blindly in our understanding of how effective these new tools are at a mass scale. Whatever you think about the new models of care they are here to stay. President Trump's Executive Order has made payment of telehealth services permanent in Medicare.

For good reasons healthcare is not good at turning on a dime to go in a different direction. Healthcare evolves slowly and carefully to avoid catastrophic mistakes. The pandemic has accelerated the consumerization of healthcare with patients seeking different options out of necessity of circumstances. Only with time and strategic collecting of data and analysis of outcomes will we know if care is improved.

The key to providers staying viable in this fast changing era of healthcare is to have control of data and understand how changes to practice are driving outcomes. Medicare and payers will double down on value based models of care making data management critical to success.

How do you believe things will be different share your comments here.

Published on 08/10/2020

Authored by Monte Regier, MS