Throughout 2020, the NextGen Advisors conducted interviews and facilitated discussions amongst healthcare leaders working in ambulatory practice across the U.S. As is traditional at the beginning of a new year, and in the context of a newly elected administration, we have reviewed the predictions of healthcare writers to see which themes align with those we heard from the front lines of ambulatory care as well as unique perspectives whose ideas may not have been on our radar, but none-the-less piqued our interest. What follows is a collection of themes and trends probable to play out in U.S. healthcare throughout 2021.
Where else to begin 2021 than with the issue which dominated 2020 and upended healthcare across the world, COVID-19. The enormous global vaccination effort now underway is occurring in parallel with the second or third (depending on location) wave of COVID-19 infections. Consistent with what we heard directly from provider organizations, several industry authors such as the Commonwealth Fund and Forbes anticipate the pandemic will be curtailed and brought under some level of control toward the end of the second or beginning of the third quarter of 2021. As more individuals are vaccinated and new vaccines are approved for emergency use world-wide, all seem hopeful a level of normalcy will return to everyday life, however the pandemic will serve as an accelerator of some established trends and highlight new issues which came to the forefront as a result.
Increased Focus on Mental Health
Abiding to stay at home, quarantining, social distancing and isolation are not natural human behaviors; combined with work from home challenges, home-schooling, high levels of unemployment and the closing of small businesses have highlighted the importance of maintaining mental health through times of stress and uncertainty. A silver lining for providers and patients alike has been the rapid shift of some mental health counseling and medication management to telehealth delivery which is expected to stabilize in the year ahead. Other authors note while there is increased awareness of mental health needs and their impact on physical health, without additional investment and efforts at the national level, the system will continue to struggle with lack of access and a shortage of providers to meet the growing needs of the population.
The Rise of Telehealth
Telehealth and virtual visits are here to stay. This perspective is broadly shared in recognition of the enormous value telehealth visits contributed by keeping patients connected to their care providers through the pandemic. Further, several experts note hospitals and medical groups will need to focus on integrating telehealth into their operations and that employers will be seeking greater access to virtual care for their beneficiaries to improve access, reduce time off for medical care and drive productivity.
Patient Monitoring and Home-based Care
Related to the extension of telehealth into new aspects of clinical care is the extension of capabilities to monitor patients from afar. Hundreds of new smartphone applications and connected devices have come to the market over recent years and considerable investment continues to drive innovation in developing new tools, measures and algorithms to translate the thousands of data points generated into useful clinical information. The challenge for providers and information technology companies will be aligning on what measures are meaningful, at what frequency and in what format for inclusion in the medical record. Establishing common standards in this area will be challenged by proprietary interests as each platform seeks to maintain customers, so while the number of devices and users continues to grow, how clinicians can filter out the noise will be a key consideration to make these innovations part of the mainstream approach to care.
Healthcare Industry Consolidation
Financial pressures have long foretold the coming of increased consolidation, and 2020’s impact to medical practices’ finances certainly augur greater activity in acquisitions and mergers. Not only are smaller, financially challenged practices likely to get bought up by larger players, but those practices themselves may be seeking the safer harbors of larger partners to help them weather the ups and downs of revenue fluctuations, provide them access to capital and infrastructure. Relatedly, Fortune and others anticipate the coalescence of many point solutions into larger platforms, as well as increased initial public offerings and M&A activity to achieve growth of capabilities leveraging the availability of private capital and low interest rates.
Forces pushing the patient back to the center of medical care gained strength throughout 2020. As providers sought new tools to serve patients, they in many cases leveraged technology, smart devices and omni-channel communication approaches to connect in new ways. Concurrently, patients are expecting care to be personalized and tailored to their preferences and are seeking much greater transparency about the costs for visits, medications, procedure as well as improved convenience and access to providers. Along with continued expansion of telehealth into new specialty areas and clinical workflows, there will be a growth in home-based care and technologies which facilitate the digital connection between patient and provider.
Health Disparities and Social Determinants of Health
COVID-19 shone a bright light on how individual circumstances such as race, education, zip code, income, gender and other factors result in people having not only disparate access to health care, but disparate care provision and health outcomes. As delays in essential care will likely be systemic in 2021 because individuals continue to defer screenings and preventive care; providers are being called upon to identify their high-risk populations, break down barriers to access and ensure close tracking of care plans and medication regimens.
As we enter 2021, we will no doubt look back on 2020 as a pivotal year in healthcare which brought about tremendous challenges both professionally and personally. It was also a year of incredible innovation bringing rapid change to how care is delivered; hopefully we can harness that energy to sustain advances and improvements on these issues.