Recent changes in us healthcare

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Successful supply chains are becoming a key differentiator and vital part of the care delivery process in ways we have never seen before in health care. Getting it right requires strategic systems thinking around all functions in the organization. Among the topics for boards to consider:. Cooperative competition, or coopetition, is a key trend in health care.

While some providers view big-box stores, nationwide pharmaceutical chains and other new entrants as threats, other organizations see opportunity. Their strategy is to leverage the capabilities of these power players to lower the cost of care, increase downstream market capture and focus on core specialty services while remaining highly connected to the patient.

Today we can receive goods the same day we order them, and track them minute by minute from order placement to delivery. Instead, some patients may have to wait weeks or months for an appointment and have only a vague idea of when exam results will be available. Organizations need to assess their current barriers to consumer satisfaction and deploy analytics and patient-centric technologies to improve the convenience, speed and transparency of care.

For example, when a West Coast health system adopted precision scheduling practices to minimize wasted time between imaging exams, they were able to open up 5, new exam slots annually, so patients could be scheduled sooner. While patients want the convenience and ease of digital interactions, personalized care is still the touchstone of their loyalty.

For improvement efforts to have teeth, they must be associated with programs that drive measurable outcomes. For example, a major academic medical center created a communication training program to teach doctors best practices to follow in interactions with patients.

It will continue to be a challenge for providers to find the next generation of leaders to replace baby boomer executives who are retiring at a high rate. Other top issues include:. We will continue to see the emergence of virtual care solutions across the care continuum from telehealth visits to virtual hospital care and home-based care. In February , less than 1 percent of Medicare primary care visits were conducted via telehealth; by April, driven by the pandemic, the volume had risen to 43 percent.

This growth appears to have staying power as both patients and physicians adopt a new virtualization mindset. It will be important for organizations to align their virtual strategy with the changing needs of their markets, growth strategy and evolving payment models. AI and automation are taking hold in health care at an accelerated rate as they have in other fields such as banking, media and retail. A few examples to watch:. In my conversations with chief information officers, data is becoming the currency of tomorrow and the infrastructure must support needs at scale.

Expect to see large organizations making big investments to better leverage and monetize the use of data to improve productivity, enhance patient care and drive additional funding for key programs.

Expect to see more large health systems as organizations try to monetize large investments and drive synergies from scale. With COVID throwing historical utilization rates on their head and making projections nearly impossible to calculate, employers, providers and payers are forced to consider utilization, rates and risk as they model the coming year. Please note that the views of authors do not always reflect the views of AHA.

Emerging Issues Top 10 Emerging Trends in Health Care for The New Normal Continued disruption will require health care boards to adapt their governance models By Geoffrey Martin In these unprecedented times, what priorities should hospital and health care system boards focus on to prepare for and beyond?

Collaborative Ecosystem COVID has exposed vulnerability at health care organizations across the globe on critical issues, including safety, equipment, data availability, and infrastructure. Among the topics for boards to consider: Increasing storage and self-distribution. We see a trend toward more self-distribution models instead of just-in-time delivery from distributors. This allows organizations to buy in bulk, control distribution and minimize their reliance on items at risk of being depleted.

Organizations do not have a limitless supply of capital so this is not a one-size-fits-all procurement strategy, but it may make sense for certain items in the supply chain. Deeper relationships and back-up suppliers. The value of vendor-of-choice relationships became apparent as many hospitals scrambled for pandemic-related supplies. The key is striking a strategic balance between price, performance and trust. Neither is overreliance on one vendor without having plans B, C and D in place.

We see many organizations developing connections with tiers of back-up suppliers — often smaller and geographically closer than their primary vendors — to gain flexibility, speed and as much certainty as possible that critical items will be on hand when needed.

New supply chain models for new care settings. Health care futurists believe that by , most care will be delivered at home, in outpatient settings or virtually. Adapting to this new way of care — in terms of supplies and delivery methods — will require relationships with different types of vendors, such as retailers, contract employees and technology providers. This is an exciting but huge challenge: how to reimagine supply chains to deliver non-hospital-based care in a safe, cost-effective and high-quality way at scale.

Smarter, faster, predictive information. Expect to see more automation software and artificial intelligence AI in health care supply chains. In addition to freeing personnel from repetitive tasks, these technologies can assist decision-makers in identifying trends and providing resources to workers. For example, predictive analytics focused on population health within an organization or system could alert managers to trending disease states and their associated supply needs. Supply chain managers could use AI tools to master the new transportation logistics of getting supplies to widely dispersed home care settings and so on.

Offload financially draining services. Organizations like CVS and Walmart now offer basic primary care, simple diagnostic services and chronic disease management — services that health systems have struggled to provide and do so profitably. Identifying opportunities to partner with retail organizations to fill this gap can help simplify organizational services, increase access and provide better patient care at a lower cost.

Expand the market while improving community health. New entrants can be a force multiplier and increase the overall market for health services. Look for opportunities where your services could have a significant impact on community health and partner intentionally.

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So what exactly can we expect? Over the last several years, court cases have threatened protections for people with pre-existing conditions, including diabetes. Moving forward, those protections will receive more steadfast support, while Congress also works to make the ACA work for more Americans.

Separate and in addition to access policy enacted through the ACA, the Biden administration ran on a message of looking to introduce a federal public healthcare option , to exist alongside current private healthcare options. Additionally, the Diabetes Self Management Training Act , which stalled out in , may be revived, bringing a renewed focus to the importance of diabetes education, particularly for historically underserved populations covered by Medicare.

With the appointment of Dr. Marcella Nunez-Smith as the COVID Equity Task Force Chair, we expect and hope that issues of healthcare inequities , brought about both by long-standing systemic racism and poor access infrastructure, will be a focus not just regarding COVID, but also alongside all healthcare issues, including diabetes of all types. In January , Senators Chuck Grassley R-Iowa and Ron Wyden D-Oregon , leaders of the Senate Finance Committee, issued a page report on the rising cost of insulin , placing blame on pharmacy benefit managers PBMs —which act as brokers between drug manufacturers, insurance companies and pharmacies—s well as insulin manufacturers for rapid price increases.

Price caps, even the ones happening on a state level, also do not help everyone as they are currently written. All current state price caps only apply to those with private state health insurance or state Marketplace plans. There are loopholes for companies that offer employer-based health insurance across state lines or for those who are self-funded.

This leaves rebate reform as the key place where shorter-term and far more impactful to out-of-pocket patient costs change can happen. The bill is aimed at preventing PBMs and health insurance plans from receiving rebates or discounts for insulins. It drops the list price of most types of insulin back to their list price, and requires that insulin not be subject to a health insurance deductible.

This is another bill that is not ideal and is more of a bandaid solution than overarching reform, but it could create shorter term change in insulin prices although primarily for insulins that were available prior to Changes are expected to be made before reintroduction of this bill.

Overarching rebate reform would have to be tackled across Congress and is more likely to happen across all drug types than just for insulin , which is better for all Americans. However, there is likely to be a big focus on insulin and other blood glucose lowering drugs, given the national attention on insulin pricing and the high amount of Medicare funding one in three Medicare dollars spent on diabetes. Rebates typically account for percent, sometimes up to 70 percent, of the list price of insulin, which leaves the greatest burden on people with diabetes who do not have insurance or have a high deductible health plan for which they must pay the full list price until their deductible is met.

Early in the new administration, there will be hearings to discuss changing qualifications for continuous glucose monitor CGM eligibility for Medicare beneficiaries, hopefully expanding access opportunities for those who have type 2 diabetes, regardless of diabetes medication regimens. Following the success of 10 states introducing various forms of insulin price cap and emergency insulin access laws in , we are going to see a lot more on a state level specific to diabetes than we will see immediately on a federal level.

If passed, this would mean that 17 states have insulin price cap bills but, as stated previously, these do not address the root cause of high list prices for insulin, and do not apply to everyone, particularly the uninsured.

Missouri has a insulin rebate pass-through bill introduced House Bill No. New York has introduced their version of an emergency insulin program bill A , aimed at addressing emergency access to analog insulins and related supplies. Substantial healthcare policy change takes the voice of many, and individual advocates make a resounding and impactful difference. If you are looking to get involved with diabetes access advocacy, start here. Make sure they know your personal experience and how issues of healthcare, drug pricing and access impact you.

People who take insulin require consistently affordable and predictable sources of insulin at all times. If you or a loved one are struggling to afford or access insulin, you can build custom plans based on your personal circumstances through our tool, GetInsulin. To learn more about the insulin access crisis in the United States, click here. Board of Directors. We should anticipate more focus from the new administration on public options solutions.

Another area that we may see a focus on is pharmacy spending. We have seen the new administration and prior administration consider expanding the ability to purchase prescriptions from Canada, or trying to implement some safety nets to avoid double-digit increases in prescription costs.

We have several proposals in D. If that takes place, it will most likely extrapolate into the private insurance market as well. Hopefully, these are steps towards granting protections for participants that have been left without any form of protection in this system. Carice Anderson, author and director of people manager strategy at BlackRock, says it's taken years for her to let go of the emotional burdens of being Black in the corporate world.

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Setting HR up with tools to consolidate their workload means more focus on the well-being of a workforce. Johannes Bhakdi, founder and CEO of Quantgene, explains why employers need to look beyond their health insurance plans if they want a healthy workforce. Employees cited the interviewing process as one of the most stressful parts of the job search.

Getting rid of it has the potential to boost recruiting. Sign Up. Employee Benefits. Follow Us In Real Time twitter facebook linkedin. Tags Health and wellness Health insurance. By Deanna Cuadra CloseText. About Deanna. Close extra sharing options. Deanna Cuadra. Associate Editor, Employee Benefit News twitter linkedin. For reprint and licensing requests for this article, click here. Health and wellness Health insurance.

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