I’ve been attending the JP Morgan Healthcare Conference for many years in a variety of roles. This year I also attended part of CES. Heading into them this year, it would be easy to have low expectations for the future of health care. Throughout 2018, consumers were buffeted by an almost constant barrage of health care news: industry acquisitions, consolidations, rising health care costs, new health tech ideas, new market entrants/startups, congress debating over the ACA, and more.
I was therefore encouraged about what I saw as opportunities to transform the health care system. While there is no shortage of challenges, there are also some solutions. Here are my five takeaways. I would be interested in yours!
1. The demand for more value is driving innovation in health care. I’ve said many times that the Affordable Care Act made meaningful progress in addressing many of the “access” issues around health care, particularly in Medicaid. We have a long way to go to complete the access work, and much work remains to address overwhelming increases in health care costs. But I was optimistic about a variety of initiatives intended to address costs. In some instances, I saw new methods for value based care and pricing, new programs and incentives for encouraging access to preventive care and screenings for underserved populations, innovative use of health care data and more and new connections to clinical trials.
2. The recent health care consolidations have potential to truly transform health care. While consolidation in any sector needs to be examined carefully so as not to create an increase in costs due to market power, it appears as though a number of recent acquisitions and consolidations may bear fruit. As examples, The CVS/Aetna combination will offer the entire industry a new platform of local capabilities, including more consumer services through new models of pharmacies. We’ve yet to see the details of the Berkshire Hathaway/JPMorgan/Amazon venture, but interest is high. And conversations about costs and pricing were everywhere.
3. Private sector innovation has potential to accelerate the move to value based care that eliminates variability and improves quality. Value based care, including value-based pricing, provides a substantial opportunity to address underlying costs of health care while pushing the health care sector towards more approaches that will improve health care quality by delivering better care at a lower overall cost. This sentiment isn’t new, but new models and approaches to value based care are beginning to get some traction and there is early evidence that some of the models are working. It also appears that meaningful metrics are being evaluated thoughtfully, as well as some interesting new metrics that are being considered.
4. Digitalization will move to meaningful acceleration of data into information. My toughest challenges to solve as chairman and CEO of a Fortune 100 health insurance company were often exacerbated by a lack of coherent, meaningful data. We had to build much of the infrastructure to support information pathways. Since then we’ve seen a meteoric rise in digitalization, which is moving data into actionable information in a much more meaningful way, and the industry continues to push hard in that direction.
One area where I hope to see substantial improvement is population health. For example, by responsibly making use of EHR data and pharmacy data, coupled with the use of in-home sensors and patient monitoring, we can improve overall health, detect potential noncompliance with prescriptions or other indications of health deterioration, address issues and ultimately avoid unnecessary health services.
5. The consumer will continue to migrate to an active role in purchasing and consuming health care. New market entrants, insurers, drug companies, retailers and others in the sector are focusing on activating the consumer by making health care — including mental health care — more convenient and accessible using technology. Just a few examples include digital access to mental health services, tools and services to conveniently schedule and access health care, and wearables across the patient journey. We know big tech companies are moving aggressively into the health care space and announcing expansions of services; we’re looking forward to hearing what those services will be.
Clearly one area for opportunity in the consumer tech and wellness space is the need for more end-to-end innovation: e.g., how will this service connect to providers? Or connect to payers, employers, or EHRs? I did see a few examples where I thought that integration was being applied; one was Tyto Care which included: a controller display, an otoscope adapter for examining ears, a stethoscope adaptor, a tongue depressor adapter and a smart phone app for conducting guided exams with your doctor. Using the kit, parents can look in the ears of their child who has a fever and may have an ear infection but how does one know how serious it is? The device was connected so that when you looked in the ear, the clinician could see it too. With this kind of technology, it’s almost easy to see the possibilities.
Long story short, I see the transformation of the health system being very possible as long as the consumer is at the center, relevant connections across the health care continuum are being made, and we’re mindful of creating value by raising quality while lowering overall costs.