2023 kicks off with promise of medical and technical advancements, fixes or patches to what many have been deemed a broken healthcare system, and all eyes on creating better consumer experiences and outcomes while tackling the rising cost of delivering care.
Environmental challenges remain as the rise in CPI still topped 7% in November and predictions of a recession loom. For the average consumer, this can mean added stress and feelings of depression, inability to pay for health care-even copays and coinsurance, delayed care plus greater demands on community organizations that provide support during tough times. For the Medicaid population, especially those covered under the Public Health Emergency post PHE numerous Medicaid enrollees will need to find alternatives while other who still qualify will need to redetermination, certainly a top priority for Medicaid MCO plans and delivery systems with many States engaging both for help. Add to this the COVID variant saga that just won’t quit has resulted in fatigue for consumers, providers and businesses alike.
Healthcare investments are trickling in, mostly early stage and series B round funding. Certainly, the lessons learned from the hype cycle in digital and some next gen health plans, with company valuations down from their highs by 75 to 90% in 2022 are carrying over into 2023. A more discipline approach is on everyone’s mind given these health care specific downward trajectories plus highlights from crypto’s fall from grace has everyone on high alert adding more rigor to review of the next best thing.
Consumer focused strategies continue to take hold from everything engagement to new entrant retail. The shift to a health system that is life centric while hospitals remain a vital component, but part of a much larger eco system that includes home care, retail, and community-based organizations together driving value. Successful consumer engagement entails being available with the right services and tools to meet consumer’s needs based on where they are on their health journey at any given moment. Rates of chronic conditions and obesity have not budged and continue to represent 80+% of the health care spend. Well integrated smart care extenders and remote monitoring and care across medical-behavioral-SDoH will help to mitigate avoidable acute care visits in all populations and allow seniors to live at home longer. Healthy food will continue to promoted as a solution while fighting gravity toward easy, quick and affordable high calorie, high salt, fat laden food everywhere consumers turn. With studies demonstrating results like those compiled by the Food is Medicine coalition -reduction in overall medical costs by 16%, ER visits by 58%, hospital admits by 49%, and nursing home admits by 72%-doubling down on messaging and providing convenient, affordable access to better choices makes good health and business sense.
Investments in value based care have grown and CMS continues on plan to move 100% of beneficiaries to some form of value based care arrangements by 2030 while homecare has received recognition as a significant lever to curb costs and improve outcomes. More so than previous years there is greater emphasis on operational efficiency and workforce solutions as health systems according to a report by the AHA have been crushed by rise in acuity (9.9%) and higher drug (>36%)and labor costs (19%); while payment rates have not kept up, (Medicare ‘22 increased 2.4%, labor costs up 6.5%). Creative solutions are emerging to support the nursing workforce include permanent staffing solutions, virtual nursing support, and care extenders hold promise to reduce shortages and mitigate burnout.
In summary, 2023 will be a year focused on meeting consumer needs particularly targeting what they value, addressing work force issues and administrative complexity, and delivering results in the form of equitable outcomes for all consumers, affordability, and improved enterprise value.
Rose Maljanian Chairman & CEO HealthCAWS