We predicted last year that there would be much attention on the inequities in our health care system. Will we continue to make progress and implement initiatives that right the ship? Here is what the experts have to say. And join us for the next few weeks as we look at what we might see in 2023.
Closing the Equity Gap
We will see more programs implemented that bridge the equity gaps in chronic care management, obesity, diabetes, and preventive care, among other areas. We will see healthcare buyers seeking companies that can demonstrate their impact on access. The focus will become not only increasing access to those who already have it, but opening channels to those who are underserved
Maternal Health in the U.S. is lagging, but technology can help close the gap: More than one-half of pregnancy-related mortality in the United States occurs in the 12-month postpartum period, and unfortunately that number rises when looking at the BIPOC community. What’s more is that one in four women experience depression after childbirth. The maternal health crisis remains unsolved across most of the country – reporting the highest maternal death rate of any developed country in the world. There is urgency for the broader healthcare ecosystem to partner and address these maternal health disparities head on – from the government to technology companies and healthcare providers – and collaborate in order to find new ways to connect women with the care they need. Womens health is not a separate microcosm—it’s part of overall health. While some of the disconnect lies in the lack of access to patient data when providers need it most, the good news is that technology can help. The way to make change is to find ways to bring the data together when providers need it–and create technology solutions that fit seamlessly into their existing workflow. In a time when representation matters most, this is conversation that needs to be happening. We can – and must – do better in the future. While some of the disconnect lies in the lack of access to patient data when providers need it most, the good news is that technology can help.
Locum tenens physicians can help solve two critical problems healthcare currently faces. They come into underserved areas and provide patients the care they desperately need. They also alleviate some of the burden being put on staff physicians, allowing them to take a vacation, a leave of absence, or just have some additional help. And it’s not just traditional locums; we’re also seeing growing demand for tele-locums, with physicians working online, never having to leave the comfort of their homes.
We’re seeing a growing imbalance between the supply and demand and I think it’s only going to get worse, especially in rural and other underserved areas. I also think physicians are expecting more work-life balance and flexibility from their jobs. At the same time the pandemic made a lot of people postpone needed care. They are now coming back in droves.
Prioritizing the aging population at the state level: The senior population is growing at such an accelerated rate that the need for better tools and technology to improve care outcomes and quality of life is absolutely critical. We’re seeing an inevitable shift toward home-based care powered by technology and we’ve also recently seen states implement master plans for aging. This is new and something that needs to be prioritized in the year to come. In 2023, I’m excited to see momentum around prioritizing senior care and initiating plans for evaluating and improving the state of long-term care. The use of telehealth, remote patient monitoring and new solutions to improve interoperability will all help to elevate “the nursing home of the future,” and prioritize care for a particularly vulnerable patient population.
In 2023, the digital health revolution will answer critics on one key access and health-equity issue – clinical trials.
2023 will represent a breakout year for clinical-trial diversity because of digital health. Innovation in digital health is advancing the clinical trial industry by leaps and bounds.
Population health initiatives must become more inclusive to successfully support advanced value-based care models. Healthcare staffing shortages, interoperability and remote patient care are new factors to consider and requirements to address when planning your 2023 population health programs. Finally, expansion to integrate pharmacy practices into population health cannot be an afterthought or remain segmented, like behavioral health was for many years and remains (to some extent) now.
While COVID remains an active player on the global stage, inadequate vaccination rates have ushered in a raging Influenza season and among pediatric populations we’re seeing outbreaks of measles and wastewater isolation of polio in the US. These infectious diseases bring new challenges to treatment and care as emerging pathogens begin to crowd the main stage with recurrent outbreaks of Ebola and the debut of a global outbreak of Mpox. Amid this unprecedented disease landscape, however, is a growing wealth of novel resources that can help improve health outcomes. In the coming year, we’ll see technology play more of a central role in infectious disease response as public health is more fully integrated into the wider medical universe. Incorporating insights from previous crises, we should expect more digital and AI/ML driven tools being used to streamline diagnosis and care, as well as more robust resources that better support frontline clinicians faced with overflowing and understaffed healthcare settings.
With clinician burnout at an all-time high, healthcare provider organizations will tap on pharmacists as a strategic clinical asset in the year ahead. Pharmacists present a major opportunity to address workforce challenges, support care teams and extend the reach of care coordination across the community.
The 2022 APhA Strategic Plan advocates for the expansion of pharmacist-provided services, as well as advancing the adoption of care delivery models that leverage pharmacists’ training and patient connections. Pharmacy practice is trending towards two distinct workflows, a clinical service-oriented business model (i.e., chronic disease management and select acute care services) alongside a traditional dispensing pharmacy model.
Sharing more clinical responsibility with pharmacists expands care delivery, access and affordability. Professional services enabling provider status coupled with EHRs customized for pharmacies with population health management components connect the patient, pharmacies, and payors, enabling healthcare provider organizations to take full advantage of these new care delivery opportunities.
The future of affordability – driving access at scale across stakeholders
Healthcare affordability has long been a challenge solved one patient at a time. In 2023 and beyond, healthcare has the opportunity to harness available technology, data, and analytics to proactively examine patient populations and drive affordability at scale. Breaking down silos across industries – providers, health systems, pharmacies, and life science companies – will be key in drastically changing the industry’s approach.
Following the pandemic, the industry is stretched more than ever before – clinical burnout, effects of the Great Resignation, and lack of career satisfaction are plaguing the industry. Technology workflows are key in driving efficiencies – taking additional administrative burden off healthcare workers – all while helping patients. Take pharmacy staff, for example. For years, pharmacists and pharmacy technicians have played a critical role in identifying medication financial assistance. However, today, when pharmacy teams are on the front lines delivering clinical care and critical vaccines, technology has the power to transform a manual, reactive financial navigation process into a proactive, automated one. . Next year, the industry will see healthcare entities from life sciences to provider practices implementing technology workflows to proactively address affordability in a holistic, comprehensive way. We all must do our part in helping as many patients as possible afford care – because we can and we should.
Over the past few years there have been improvements in the market around identification of patients with Social Determinants of Health. Multiple states include SDOH codes as risk adjustable, and multiple vendors have improved their ability to identify underserved patients and communities. With ACO Reach launching, I expect there to be a larger focus and more progress made on developing scalable SDOH-focused programs in 2023. I’m more hopeful than I’ve been in the past that the industry will incentivize and drive real progress over the next several years.
Over the past few years Social Determinants of Health (SDOH) and Health Equity have come increasingly into the spotlight. Much of this has been accelerated due to obvious differences in outcomes seen during the COVID-19 pandemic – many of these due to different social determinants. A hallmark of the Biden-Harris administration has been to turn this focus into action. As such, we are seeing increased push at the government level to tie reimbursement and value-based care to identifying and tackling the disparities that exist across patient populations. A prime example is the Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health Model (ACO-REACH) with aim of improving the care offered to people from underserved communities, which starts on 1 January 2023. With these directives to deliver more equitable healthcare, there will be increased focus on identifying the disparities that exist in each HCOs population in 2023. We will therefore see the increased use of SDOH insights – such as those made available through census level data – and also technologies to identify these features at the individual patient level, from the rich information with the Electronic Medical Record. With much of this data written in human language in non-discrete fields, AI techniques like Natural Language Processing will be increasingly utilized in this domain.
It’s exciting to consider the outcomes possible in 2023 after CMS released the new CPT codes for remote therapeutic monitoring (RTM) earlier this year. It opens the door to making high-quality musculoskeletal care more accessible to minority and lower-income populations who are historically less likely to have orthopedic surgery or make it into the clinic for ongoing physical therapy sessions. RTM through digital care management tools can enable individualized care pathways based on the patient’s demographics, social determinants of health, and clinical status. Care paths can be immediately adjusted to reflect the patient’s reported pain, range of motion, and adherence to remote physical therapy, all while reducing barriers to care for patients who may be unable to present for in-person care. With broader acceptance of and reimbursement for virtual care, a wider range of patient populations can access needed care, improving health equity in the US.
Healthcare organizations increasingly are aware of the impact of health inequities and social determinants of health (SDoH) on outcomes and healthcare costs. These inequities are exacerbated by low-quality patient data, which disproportionately impacts vulnerable populations. In 2023, provider organizations will seek to close care gaps by deploying automated intelligent technologies that will dramatically reduce duplicate patient records and mitigate other data quality issues.
Next Year Will Usher in a New Level of Coordination to Address Health Equity:
Improving health outcomes cannot be achieved without health equity. Put simply, health disparities prevent individuals from accessing quality healthcare and create barriers for patients to live a healthy life. These disparities can impact a patient’s ability to manage chronic conditions, receive timely treatment, adhere to care plans, and more. Many of the issues preventing patients from taking action to access care are the same factors that can prevent patients from adhering to treatment such as language barriers, transportation and geography challenges, cost, and low health literacy. Last summer, Highmark Health and Allegheny Health Network launched a social care network that compensates non-profits that address social determinants of health for its patients such as food insecurity, transportation barriers, and housing. Through this innovative program, 20 participating non-profits in Pennsylvania have the potential to earn value-based reimbursement – this is what the future of whole health looks like. With the goal of driving better patient outcomes, improving population health, and reducing healthcare costs, the focus on health inequities and social determinants of health will continue to play a key role in healthcare in the years ahead.