Will We See a Value-Based World in 2023?

The delivery of care has been under reconstruction and was pushed over the cliff during COVID. Will primary care models get us closer to value-based care? Will telehealth and RPM be used more strategically and grow in use? Home is where the heart is but will it be where care will be? 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.

Ernie Clevenger, President, Health Care Administrators Association
President, MyHealthGuide, LLC
Twitter: @HCAAinfo

I see three important trends coming to our industry in 2023. Telehealth will be augmented with patient reporting devices giving remote physicians better views of their patients. Specifically, electronic stethoscopes, derma scopes, and otoscopes are making their way alongside traditional remote tools such as glucometers and BP cuffs. Secondly, behavioral health will increase in demand as hybrid work at home and office bring a new dimension to stress and health. Third Party Administrators (TPAs) and wellness experts should consider adding screening tools such as the PHQ-9, social determinates of health and more to identify areas of focus and treatment. Finally, management of chronic conditions continues to be of critical importance. While acute episodic care is frequent and gets a lot of attention, the chronic patient (diabetic, hypertensive, COPD, etc.) accounts for 85% of total healthcare spend. ROI data analysis will be critical to find the most effective means of accomplishing these three trends. Clinical and financial feedback must be constant to direct resources with fiduciary and efficacy responsibility.

Dr. Nick van Terheyden aka Dr. Nick
Twitter: @drnic1
Host of The Incrementalist

Value-Based Care – might get a much-needed boost as increasing numbers of models focus on upping the primary care elements necessary to deliver on the promise. With enough scale and perhaps a fully open access model to primary care, we could see relief to the overwhelmed emergency department safety net with corresponding economic savings.

Emily Goetz, Vice President of Commercial, Bright.md
Twitter: @BrightMD_Health

Patient preference shifted even more towards on-demand, personalized care options in 2022—and this shift is only expected to grow. Heading into 2023, health systems are rethinking how to approach virtual care delivery in order to meet evolving consumer demands. But their providers are also top-of-mind: with staff shortages and provider burnout straining capacity, virtual care solutions that aren’t designed to improve provider efficiency and integrate into existing clinical workflows are being axed. The value of asynchronous telehealth to fuel a sustainable, consumer-centric model has never been more clear. When done well, asynchronous care increases patient satisfaction and retention, streamlines clinical workflows, opens up access to quality care, and even addresses common staffing challenges. Especially with big tech disruptors now taking an async-first approach, including the recent Amazon Clinic launch, we can expect a major uptick in health systems adopting asynchronous care solutions to build virtual care 2.0 and power hybrid care for the long-term.

Dr. Yossi Bahagon, Chairman, Sweetch
Twitter: @SweetchHealth

Redefining the Patient-Provider relationship through extra touchpoints with a new model of care management that combines in-person periodic visits with multimodal touchpoints between visits to meet the patient where they are, using various health technologies including apps, wearables, telehealth, and more. Expect to see the integration of the patient’s “life print” – habits, intrinsic motivations, capabilities and availabilities into clinical recommendations, ensuring that compliance is realistic for every individual.

Mike Brandofino, President and COO, Caregility
Twitter: @caregility

Healthcare Systems will Take a More Strategic Approach to Telehealth – In 2023, I think we’ll see hospitals and health systems take a more strategic approach to telehealth, in large part to address the staffing crisis, from burnout to the shortage of qualified resources. Inpatient hybrid care models will make virtual engagement available to every patient, giving clinicians and third-party providers remote access to every room. We are rapidly moving to a world where we drop the word telehealth and it just becomes how healthcare is delivered.

Rachel Disselkamp, Senior Director of Healthcare Solutions, Skedulo
Twitter: @Skedulo

In 2023, I predict that telehealth and remote patient monitoring will continue to grow in focus and investment. These high-profitability, scalable options help healthcare organizations both provide different services and sustain higher levels of patient engagement, while also offering more flexible work options to a workforce that has largely been excluded from the shift to “remote work”.

More healthcare organizations are shifting from a purely episodic care mindset to a care continuum strategy. This invites a more holistic, long-term approach to treatment, necessitating a higher-touch experience between patient and provider. Facilitating this requires new modes of meeting the patient when and where is convenient for them, and ensuring limited gaps or delays in care. Logging in for a telehealth appointment may be easier for some patient populations than driving to a facility. Similarly, remote patient monitoring helps providers understand the right times to intervene rather than sticking to an arbitrary schedule or waiting for an episode to occur.

Dr. Keith Dressler, Chairman and CEO, Rhinogram
Twitter: @rhinogram

Since the onset of the COVID-19 pandemic, healthcare organizations have rapidly adopted telehealth and virtual care practices, and by now, most individuals have experienced the digitization of healthcare in one way or another. Healthcare technology helped remove barriers between patients and access to care when it was an absolute necessity and continues to do just that. As a result, I predict that in 2023 we will see providers across all specialties invest in health tech. Why? Well for starters, many patients are still catching up with their healthcare after putting off non-urgent appointments and providers are scrambling to keep up. Additionally, the healthcare workforce shortage is deemed a national emergency, with an estimated 1.5 million healthcare jobs lost in the first two months of COVID-19 alone. Furthermore, despite the ubiquitous presence of smartphones among consumers of all ages – along with the demand from patients to have significant and timely communications with their providers – medical practices still use telephone calls or email as the primary communications vehicle. Ultimately, this combination of challenges is not only a driver in staff burnout, but it’s getting in the way of clinical care and diminishing the overall patient experience and satisfaction rate. In 2023, I expect more and more providers to mitigate these issues by investing in a text-first, HIPAA-compliant, collaborative communications technology. Backed by legislation, telehealth is an expanding market, currently worth a quarter trillion dollars. These numbers speak for themselves – the time to invest in health tech is now!

Sarah Carroll, Vice President of Center for Care Transformation, AVIA
Twitter: @HealthAVIA

Care is moving home in 2023 with consumer demands, financial pressures and long-lasting workforce implications from the pandemic forcing health systems to think creatively about delivering safe and effective care outside the hospital. As a result, health systems must be strategic, using a framework for what AVIA defines as Connected Care at Home to guide their next actions, such as scaling remote monitoring, improving care coordination, and augmenting staff with care delivery partners. These actions will help health systems remain competitive against disruptors, drive new revenue opportunities, improve quality, and increase access to care.

Jeff Fuller, VP of Analytics Solutions, CipherHealth
Twitter: @cipherhealth

Amid the ongoing transition to value-based care, hospitals will change some of the ways in which they define success—with help from the voice of the patient. The definition of clinical success and value as well as what influences satisfaction can vary from patient to patient, so hospitals will endeavor to better understand the outcomes patients are looking for through an increasing reliance on patient-reported outcomes measures, or PROMs. With only so many touchpoints in the patient journey, hospital leaders will need to find ways to integrate more opportunities to collect patient-reported outcomes measures, and will leverage existing opportunities like on-site rounding and post-discharge outreach to do so.

Krishna Kurapati, Founder and CEO, QliqSOFT
Twitter: @QliqSOFT

A huge trend will be the delivery of more care at home in 2023. An uptick in value-based reimbursement and 88 percent of older Americans preferring to age in place present opportunities for providers to deploy or expand AI and ML offerings such as automated check-in and remote patient monitoring. Continuing labor shortages will also drive the need for digital workflow tools to support visiting nurses and care team members who visit these patients. New delivery models such as Hospital at Home will spark demand for personalized preventive care tools in primary care that are innovative, proactive and consumer focused.

Wendy Deibert, SVP of Clinical Solutions, Caregility
Twitter: @caregility

Virtual Nursing will Move from Concept to Practical Application
We’ll see virtual nursing move from concept to practical application as health systems seek to put a dent in workforce shortages in 2023. Hybrid nursing programs introduce virtual support resources and remote work flexibility to nursing teams, which can have a tremendous positive impact on nurse training, clinician experience, and care delivery.

Roger Massengale, Chief Commercial Officer, Eitan Medical
Twitter: @EitanMedical

Healthcare is now at an opportune moment where new technologies are being introduced to improve patient care. Medical device companies, healthcare providers, and pharma companies are united in working towards allowing patients to be treated at home. This will not only reduce costs but will potentially increase quality of life, contributing to improved health outcomes—the ultimate goal of the ecosystem.

In 2023, we will likely see an increase in the development of medical devices that are geared towards home use. Connected devices will allow healthcare providers to remotely monitor their patients’ treatment progress and enable patients to safely and confidently manage their daily healthcare regimen.

Matt Adamson, Vice President of Product Planning, ZeOmega
Twitter: @ZeOmega

In 2023, I predict states will follow initiatives being implemented in California, New York, and North Carolina with a focus on delivering whole-person care and strengthening the integration between behavioral and physical healthcare. This will require health plans and provider organizations that participate in these programs to have powerful IT solutions in place that seamlessly bridge population health to regulatory compliance. Artificial intelligence will also begin to help organizations improve care delivery by anticipating what is required to complete work, helping users with note entry, and ensuring information is generated appropriately, so downstream processes can also become more efficient. Lastly, member engagement will see even greater investment by healthcare leaders. Higher engagement is one of the most tried and true indicators of better health outcomes. In a time where patients can no longer be reached via traditional mail or phone, digital strategies that provide value — and even make health visits fun — will be tested and either quickly implemented or discarded. Engagement is the holy grail for addressing the quadruple aim, and it will result in a major focus of dollars and resources from an IT perspective.