Thought-Leaders newsletter

Perspectives on a selected key topic May / June 2021

hat are some specific implications for consumers and providers regarding the impact of an over 70% increase of stakeholder investment in digital health during the past two years?”

Lindsay R. Resnick
Executive VP
Wunderman Thompson Health

Call it ‘techceleration’ — the speed of digital technology sweeping across the health care landscape is unprecedented. And its technology with purpose: helping consumers take ownership of their health, by making it easier to self-diagnose a condition, change a health habit, enable compliance with a course of treatment, or interact with their community of care providers. Health technology is no longer narrowly focused on treating patients once they develop a condition, it’s become a proactive wellness and prevention tool to inspire better health habits that help people live a longer, qualitatively better life.

The pandemic was a gamechanger for digital health. With limits on face-to-face health care interactions, digital and virtual care advanced on the maturity curve faster than anyone could imagine. Digital ‘anywhere’ is now an official ‘site of care’ in the consumer’s health continuum along with retail clinics, physician offices and emergency rooms. It brings a wide range of health solutions including wellness ‘bots’, smart toilets, digital therapeutics, AI-driven decision support tools, fall prevention wearables, and remote biosensors transmitting vital sign data.

The revolution is over. Digital has won. It’s now at the center of people’s personal and professional connections. It’s where we find ourselves every day, where culture and business meet. It’s health care for the digital consumer, whether Gen Z, Millennial, Gen X, or Boomer. They’re embracing technology and innovation for more convenience and better health outcomes. For payers and providers, it’s no longer about digital transformation. To succeed, they must renovate business models, reset value propositions, and reimagine customer journeys. Useability is everything.

In the classic 1967 film The Graduate, Mr. Robinson mentored young Benjamin with this advice: “I just want to say one word to you. Just one word: PLASTICS”. Today’s advice as Benjamin looks for a career in healthcare is equally profound…“I just want to say one word to you. Just one word: DIGITAL”.

William T. Eggbeer
Senior Advisor
BDC Advisors

The pandemic has put a spotlight on the digital healthcare market and has attracted a swarm of virtual care entrepreneurs with consumer- and provider-focused innovations ranging from personal health and fitness, to primary care, home-based hospital care, care for patients with chronic conditions, on-line behavioral health services, and nonsurgical specialty care (including pre- and post- procedural care). We have learned that for many healthcare consumers, in many circumstances, in-person provider contact may no longer be considered as important, or even advantageous, opening the door for digital innovation and the virtualization of healthcare.

We expect that digital innovation will lead to long-term disruption of the organization of healthcare services. Many services will no longer be geographically bound, and aggregators of virtual services such as telemetry, sensing, expert consultation and mental health will create new areas of competition and market reach. Provider systems have been strategic investors in digital innovations for several years now, investing in innovations that strengthen clinical and supply chain quality and efficiency. Many observers expect that local health systems will become increasingly comfortable outsourcing capabilities to national-at-scale clinical service organizations. This is not to suggest that direct physician contact will disappear. Consumers will continue to value high-touch interventions. But the long simmering issue of hospitals serving as the source of infection, and hence to be avoided, has helped build consumer acceptance in using virtual platforms for a wide range of communications. In-person physician care will still be essential for care for the very ill, procedural diagnostics and surgical interventions. But for routine well-care, uncomplicated chronic care, professional consultations, and care for isolated communities virtual care is likely to expand as more the norm. All of this, of course, depends on maintaining adequate reimbursement for virtual visits either through CPT codes or salaries. If Medicare and other payers were to shut off payment for virtual care we could go backward. But this seems unlikely since the digital innovations are ultimately more efficient, and the strong backing for value-based care from most major payers.

As life begins to return to normal after vaccinations take hold, provider system leaders in particular may wish to assess the strategic implications of virtualization in terms of:(i) whether their system has sufficient scale to develop virtual clinical product line capabilities that would allow them to serve a broader regional market; (ii) the impact of virtualization on the health systems physician enterprise, particularly on independent physicians who have been disproportionately impacted by pandemic loss of business; and (iii) determining whether the system has the capacity for effective market segmentation and the ability to design and correctly price consumer and provider focused solutions based on that that data.

Hank Osowski
Managing Partner
Strategic Health Group LLC

A patient connects with his primary care physician for a routine “visit”; a plan member with complex co-morbidities chats with her care coordinator to monitor care plan progress; a patient checks his blood glucose level using a Bluetooth enabled device that tracks readings and sends a report to his mobile phone and to his physician. These are just some of the applications of digital health that are becoming routine. Though digital health technology is not new, the COVID pandemic experienced beginning in 2020 has accelerated the acceptance and expanded use of these invaluable tools. The lack of routine access to physicians and other providers has driven the investment in and rapid expansion of digital tools and devices.

Telehealth has been used effectively for many years to connect remote patients and communities to health resources and specialist care in urban centers of excellence. This remains an important value of telehealth. However, even before the pandemic created an environment promoting the growth of digital health technology, application developers and device manufacturers were focusing on ways to exploit the power of the technology to facilitate health improvement. Early adopters began to demonstrate the very real possibilities, but widespread adoption was inhibited by the absence of a demanding imperative and reluctance in some quarters to the “terror” of technology. The public health emergency and closing of medical practices changed the game.

A recent Kaiser Family Foundation analysis revealed that slightly more than a quarter (27%) of Medicare Beneficiaries had a telehealth visit between the Summer and Fall of 2020. One third of the beneficiaries, who had access to a provider with telehealth capacity, did not have a telehealth visit. Medicare rules were modified during the public health emergency to encourage use of digital health solutions. It will be interesting to see if CMS and Congress will continue to support digital health expansion or revert to more restrictive rules.

With the introduction of more flexible rules, Medicare Advantage plans have been able to offer more innovative supplemental benefits, including additional telehealth benefits, that are not covered by traditional Medicare. Even during the pandemic, Medicare Advantage plans have continued to be leaders in innovation, uncovering new methods of assuring members received needed care. This experimentation has produced positive results and the expectation is the Medicare Advantage plans will continue to build on these successes with digital health.

Overall, telehealth is still a work in progress. Both providers and patients are just getting comfortable and practiced with the technology. Too many beneficiaries do not yet have reliable access to these tools. What we have learned about the use of digital health during the public health emergency is that we can maintain the quality and safety of routine and urgent care via the use of digital health while reducing the overall cost if care. Going forward this could be especially valuable for individuals with limited mobility or transportation challenges. One important goal would be a coordinated effort by our industry to create a digital health ecosystem that focuses on improving care protocols and achieving better outcomes for patients. Digital health technology is an amazing tool, a vehicle for better care, but it is not the destination.

MCOL - The healthcare business digital media company
www.mcol.com

MCOL respects your privacy.
Please read our online Privacy Policy.