The debate how to improve access to American healthcare has brought about some grand and complex schemes. But, what if the eventual disruption of the health sector comes about as result of a series of small changes that eventually become significant enough to bring about a tipping point?
Ripe for Disruption?
Americans are familiar with the competing government visions for disrupting healthcare. The ACA focused on increasing insurance coverage and decreasing healthcare costs over time. The first version of the ACHA focused on repealing ACA taxes and increasing insurance policy choices. The conservative think-tank Heritage Foundation favors a fully market based health system with access to doctors and treatments tied to whatever the market set, a scenario which would see more rural and low performing hospitals closing and insurers paying less for ‘low performing’ doctors.
The American Congress has healthcare reform / disruption on hold for now. Meanwhile, the American hospital system is financially strained and downsizing, in spite of taking in nearly a third of the $3 Trillion healthcare pie. Both rural and urban hospitals are dealing with decreasing operating budgets which they attribute to increased technology costs, pharma, bad debt, labor costs, decreasing patient services and shrinking reimbursement rates. Speculation has been going on for some time that the American health care sector, which is three times larger than the banking industry and comprises more than 17% of the United States GDP, is ripe for disruption.
But, which parts of the healthcare sector are disruptable? Who will the players be? How will costs for treating expensive chronic conditions be contained? Will the sector be disrupted by 1 big change or through a series of smaller changes? Let’s take a quick look at just three possible forces in a ‘tipping point’ path to healthcare reform.
Better Income through Better Patient Services
Last week Mount Sinai reported an overall increase in revenue largely due to increased patient services. Other hospitals are losing money on patient services, what makes Mount Sinai different? Mount Sinai expanded access to its services including opening a full service primary care center in Brooklyn and a partnership to use predictive analytics to identify high-risk patients.
Mount Sinai’s expansion to make its services more accessible reflects a national trend to provide services in areas and at times that are convenient to consumers. Retail and satellite clinics (aka Doc in a Box) are popular because they are convenient, have longer hours of operation, are transparent about costs, and are affordable. In other words, they provide value to the customer.
A recent panel discussion at the Healthcare IT Marketing and PR Conference (#HITMC) in Las Vegas NV speculated that the future of healthcare could hold even further ‘commoditization’ of healthcare beyond satellite clinics. What other areas of healthcare could provide better patient value while improving the healthcare bottom line? Artificial intelligence likely will have a role in providing a more standardized system of care. As health IT products such as population health tools, EHRs, and more improve, it’s not difficult to envision the path to additional consistency and standardization or ‘commoditization’ of care.
If Hospitals do not have the funding to transform healthcare, who does? Despite saying that they said they’d never become a healthcare company, Google appears to be moving in a life-science direction. A Google Alphabet subsidiary Sidewalk Labs called Care Labs posted a ‘big picture’ of how healthcare delivery could look in the future. The community health project post addresses improving access but also achieving cost savings through prevention.
Eye brows raised recently as three Google Alphabet subsidiaries began hiring life science talent. Even sidewalk labs which aims to use technology to solve urban problems is hiring health care positions including a chief health officer and a head of community health.
A Globally Scalable Platform for a Pricey Health Issue
Most of us have heard of the promise that blockchain has for healthcare from access to EHRs to combatting fraud. But, did you imagine that it might be used to improve diabetes management? Last month at the CoinAgenda conference in Puerto Rico a startup named Healthcoin won an award for best private blockchain. Still in its prelaunch, Healthcoin incentivizes improving patient’s biomarkers for diabetes. When measurements for information related to A1c, blood pressure, and HDL cholesterol improve, the blockchain issues them a token. When launched, the company envisions employers and insurance companies paying pre-set rewards for tokens. In addition, they will be building a biomarker database which can be mined by pharmaceutical companies for help in drug discovery.
A blockchain solution for diabetes management and a new big data source to boot? Wonder if Google is interested?
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