Change is always hard, but it can often bring about positive outcomes. It might be hard to see it now, but even this COVID-19 pandemic could lead to changes in health care that are beneficial. Here are just a few areas where we expect to see positive disruption in health care:
Some might be surprised to know that healthcare outcomes have not always been measured by how well the patient was cared for or whether their condition was improved as a result of the care they received. Many medical facilities and providers, for example, would get reimbursed based on the equipment used or if certain policies were followed, whether the patient actually got better from it or not. With value-based care, the focus of medicine is being put back on the most important part: the patient. Although the change has been hard for some in health care, such as skilled nursing facilities moving to a PDPM (Patient Driven Payment Model), in the end, value-based care is better for everyone. Not only do patients benefit with improved health, but value-based care also helps them financially. Providers see higher patient satisfaction, payers see greater cost control and reduced risks, suppliers can align prices with patient outcomes, nurses and doctors get to do what’s best for their patient, and overall we get a healthier society with a reduction in unnecessary healthcare spending. For more on Value-Based Care, read up on Dr. Elizabeth Teisberg’s work defining the concept with Dr. Michael Porter.
Thanks to COVID-19, telehealth has moved from a digital healthcare service that is sometimes used to a full-blown necessity. Virtual doctor visits can free up space in hospitals for COVID-19 cases and reduce the risk of infection to others. Even outside of a pandemic, telehealth is a convenient way for someone to see their doctor without having to take off work, pull their child out of school, or drive far to see an in-network provider. Before the pandemic, many people in the healthcare industry had a hard time justifying the cost, but luckily CMS has committed to paying providers the same rates for virtual visits as in person during COVID-19. This could lead to lasting change even once the pandemic is over as people see the convenience and effectiveness of telehealth.
One of the most frustrating things about health care is that more often than not, people don’t know what they’ll be paying until they’re hit with the bill. Some services give price estimates, insurance companies offer estimates, and some medical practices disclose prices ahead of time, but none of this is enforced by a regulatory group or the government. And good luck trying to get most hospitals or providers to give you an accurate price quote up front. However, all that will change in 2021 with a new CMS policy that states hospitals will have to “make public standard charges for at least 300 ‘shoppable services’...the hospital provides in a consumer‑friendly manner.” This is of course incredibly beneficial to patients, self-insured employers, and health plans, but it can also be beneficial to the healthcare providers who embrace this change. For example, see the difference Texas Medical Management is already making by embracing price transparency. Through price transparency, the healthcare industry will move toward a competitive market, which means more engaged healthcare consumers and better patient outcomes at fairer prices.
Health disruption may sound negative, but really it just means that innovations in technology or new processes in the industry lead to positive changes for patients, which is the entire point of health care anyway. For the providers and healthcare professionals who embrace the disruption, it means positive changes for them too. There might be growing pains, but ultimately, health disruption leads to a physically, mentally, financially, and emotionally healthier society.