November 19, 2019
In our previous post, we covered some of our predictions for the payer, employer, and pharma ecosystems in 2020. We now turn our attention to where providers, consumers, and the government will be focused in the coming year.
Everything about the way medicine is practiced today has created barriers in the doctor-patient relationship. It begins with booking an appointment, which — particularly with specialists — need to be booked weeks, if not months, in advance. Once the visit occurs, the doctor’s schedule is so packed that the patient interaction is rushed and far too short. Meanwhile, the doctor spends half of the time typing notes into the EMR. And once the appointment ends, the provider office now assumes the role of a bill collector.
None of this sounds particularly warm or representative of the relationship prospective providers imagined when they set off for medical school.
The good news is that we’re seeing responses to this unfortunate reality — and we anticipate more on the horizon. Direct primary care models (like Paladina) that make space for meaningful patient-doctor interactions. Technology solutions (like Olive and Notable) that seek to free up doctors and administrative staff from monotonous workflows. New approaches to payment models (like OODA) that take responsibility for bill collecting away from the provider.
“Consumerization” is seemingly on the tip of everyone’s lips in the healthcare industry and manifests itself in a variety of ways. But the most interesting in our view is the impact that companies with deep consumer expertise — most notably Apple, Amazon, Walmart, and Alphabet — will have as they expand their healthcare offerings.
All of these companies have taken their first steps into healthcare, including (but not limited to!): Apple efforts in wearables, Amazon via its acquisition of PillPack and the creation of Haven, the launch of Walmart Health clinics, and an array of activity at Alphabet, most recently its mysterious “Project Nightingale.”
What these companies have proven time and again is the ability to reimagine everyday behaviors in a digitally-enabled and accessible way. For instance, in a world with Google Maps, it’s hard to recall when we used to head to AAA to pick up a paper TripTik. It will be fascinating to see how successful they will be in the notoriously messy world of healthcare.
There is no shortage of instability and ineffectiveness in Washington right now. However, healthcare has surprisingly been an under-the-radar, bipartisan bright spot. Thanks to the leadership of people like Seema Verma and Adam Boehler at CMS and Scott Gottlieb and Amy Abernethy at the FDA, there have been meaningful, innovative, government-led efforts to improve the way healthcare is delivered and paid for.
That said, the role of government in the healthcare system is going to come under a very intense spotlight in 2020. “Medicare for All” is arguably the most hotly contested issue in the Democratic primary debates thus far and is only set to intensify. And whoever emerges from the Democratic field will then spend the remainder of the election cycle arguing with Donald Trump, who undoubtedly will continue his unabating assault on the Affordable Care Act (despite news of decreasing premiums in 2020).
Regardless of who wins the election next year, it’s difficult to imagine that a divided government will actually enact sweeping, headline-grabbing changes to healthcare policy. Nevertheless, we remain optimistic that smart rank-and-file leadership — at both the state and federal level — can continue to improve care, increase access, and lower costs.