Latest / CareTalk: Healthcare. Unfiltered. / Mid-Year Grades for Our 2023 Healthcare Predictions

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Mid-Year Grades for Our 2023 Healthcare Predictions · CareTalk: Healthcare. Unfiltered.

• 0:00
  Well, John and I made some pretty bold and also not so bold predictions about health care back at the start of the year.
• 0:06
  So now it's a good time to have that mid year reality check to see what's come true, what we missed the mark on, and what we just plain didn't even think about.
• 0:22
  Welcome to Care Talk, America's home for incisive debate about healthcare business and policy.
• 0:27
  I'm David Williams, president of Health Business Group.
• 0:30
  I'll be hosting the show myself today and give John a chance to enjoy his vacation.
• 0:35
  Before I jump in to review the predictions, I do have a favor to ask.
• 0:38
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• 0:45
  That helps us stand out from the crowd and lets others find us.
• 0:49
  Okay, here goes.
• 0:51
  Well, prediction number one was about virtual care.
• 0:54
  John said virtual care is just going to be care.
• 0:57
  In other words, the virtual part won't really matter.
• 1:00
  I actually think he got way ahead of himself on that one.
• 1:03
  And in fact, I saw a recent study that said only about 10% of care can be done remotely.
• 1:10
  That seems kind of low to me, but the fact is that virtual care is still just one part of the equation.
• 1:15
  I also think there is some downside to virtual care, and there's some good reasons why we see a rollback.
• 1:21
  Unfortunately, there were a lot of missed diagnoses and treatments that occurred due to virtual care.
• 1:27
  During the pandemic, I know of an example, for example, of somebody who had a stomach ache.
• 1:31
  They thought they did, and it actually turned out to be stomach cancer.
• 1:35
  If they'd had an in person visit, maybe that would have been caught on time.
• 1:41
  Prediction number two was my prediction, and it was intentionally provocative, which probably gave it more of an opportunity to be wrong, and it was.
• 1:49
  I said that staffing shortages in healthcare would soon be a thing of the past, especially if there was a recession.
• 1:55
  Well, there hasn't been a recession and there's been no rush of healthcare staff back to the front lines either.
• 2:01
  In fact, I was just speaking with someone today who told me his daughter's a nurse.
• 2:04
  She was burned out by COVID and she's only doing about two shifts a week.
• 2:08
  So I think we are going to be in that situation for a while.
• 2:12
  And it may be that the healthcare staffing shortage does not.
• 2:17
  Pass any time soon.
• 2:20
  Prediction number three.
• 2:21
  I said, Medicare advantage would lose its luster as people realize it's not all it's cracked up to be.
• 2:27
  And for this one, I'm going to quote my mom.
• 2:29
  Who's in her mid eighties and she's going to be the arbiter here.
• 2:32
  She has regular Medicare, traditional Medicare, but she brought it up to me.
• 2:36
  And she said that, Hey, Medicare advantage, she's been hearing about people getting that.
• 2:40
  And she says, you know, that's not Medicare.
• 2:42
  In fact, it's misleading.
• 2:44
  And she has a friend who says their treatment wasn't covered.
• 2:46
  Uh, under Medicare Advantage, and she's quite upset about the whole thing.
• 2:51
  So, uh, you know, she wasn't really interested in hearing my counter arguments about things like care coordination and alignment of incentives that John's always talking about.
• 3:00
  And she certainly didn't have anything, uh, nice to say about cost savings.
• 3:03
  So, I do think Medicare Advantage is losing its luster.
• 3:07
  And I'll say thanks, Mom, and hi, Mom, in case you happen to be watching this one.
• 3:13
  Prediction number four was about value based care, or as John calls it, care on a budget.
• 3:18
  Well, I said we'd have incremental gains here, and I think that's, in fact, what has happened.
• 3:22
  Part of that is related to Medicare Advantage, which was discussed in the previous prediction.
• 3:28
  Uh, value based care has also been expanded to the ACO REACH model.
• 3:32
  So that's bringing value based care to the fee for service population.
• 3:36
  So I think we are on track, uh, with value based care becoming incrementally more important.
• 3:41
  There's no way that's going to have a huge breakthrough through the year.
• 3:44
  Now, prediction number five.
• 3:47
  We said that home based care is becoming more important as I look back on that as kind of a wishy washy prediction, but it's certainly important to the people who rely on home based care, and there is a shortage of staff and also a shortage of coverage.
• 4:02
  So this is one of the places where crackdowns on immigration are really hurting the ability to serve the need, especially as the population ages for a long time.
• 4:12
  People coming from other countries have been able to serve that caregiving need for the home based population, and there's just fewer and fewer people coming in.
• 4:19
  Even though we need more of them.
• 4:22
  So this is a prediction where it's correct.
• 4:24
  It's been held back by supply, uh, and not by demand.
• 4:29
  Demand is there and it's gonna continue to increase.
• 4:33
  Prediction number six is that private equity investors are going to undergo additional scrutiny for undermining healthcare reform.
• 4:41
  This one is a little harder to see through.
• 4:43
  Because there are, but there are some pockets of outrage from payers and consumers when prices have been jacked up or where some other clearly profit maximizing, uh, activities are occurring due to the desire of private equity to make as much money as possible.
• 4:59
  But I would say that so far this year, this prediction and this blowback has actually been overshadowed by more of a blowback on diversity, equity and inclusion, which is something that investors had been stressing.
• 5:11
  Now, there's some states that are wanting to prevent investors from considering those factors or promoting them at all.
• 5:16
  So what I've heard about is rather than blowback on private equity investment in health care, there is a pushback on DEI.
• 5:24
  Leading actually to layoffs of DEI professionals within investment funds.
• 5:29
  Um, and we haven't, we've heard more about that than about any impact on healthcare reform.
• 5:34
  I still think that there's going to be a pushback, a blowback against private equity investment in healthcare, but it might be next year's news and not this year's.
• 5:44
  Prediction number seven related to artificial intelligence.
• 5:48
  I said, artificial intelligence and healthcare would sputter for now.
• 5:52
  Now we made this prediction before the big chat GPT announcements at the start of 2023.
• 5:57
  And even with all that, I would still say.
• 6:00
  It's sputtered, but kind of like the Internet, it may not live up to its initial hype.
• 6:05
  However, eventually, the impact could be even more profound than what we can imagine right now.
• 6:09
  Certainly, you're seeing it in other areas besides health care, for example, in Hollywood, where the writers see the writing on the wall and are saying, we need to do something now about artificial intelligence if we even want to keep this as a career.
• 6:22
  AI does have a big role to play in health care behind the scenes in handling big data sets, helping out with diagnoses and clinical trial recruitment, and reducing the amount of paper pushing, which has been a key source of burnout for health care professionals.
• 6:36
  So it's not that AI is going to sputter completely or that it is, but the sort of high profile generative AI is going to take a while to come in.
• 6:47
  Prediction number eight was that retailer retailers in healthcare were going to hit their stride in 2023.
• 6:53
  Now these retailers have certainly stepped up and I'm including in that John's employer Walgreens with village MD trust traffic, convenience, and clinician were all factors that John cited about why this was going to be the year for retail healthcare.
• 7:08
  I think it's actually going to take a lot longer.
• 7:10
  for the big retailers to make a difference.
• 7:12
  In fact, I would say five years, not one year, but this idea of convenience, low cost and consumer oriented service is a good one.
• 7:22
  Prediction number nine.
• 7:24
  Finally, I predicted a mellow political year for healthcare, even though I don't think John really bought into this one.
• 7:31
  Now, it has been fairly mellow as it relates to COVID measures, which is what had made the last few years so contentious fighting about masks and vaccines, shutdowns, public health kind of issues.
• 7:43
  Uh, but that's really because COVID is way down and the current strain that's out there is mild.
• 7:47
  So there's not that much to argue about.
• 7:49
  However, There has been plenty of fighting over reproductive health and gender affirming care in particular, and we may yet see some fighting in Congress over spending on Medicaid and Medicare for both the budget and any further discussion about the debt ceiling.
• 8:04
  The states are also, have some fighting going on between the states and the feds on Medicaid redetermination, as some states are moving like jackrabbits to kick people off coverage, and others are being more measured.
• 8:17
  Well, that's it for yet another edition of Care Talk.
• 8:20
  I'm David Williams, President of Health Business Group, and I've been providing a mid year update on our 2023 predictions.
• 8:27
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• 8:31
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• 8:49
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