Published August 18, 2022 | 4 min read
Key Points
- Virtual health solutions can potentially impact healthcare delivery, particularly consumer-driven primary care, behavioral health/telepsychiatry and post-acute/home health.
- As patients look for specific on-demand services, panelists now view physicians as gatekeepers of procedures.
- The proliferation of medical devices will shift procedures to lower cost settings with greater price transparency.
- Patient-physician relationships will be reframed, as specific generations opt for primary care physicians, and others seek ‘a la carte’ care at clinics.
At the RBC Capital Markets Global Healthcare Conference, experts on our RBC Imagine™ panel discussed the future of healthcare and the trends that have been amplified by the COVID-19 pandemic. This conversation expands on themes identified in our recent survey of over 200 U.S. physicians across specialties to learn firsthand how the practice and delivery of healthcare has changed since the pandemic, and what doctors are preparing for now as society continues to reopen.
Our experts, a former hospital director and current strategy director for a major northeast healthcare system, a former hospital CFO, and a future-oriented healthcare consultant, all agreed that the key impacts would become lasting changes; telemedicine would continue to grow, physicians will evolve to gatekeepers as healthcare reshapes consumerism, and relationships will be reframed, initially by generation.
How a pandemic shapes the future of healthcare
COVID-19 as a disease is not going away. There will continue to be surges and variants, but most patients today are discovered positive when treated for other conditions, and our experts believe it can now be contained. However, it remains a disruptor for healthcare services, with both positive and negative effects.
Surges in the disease are still putting pressure on already-tight staffing and margins, and agency fees and margins remain a top expense for hospitals. There’s also a “secondary wave” associated with surges of patients choosing to delay elective procedures, leading to fluctuating volumes of patients and financial and resource planning challenges.
But the pandemic has also accelerated healthcare trends by as much as a decade, encouraging increased use of telemedicine and hospital at-home services, as well as prompting hospitals and physician groups to look for scale in their back-end operations. Our panelists believe this will ultimately serve to reshape the healthcare system from patient to consumer more efficiently.
“We launched our thesis on the future of the healthcare system about four years ago, and we projected the rising adoption of virtual health, empowering homes as alternative care settings, clinical trial acceleration, and a relentless focus on consumer engagement as the major themes heading to 2040,” said one expert.
“And what happened during COVID was, these areas that we felt were going to happen in the future of health were accelerated by as much as 5, 10 or 15 years.”
Virtual healthcare has room to grow
Our experts universally agreed that telehealth is one of the areas with the greatest potential to positively impact the delivery of healthcare going forward. The wide range of use cases that they believe are most exciting in the near-term include consumer-driven primary care, behavioral health/telepsychiatry and post-acute/home health.
The technological barriers to virtual health have been mainly addressed, although broadband access is still a challenge in some areas and for certain socioeconomic groups. However, whether physicians are in-person or virtual, medical staffing has become an increasingly acute issue, and at-home setups need to be established to optimize remote care.
Continued improvements in the reimbursement landscape and the ongoing shift to value-based care could hasten uptake and help overcome these barriers. Then, it’s really only the easier-to-address logistical issues (like better workflow integration) that remain the primary friction.
Technology powers healthcare migration
The migration of care from hospital settings was already underway, and the pandemic only accelerated it. Today, ambulatory surgical centers (ASCs), post-acute settings, and even home care settings are growing in use, powered by telehealth on one hand and wearable technology and medical devices on the other.
As these technologies improve, they will continue to lower costs and increase efficiencies, but our experts believe that this can’t be easily achieved unless Medicare leads the movement. With Medicare out in front, commercial payors would follow, and in the future, patients should be able to price-shop elective procedures.
Our panelists also hypothesized that over the next 10+ years, many companies – including ones not considered healthcare companies – will converge into healthcare. These companies will view every participant in the U.S. economy as part of the healthcare industry, and will focus on improving the health of their talent base. They also expect greater vertical integration, with larger companies owning pharmacies, pharmacy benefit managers and payers, physician groups, and ambulatory care settings, which will allow greater economies of scale, efficiency and monetization of internal assets.
The doctor/patient shift to gatekeeper/consumer
As these trends in treatment delivery play out, there’s also an accompanying shift in the mindset of patients. Our panelists all agree that having a multitude of options will drive better access, compliance and quality of outcomes among the different needs of patient-consumers.
“We know from experience that about 40% of the patients who come to urgent care centers don’t have a primary care doctor and they don't want to have a primary care doctor. They view healthcare as something that they can consume ‘a la carte’, and they're fine with that.”
“These tend to be millennials and younger, who are used to doing everything on their phone,” said one panelist.
“But there’s an older group of people who do value the doctor/patient relationship. Most of what goes on in a primary care visit is not really diagnosing the illness or prescribing medication, which happens in two minutes. It’s the rest of the relationship, including asking, ‘How are you eating? What’s happening in your family?’ These social determinants really impact the health of the patient.”
These preferences may not remain static either, but may change over the lifetime of an individual or depending on the type of care they need, i.e., for a chronic illness over a long period. Therefore, primary care physicians need to be retooled to become gatekeepers, assisting patients in accessing individualized healthcare through the advances in technology that can support new delivery systems.
This content is based on commentary and analysis from RBC Capital Markets' Global Healthcare Conference held in New York, NY on May 17-18, 2022. For more information, please contact your RBC representative.