By Pooja Babbrah, Practice Lead, PBM Services, Point-of-Care Partners
Twitter: @pocpHIT
Healthcare delivery has been shifting over the past few years away from traditional sites of care, such as hospitals and clinics, to alternative sites of care, such as urgent care clinics and ambulatory surgical centers. This evolution has been fueled by the availability of new technologies, new reimbursement methods and the desire to reduce costs and improve outcomes.
But now there is a new factor in the mix. Patients are in the driver’s seat when it comes to their healthcare and their data. They want quality and convenience. The COVID-19 pandemic further gave patients the opportunity and technologies to get diagnosis and treatment where they are. This created the expectation that such opportunities will be available into the future.
As a result, payers and providers will be finding new ways to meet patients where they are in 2022. They include:
1. Serving the under-served.
The push for DEI — diversity, equity, and inclusion — in healthcare and the need to expanded revenues are creating opportunities in going where services are needed, such as rural and underserved areas. Dollar General, for example, will be adding clinics to their stores to support care in rural areas and “health deserts.” That translates to more than 10,000 stores — including many in rural areas and small towns — where customers must drive long distances to get medical care.
2. Satisfying the demands of consumerism.
Then there’s the continuing rise of consumerism. Consumers are looking for the same kind of convenience and quality in accessing and obtaining services as they have come to expect from other industries, such as airlines and hospitality.
CVS is acting on that trend by closing some stores and trying to capitalize on digital growth from on-line shopping and turning its stores into “health-care destinations.” Rite Aid is following suite by announcing closure of at least 63 stores in 2022.
Not only do patients want convenience, but they are also looking for a better patient experience. One way to do this is to create a “digital front door,” which creates ways to more easily access, interact with and pay for their health care. Phoning the doctor and trying to navigate through myriad phone trees to reach a human is a definite turnoff. Millennials, in particular, are looking for cost transparency and digital access through apps.
And it’s a lot easier for patients to switch providers. If patients aren’t satisfied with their care and patient experience, they can vote with their feet and take their data with them. Eighty percent of consumers say they’d be willing to switch providers for convenience factors alone.
Patients are feeling less connected to their doctors once they leave their offices. As a result, loyalty, and the hassle of transferring records are not major retention factors anymore.
In addition, consumer-centric care will become a strategic focus for many organizations in 2022. Building care systems around the needs and preferences of consumers is a new business imperative. An example is Walgreen’s Boots Alliance, which has launched its new consumer-centric healthcare strategy to drive sustainable, long-term profitable growth. The plan features the Walgreens Health, a new business segment enabled by investments in VillageMD and CareCentrix. This is part of the company’s accelerated capabilities in primary care, post-acute care, and home care.
3. Offering comprehensive telehealth services.
Telehealth will continue as a tool to meet patients where they are, especially for those with behavioral health issues. This is due to several drivers: addressing the substance abuse epidemic (which still continues with a vengeance); the behavioral health issues created by the COVID-19 pandemic, including suicide and depression, especially among the elderly and teenagers; and expanded coverage by Medicare for behavioral health visits. There may be an appetite for public and private insurers to cover emerging platforms for targeted populations, such as LGTBQ+ and pediatrics. Stakeholders also will need to keep up with the ever-changing patchwork of federal and state requirements concerning consents for behavioral health diagnosis and treatment.
4. Increasing use of remote patient monitoring (RPM).
RPM took on heightened importance because of COVID 19. Now RPM is slowly becoming the future of delivering healthcare services to patients by providing them with an array of medical devices–such as implantables, blood pressure cuffs, wearable and ingestible sensors for patients, and in-bed alarms and monitors–so doctors can access real-time patient data for better treatment. Medical device manufacturers will continue to add in-home healthcare monitoring capabilities. RPM should pick up speed because of expanded Medicare and Medicaid coverage and reimbursement.
5. Leveraging growing use of wearables.
Wearable technology use will continue on its upward trajectory in 2022. You name it, there’s a wearable to monitor it — calories burned, blood sugar, sleep quality, whatever. Wearables have been named the top fitness trend for 2022. In addition, the wearables market will continue to expand into medical-grade devices that can easily be worn and integrated into everyday life. For example, continuous glucose monitoring devices and wearable insulin delivery systems have revolutionized diabetes management and are already rivaling traditional blood glucose monitoring and insulin delivery. Medicare will help fuel this trend by expanding coverage and reimbursement.
Beyond reimbursement, there will be a focus on leveraging the power of wearables by including data from them in patients’ electronic health records. The Office of the National Coordinator for Health Information Technology (ONC) is likely to continue its efforts in this area, as well as explore other ways to harness the power of data from wearables and APIs.
6. Using software to improve outcomes.
2022 will continue to see an accelerated trajectory for DTx. Digital therapeutics are software products used in the treatment of medical conditions. They are designed to enable patients to take greater control over their care, similar to consumer wellness apps but with two key differences: Digital therapeutics focus on delivering clinical outcomes and they deliver evidence-based therapeutic interventions via software that replace or complement the existing prevention, management and treatment of a disease. They should not be confused with digital health, in that DTx must be approved by regulatory bodies, with displaying proof-of-concept at the core of their model. DTx creates opportunities to increase patients’ awareness of their health and their ability to play a more active role in managing their disease, thereby creating the potential to improve health outcomes and reduce the demands on healthcare systems. Prospects for 2022 include virtual care, and treatments for chronic diseases, such as asthma and congestive heart failure, and behavioral health issues. Expect to see DTx companies selling products through online retail outlets. Health plans will increase coverage of DTx, although pricing and reimbursement are issues that must be addressed. The Food and Drug Administration will be receiving many more DTx applications to consider for approval.
7. Swallowing smart pills.
Digital medicines or “smart pills,” are distinct from DTx. Digital medicines combine a prescription medication with an ingestible sensor that is designed to communicate with a software application to track compliance. This is another growth area for 2022, using this innovative technology to address medication adherence—also a front-and center issues this year. As with DTx, health plans will increase coverage of digital medicines, although pricing and reimbursement are issues that must be addressed.
These are just a sample of the seismic consumer-related trends that we’ll see in 2022.
This article was originally published on the POCP blog and is republished here with permission.