2021: The Year Broken Health Care Systems Begin the Healing Process

The Covid-19 pandemic didn’t break healthcare. It just brought to high relief the existing fractures. This is good, because those fracture lines become the map and roadways for where we in health care innovation need to focus our efforts. And having the failures of our systems be so obvious is giving set-in-their-ways health systems, payors and technology providers impetus to do the hard but necessary work to retool our systems and processes. Think of Covid-19 as an industry disruptor of the biggest kind.

So what did we learn from 2020 that we can apply in 2021? How will 2021 be different?

The Covid pandemic accelerated several trends; from telemedicine, to consumerism, to awareness of health equity, to new models for behavioral health. The health care environment in 2021 is poised to create new models and technologies to address these trends, should it so choose.

What these trends have in common is that they reflect an urgent need to re-evaluate how we deliver the right care, at the right time, in the right place. This will only come about when interests are aligned between payors, providers and patients via value-based care. During the pandemic, insurance companies took in premiums and paid out much less than normal, enriching their coffers at the expense of health systems. It made it clear that fee-for-service models need to go, and now health systems have the incentive to retool their processes to make value-based care work. Putting the right health care in the right place, at the right time is now the priority.

In our work at the Digital Innovation Group at Providence, we create partnerships with health systems, technology providers and payors to develop innovations that actually address the real issues. To that end, we think of innovation approaches to these challenges in four distinct buckets: Distributed care for access and convenience; navigation and personalization; helping marginal and traditionally underserved populations; and scaling behavioral health.

Distributed Care for Access and Convenience

Distributed care models are one important way that value-based care can work. Telemedicine went from 1% to a full 20% of visits last year; a number that will increase in 2021. Now that people have discovered how convenient and safe virtual care is, they won’t want to go back to the clinic unless entirely necessary. And health systems, as they move to value-based care models, will increasingly drive patients to the lowest cost location and provider. Not every issue needs or warrants a clinic visit; the historic default. Instead, for example, we will give people tools to home monitor their symptoms. When we reduced friction in this activity by not insisting on a log-in process, engagement in self-monitoring rose from 10 % to 80%.

Navigation and Personalization

Navigation and personalization are a requirement for distributed care to work. If you’re going to look at a patient’s experience in its entirety, it becomes important for the “right care, right time, right place” conversation to happen over and over again. So you have to have one place for a patient to begin a digital relationship and start to trust you. Our work with our consumer engagement platform, for example, is designed to create a digital home for health care for our clients, starting with finding a provider through to getting health data and self-serving access to virtual care. With so many places to get care, from health care apps to telemedicine, to primary care , to urgent care retailers, to Big Tech, or the ER, a good navigation solution will find the most efficient solution to your needs. Like Amazon shopping shows you only products relevant to you, our platform serves up information and features tuned to the consumer, reducing friction and increasing trust. Instead of going to 20 different health apps, they use our platform as their health care home and find what they need within it, all in an end-to-end experience. We’ll continue to make that offering increasingly relevant to individuals over more of their health journey.

Scalable Behavioral Health

Covid and its social and financial restrictions have precipitated a behavioral health crisis; one exacerbated by the lack of provider supply. Here is one area where we can appropriately target digital innovation. Because low-acuity mental health issues such as mild depression and anxiety are cognitive in nature, they lend themselves to virtual visits; some therapies, such as Cognitive Behavioral Therapy (CBT) are clinically shown to a) work and b) work as well via an app as through a provider. These are promising areas to help address low-acuity behavioral health issues, as well as provide triage and prioritization for higher-acuity issues.

Underserved Communities

Health equity has implications for all populations, lower income or not. When everyone is healthier, everything works better, from our economy to our health systems’ operations. And Covid highlighted the need to address health equity in real ways. While we are just at the beginning of our research on how technology can support these populations in the best ways, we have committed investing $50 million in this area. Commercial healthcare apps are not typically targeted at low-income populations; we aim to change that in linguistically and culturally appropriate ways. The ubiquity of cell phones and texting means there are ways of reaching underserved communities in high-impact ways with health care apps.

2021 Will Be the Year of Positive Innovation

Digital solutions will help clients find and access care, affordably. They will help health systems keep costs down while ensuring clinically appropriate care. They will help people through their entire health journey, no matter who they are, or what their medical issues are.

This is the year for health care systems to retool their processes for both digital care and value-based care. It’s the time for tech entrepreneurs and healthtech to partner with health systems to integrate with their existing domain knowledge and patient relationships. It’s the time for payors to move to value-based models quickly, and compensate for the use of technology. 2021 can be the inflection point for a lot of healing of health care.