Four physicians joined Becker's to discuss the healthcare trends, from telehealth to private equity, they are following right now.
Question: What healthcare/economic trends are you following closely right now?
Editor's note: This response was edited lightly for length and clarity.
Stephen Almond, MD. Pediatric and Transplant Surgeon with Children's Physician Services of South Texas (Corpus Christi):
- Telehealth: COVID-19 has shown us that many patients can be seen and evaluated electronically. This trend will continue, and I predict it will lead large health systems to employ and oversee a large number of advanced practice nurses that will care for most primary care visits.
- Similarly, companies will develop "home healthcare centers" that will be in each home, just like we have entertainment centers. People will sit down at these healthcare centers, hook themselves up to monitor team devices and transmit them to a company's advanced practice nurse call center and have their problems diagnosed and treated.
- Companies will pop up that will bring or send diagnostic tests to patients at home. These will include blood draw capabilities, EKGs, throat swabs and the like. This will become a huge industry.
Frank Hromas, MD. General Family Medicine Physician (Amarillo, Texas): The disgusting and terrible trends are (1) he corporate practice of medicine via private equity buyouts of physician practices and hospitals; (2) paramedicine's continued erosion of healthcare quality (privileges granted to [advanced practitioners], pharmacists, optometrists, etc.); and (3) the huge amount of money wasted on highly paid medical "administrators."
Matt Mazurek, MD. Assistant Clinical Professor of Anesthesiology at St. Raphael's Campus of Yale New Haven (Conn.) Hospital: Medicare and Medicaid reimbursement rates are not high enough to support the economic needs of hospitals or private practices, and every year, CMS continues to cut payments. With inflation, this scenario is a recipe for continued hospital closures and private practice groups to either dissolve, sell or consolidate. Additionally, since CMS is constantly changing reimbursements, it is difficult for hospitals to create long-term strategic plans.
The shift to value-based care is much discussed, but it has not been implemented on a meaningful scale to make a difference. We are stuck in a fee-for-service environment. Hospitals are completely dependent on procedural volumes to maintain financial solvency. And the shift from inpatient to outpatient procedures is straining hospital finances. This leaves hospitals caring for more complex, older, sicker patients on Medicare with lower reimbursements. I anticipate more hospital closures as a result of this trend.
Private equity continues to purchase groups and invest in numerous domains for care delivery. I remain deeply concerned, as current GDP spend in the U.S. on healthcare is approaching 20 percent. Private equity investors expect return on investment. With this trend, it is easy to imagine GDP on healthcare to grow to 25 to 30 percent. These dollars are not necessarily going to translate to better care and quality or access.
Mark Soberman, MD. Senior Safety Officer at Ethicon (Raritan, N.J.): Value-based healthcare delivery, AI/machine learning, the role and effect of private equity in healthcare.