Simplifying Healthcare: 2023’s Most Notable Moments & Trends?

There’s no better time for reflection than the end of the year –?it’s the perfect time to revisit and assess our initial goals, thoughts and predictions we made for the year that is near completion.??

In January, I shared my healthcare predictions for 2023 , which included an increased focus on patient experience, the importance of caring for caregivers, and the ongoing journey towards value-based care. While I believe our industry continues to prioritize and improve upon personalized, efficient care in order to advance patient engagement, we also continue to grapple with affordability and lack of coverage as the primary barriers to accessing care, and our focus has shifted to ensuring coverage and improving holistic well-being across populations.??

Some of my most engaged LinkedIn posts this year reflect that shift—payment reform , primary care deferral , cost concerns , etc.—highlighting that access to care and policy reform continue to drive conversation within my own audience and across the broader news media.??

We had no shortage of exciting events, innovation and evolution this year in healthcare, but the most notable moments to me personally took place under the following categories: Value-based care, access to care, workforce, technology and pharma.??

1. Value-based care?

One of the very first newsletters I published was dedicated to highlighting and simplifying the differences between the traditional Fee-for-Service (FFS) vs. Value-Based Care (VBC) payment models. VBC emphasizes providing quality care in the right place at the right time rather than quantity and places the focus on a population vs. an individual’s outcomes, all the while shifting incentives from a reactive approach to a preventative care approach.??

In June of this year, the Centers for Medicare & Medicaid Services announced their strategy to support high-quality primary care , emphasizing that by 2030, they strive to have 100% of traditional Medicare beneficiaries and the majority of Medicaid beneficiaries in accountable primary care relationships (think VBC) by 2030. To help catalyze and evolve the way we approach and pay for primary care, the CMS is improving financing by moving away from payment based on volume of services delivered, to focusing on increasing safety net participation, requiring health equity plans from participating providers and making value-based payment sustainable through multi-payer alignment.??

2. Access to healthcare??

Over the last few years, we’ve seen various legislation passed and care models proposed with the intent to increase access to care:?

• In 2022, the Inflation Reduction Act was enacted in the U.S. with aims to curb inflation, partly through lowering prescription drug prices and cutting health care costs for families and provide subsidies to access insurance through the marketplace.? These subsidies have continued into 2024, expanding access to coverage which is the basis for the ability to access care.?
• With the end of the Public Health Emergency (PHE) in May, the Medicaid unwinding process began shortly thereafter, giving states the ability to terminate Medicaid enrollment for ineligible individuals. Recent interventions in redetermination efforts have provided an opportunity to ensure that state efforts were thoughtful and carried out with the intent to ensure those eligible for coverage were able to retain it.?
• The Centers for Medicare & Medicaid Services have also launched the Accountable Care Organization Realizing Equity, Access, and Community Health, or ACO REACH program, to advance health equity building foundations to address the inequitable outcomes we see across populations.??

We’ve also seen the rise of non-traditional players in the space from a variety of entities (retail, tech and others). I am interested to see how this trend evolves over time and if it creates additional and novel access points to care.??

3. Workforce?

Talent recruitment and retention issues aren’t unique to healthcare – it seems like nearly every industry these days is affected by staffing shortages, burnout and overall employee wellbeing issues.??

But according to the Association of American Medical Colleges , demand for physicians is anticipated to grow faster than supply, leading to a shortage of anywhere between 54,000 and 130,000 physicians by 2033, likely affecting primary care and rural communities most. Also, the CDC recently shared that over 13% of healthcare workers reported workplace violence in the last year, with hospitals now recognized as one of the more dangerous places to work in the U.S. As a result, we will need to be creative in attracting and retaining talented physicians, as well as other caregivers, to serve our communities.???

I touched on this issue in my August Simplifying Healthcare newsletter , where I offered up a few solutions to combat these shortages?–?prioritize employee mental health and belonging, start early in creating a love for STEM and healthcare in the next generation, lean into mentoring/networking with up-and-coming talent, and invest in our current workforce with programming that will help them up-skill and re-skill.?

I’ll be interested to see how schools, hospitals and other institutions protect and engage the talent we so desperately need –?the quality of care and viability of our system depends on it.???

4. Technology?

It feels like a single day did not go by without hearing something about AI and ChatGPT this year. In terms of the broader healthcare system, the digital landscape continues to evolve, especially in how technology drives care access and affordability.

As I expressed in my AI-focused newsletters , I still believe that technology and innovation in healthcare cannot be successfully adopted without alignment of regulation, financing, patient engagement, security, and the ability to scale implementation across our system. Fortunately, we are seeing early movement in safeguards and regulations being put into place by governing health bodies –?earlier this year, the FDA announced the new advisory committee on Digital Health Technologies, set to begin their work in 2024. Additionally, the WHO outlined 6 areas for regulation of AI in health in order to avoid data biases.??

5. Pharma?

In the same vein as AI, the news cycle and our individual feeds seemed to be dominated by drugs like Wegovy and Ozempic. Conversations regarding the impact these drugs can have on the health of individuals who have access to them, was widespread.? This brought something to light for me and perhaps what I’ve always believed to be true –?healthcare isn’t just a reactive system only set in motion to respond to a crisis, but it is personal and meaningful and can have a real hand in shaping pop culture and conversation.??

I’m not sure we’ll be able to replicate the celebrity- and influencer-level of conversation we garnered with Wegovy and Ozempic, but landmark medication approvals and innovations will likely continue to dominate our day-to-day conversation. The rise of new therapies including novel sickle cell treatments and cognitive impairment medications has illuminated the importance of personalized medicine and preventative health — and continues to spur the conversation on how we pay for them.??

Looking Ahead + Final Thoughts??

2023 felt like full speed ahead on the momentum our industry has been building in the “post-COVID era.” This year was marked by a widespread focus on AI and non-traditional innovators –?often without thinking more deeply and practically through the lenses of holistic wellbeing, staffing and payment. Next year, I’m hoping to see more candid conversations around innovative solutions and their risks and benefits, as well as how they fit with the broader healthcare ecosystem in a coordinated and connected way.??

Stay tuned next month for the first issue of 2024, where I’ll do a deep dive on my 2024 Big Ideas and predictions for the upcoming year in healthcare.??

Until next month (and year!).???

- Ruth ????

Have an idea for a future topic or questions in the world of healthcare? I’d love to hear from you!?