Hazarding predictions about 2021 is almost unthinkable after the disruptive, unprecedented changes we witnessed in 2020. Because of the COVID-19 pandemic, the care delivery system navigated massive clinical, financial, operational, and leadership challenges, and many physician groups and health systems were (and still are in many part so the country) stressed to their limits to continue to provide ongoing patient care. Yet in talking to leaders of our member medical groups around the country, I heard many look toward the future. So with large amount of modesty and humility, here are some predictions.
Cost cutting gets more creative: Many leaders were required to dramatically cut costs to manage, and in some cases survive, the loss of patient volume during the lockdowns. In addition, many administrative personnel were transitioned to remote work, which reduced the need for office space and highlighted to ability to perform much of this type of work virtually. These and other lessons learned will be applied to future operations, with increased outsourcing of back-office functions, more flexible staffing models, acceleration of standardized supply chain management, and reduced real estate footprints.
Telehealth morphs into home care: Physicians, administrators, and patients all seem to agree that the rapid adoption of telehealth was one of the best outcomes from the pandemic. Providers of care are not only planning how to optimally deploy telehealth for various clinical pathways, but also exploring the huge potential scope of services that can be provided in the home setting. They see an expansion of hospital at home, SNF at home, rehab at home, and remote monitoring capabilities. Many allied health professionals—including behavioral health, pharmacists, physical therapists and nurses—will expand their presence in the virtual world.
Independent practices struggle to survive: One of the unfortunate casualties of 2020 has been the independent practice of medicine. Many small and large practices did not have financial reserves to handle the large revenue shortfalls experienced early in the pandemic, leading to staff and physician furloughs, salary reductions, closing of practice sites, and in some cases, sale to external partners. As we head into 2021, this trend will continue, as independent practices evaluate their ability to withstand further financial shocks, their future capital needs, their technology needs, and their challenges in attracting and retaining physicians.
Addressing health equity becomes standard practice: Medical groups and health systems have long been embedded in their communities and were among the first to support the call for racial justice after the George Floyd murder. Many have a long history of addressing community health needs and social determinants of health, but most have been re-evaluating their commitments to addressing health equity—as well as the outcomes their efforts can achieve—and will accelerate and deepen these initiatives. Boards will hold leadership accountable for outcomes, and accountability for achieving health equity will be written into executive report cards.
Although 2021 may be the year we begin to control and manage COVID-19, the effects of 2020 will continue to impact care delivery for years to come.
Jerry Penso, M.D., M.B.A., is president and chief executive officer at AMGA, a trade association that represents medical groups and other organized systems of care, including some of the nation’s largest, most influential integrated healthcare delivery systems.
