It’s become something of a truism in U.S. healthcare to say that we’re living in unprecedented times; yet just because it’s a truism doesn’t mean it’s not true. Indeed, as 2021 rolls forward, the landscape of U.S. healthcare is shifting forward rapidly. With a new administration in the White House and control of both houses of Congress in the hands of one party, the federal healthcare policy landscape has changed direction. And of course, the entire period of the past 12 months has been totally dominated by the COVID-19 pandemic.
But the obverse face of the pandemic is that it has compelled forward a good deal of innovation; as the adage goes, necessity is the mother of invention. Among the many forms of innovation: the acceleration of the development of hospital-at-home programs, so often talked about, and finally now realized. The same is true about the social determinants of health, which are finally becoming incorporated into care delivery and care management. So, too, is the current drive for genuine health equity, being pursued by provider leaders in concert with public health leaders.
Over all this innovation hangs the specter of the coming healthcare cost cliff, which will be upon us all before we know it. As the Medicare actuaries keep reminding us, the annual overall costs of the U.S. healthcare system are exploding right now, from the current $3.6 trillion-ish per year, to around $6 trillion per year within six to seven years. No better burning platform could be designed for healthcare innovation than that.
Indeed, say experts, the chances are good that federal policymakers, both in the agencies (the Department of Health and Human Services and the Centers for Medicare and Medicaid Services) and in the U.S. Congress, are inevitably headed towards pushing providers more quickly and intensively into two-sided risk in the coming years, as the alternative—massive provider reimbursement cuts—would be unpalatable to practically everyone.
So in this package of articles—that also includes pieces on health systems enhancing their digital front door initiatives, how the pandemic has underscored the importance of primary care, and the “new revenue cycle management” that leverages artificial intelligence and machine learning—readers will be able to look at the most important trends shaping the policy, operational, and technological landscape for providers in the coming years. We hope that these articles are helpful to everyone.
--the Editors of Healthcare Innovation