2024 Healthcare Predictions: A Look at the Future of Healthcare

Ben H.

Hatched by Ben H.

Mar 22, 2024

4 min read

0

2024 Healthcare Predictions: A Look at the Future of Healthcare

Introduction:

As the year 2024 approaches, the healthcare industry is poised for significant changes and advancements. Health systems are beginning to strategize ways to combat the loss of more profitable services and referral channels to competition. Additionally, the return of provider health plans is on the horizon, with hospitals considering the benefits and challenges of starting their own insurance plans. Moreover, the commercialization of in-house models, technology, and data is gaining traction, providing new opportunities for hospitals to generate revenue. In this article, we will delve into these predictions and explore their potential impact on the healthcare landscape.

Fighting Back: Health Systems Seek Alternative Revenue Streams

In an increasingly competitive healthcare market, health systems are faced with the challenge of maintaining profitability. The erosion of more profitable services and referral channels by competitors has prompted health systems to explore alternative revenue streams. They are no longer content with relying solely on labor-intensive services that drive up costs. Instead, they are seeking ways to generate revenue from non-traditional sources.

One possible solution that health systems are considering is the establishment of provider health plans. While this idea has been attempted in the past with limited success, the current climate presents new motivations for hospitals to give it another shot. The threat of competition from entities like Kaiser and Rizant, combined with public disputes between providers and Medicare Advantage plans, has sparked renewed interest in provider health plans. By establishing their own insurance plans, hospitals can potentially gain control over reimbursement rates and ensure the viability of their services.

Commercialization of In-House Models, Technology, and Data

Another trend that is likely to gain momentum in 2024 is the commercialization of in-house models, technology, and data. Hospitals are beginning to recognize the untapped potential of leveraging their resources for financial gain. Instead of simply using technology and data for internal purposes, they are exploring ways to turn these assets into viable businesses.

One notable example of this trend is General Catalyst's HATCo, which aims to purchase a hospital and transform it into a testing ground for new technologies and business ventures. By testing concepts within their own facilities, hospitals can gather valuable data and insights that can be used to develop new products or services. This approach not only generates revenue but also positions hospitals as pioneers in healthcare innovation.

The Power of Connectivity: Fast-Tracking Processes through Collaboration

In an era of digital transformation, connectivity has become a key driver of efficiency and effectiveness in healthcare. The collaboration between providers and health plans is becoming increasingly vital in fast-tracking processes such as prior authorization, claims, and quality reporting.

By leveraging payer platforms, healthcare organizations have achieved significant improvements in various areas. Mayo Clinic and BCBS MN, for example, reduced ADR denials by up to 75% through their collaboration. Baptist Health and Humana successfully exchanged 24,000 charts in just one year, streamlining the flow of information between them. Ochsner Health and Humana also made significant progress by instantly completing 53% of prior authorizations, eliminating delays and improving patient care.

Actionable Advice:

  • 1. Embrace Innovation: Healthcare organizations should actively seek out opportunities to leverage technology, data, and in-house models for commercial purposes. By embracing innovation, hospitals can diversify their revenue streams and stay ahead of the competition.
  • 2. Foster Collaboration: Providers and health plans should prioritize collaboration to fast-track processes such as prior authorization, claims, and quality reporting. By establishing strong partnerships and leveraging payer platforms, healthcare organizations can achieve significant improvements in efficiency and patient care.
  • 3. Stay Informed: As the healthcare industry continues to evolve, it is crucial for healthcare professionals to stay informed about the latest trends and developments. By staying abreast of changes, healthcare organizations can adapt and thrive in the ever-changing landscape.

Conclusion:

The year 2024 holds immense potential for the healthcare industry. Health systems are actively seeking ways to combat the erosion of profitable services, leading to the resurgence of provider health plans. Additionally, the commercialization of in-house models, technology, and data is opening up new avenues for revenue generation. Finally, the power of connectivity and collaboration between providers and health plans is revolutionizing processes such as prior authorization, claims, and quality reporting. By embracing innovation, fostering collaboration, and staying informed, healthcare organizations can navigate the future with confidence and success.

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