What are the biggest issues in healthcare, and how will they affect MBA students and aspiring healthcare executives as we enter 2021? From changes in payment models and health administration practices to effects on patient outcomes and healthcare ethics, let’s look at what we can expect in the short term.
1. Ethical Challenges Related to COVID-19 Vaccination and Care
December 2020 saw the regulatory approval of multiple COVID-19 vaccines in the United States. But subsequent distribution of these medicines through the healthcare system has been challenging.
Due to a combination of immense demand, limited supply, and complex prioritization criteria cutting across age and occupation demographics, vaccinations took more than one month to ramp up to a pace of 1 million doses per day, per the Centers for Disease Control and Prevention (CDC). States have also taken different approaches to their vaccine rollouts, often shifting gears in response to criticism, logistical challenges, and ethical considerations.
Currently, these ethical issues in healthcare centers on how to balance the needs of the elderly population with individuals whose work is likely to put them at elevated risk of infection. For example, Oregon has attempted to prioritize both teachers and senior citizens for vaccination.
These ethical concerns could persist for years. Compounding issues may include the mutation of COVID-19 and the possible need for flu-like booster shots over the long term. Healthcare executives must have detailed strategies for whom to prioritize for vaccination and other COVID-19 medical services.
2. Finding the Right Approach to Manage the Rise of Telehealth
Usage of telehealth and digital health platforms, in general, surged in 2020, as the coronavirus pandemic accelerated the already-strong growth of these solutions. The CDC estimated a 150% year-over-year increase in telehealth visits in the final week of March 2020. Growth should continue for the foreseeable future.
Moreover, telehealth is becoming a more common feature of health plans. PwC found that 95% of large employers now cover it through their insurance plans, compared to only 56% in 2016. But the same report revealed that there are still some issues in healthcare delivery via telehealth services, including higher rates of reported problems using such solutions among nonwhite populations.
There is also the issue of ensuring that telehealth data and systems comply with HIPAA. Although the United States Department of Health and Human Services announced enforcement discretion for telehealth medical services in 2020, telehealth providers should still make every effort to align their health information practices with HIPAA in 2021 and beyond.
In practice, this means taking precautions to ensure secure transmission and storage of health information. This can be challenging due to the popularity of consumer-oriented video conferencing solutions like Apple FaceTime, Google Meet and Zoom for telehealth.
3. A Rebound Toward Higher Healthcare Costs
The 2021 Segal Health Plan Cost Trend Survey outlined a central issue in healthcare for this year and beyond — namely, the resumption in healthcare cost increases for employers and employees after a brief decline in 2020.
Segal’s respondents reported a sharp drop in employer spending in 2020 due to the suspension of nonessential care delivery as a result of COVID-19. However, for 2021, per-person costs for PPOs and outpatient prescription drugs are both expected to grow by more than 7%.
Provider cost increases and higher physician utilization rates as a result of telehealth will be the main contributors to these higher costs in 2021. A SHRM survey added some additional context to why costs continue to go up, with respondents highlighting musculoskeletal conditions, cancer, cardiovascular disease, diabetes, and high-risk maternity and neonatal care as the costliest issues in healthcare.
SHRM’s respondents expected large employers to pay about $11,000 per employee in 2021 and for employees to pay an average of $4,650. Both numbers are up several hundred dollars over 2020 levels.
4. Innovations in Value-Based Care
Value-based healthcare, which involves provider reimbursement based on performance measures rather than the traditional fee-for-service (FFS) model, was already on the rise before COVID-19. However, the pandemic exposed the fragility of FFS, as the elective surgeries that fueled so much revenue for hospitals were suspended. Orthopedic procedures, for instance, declined 90% in 2020, the CEO of Archway Healthcare told HIMSS Media.
In response, providers may look to take deeper advantage of the Centers for Medicare and Medicaid Services’ Shared Savings Program and accountable care organization (ACO) payment models. ACOs in particular are expected to be pivotal to securing a steady cash flow for providers and to controlling the rising costs of Medicare, which will almost certainly top $1 trillion annually at some point in the 2020s.
The change in presidential administrations in January 2021 could also lead to some changes in the Affordable Care Act and the introduction of a public option. Either of these moves would have major implications for provider reimbursement rates.
Preparing yourself for the biggest issues in healthcare
Earning a healthcare-focused online Master of Business Administration from the George Washington University will give you the comprehensive knowledge and experience to navigate these challenges and others in your healthcare career. This program is open to current and aspiring healthcare professionals, and it’s easy to get started: Visit the main program page today, where you can download a brochure or begin the application process.