Open Mic – Hosts Predictions for 2024
Throughout 2023 our radio and podcast hosts brought us discussions about the latest insights, breakthroughs, and trends shaping the healthcare landscape. As we embark on another year of changes and advancements, we asked them to forecast what the healthcare industry might look like in 2024. Here is what they had to say.
Interoperability: It appears all the pipes and fittings are almost in place for the launch of the much-anticipated Trusted Exchange Framework and Common Agreement network (TEFCA). Years spent in the planning and development phases have brought us to the point where 2024 will be the year the spigot is turned on and we get to see what comes out of the hose.
Certification: No rest for the weary for healthcare technology developers. New requirements are expected including upgrading to the USCDI data requirements and the anticipated updates to the functionality of Clinical Decision Support to name just a few. There was a time when EHR developers had two or three years to bring new requirements into production. Those days are gone.
AI: It has been just over a year since ChatGPT erupted and brought widespread public attention to the promise of AI. With the initial mania finally subsiding we can expect to see foundational shifts as true beneficial use cases can be separated from the hype. We know there is monumental power in AI and I’m hoping some of that energy will be used to address the nagging issue of affordable and accessible healthcare.
Digital health did not die with the demise of Pear Therapeutics, Babylon Health and Olive AI. It will morph into something more practical. The long-anticipated shift from enthusiastic, opportunistic investment to savvy dollars entering the sector is underway. The health provider system will seek to digitize everything that doesn’t require human touch in the next two years – from patient health records to scraping patient information files to capture reimbursement codes, perfecting Chatbot for consumer engagement, and ChatGPT summarizing patient visitation history for medical staff. Like highway electronic toll collection systems, health systems will lead the way if technology can accelerate and eliminate costs.
Edison failed 2774 times and then reached a working design of an electric light bulb. A new generation of digital therapeutic C-Suite leaders recognize their companies compete with or complement NDA-approved drugs. To succeed for patients, providers, and payers – and their investors – they will think and act less like flashy tech companies and more along the lines of biopharma researchers pursuing comparative trials with far more participants. Adding digital therapeutics alongside tablets and capsules supports value-based care models and enables physicians and patients to reach successful clinical outcomes.
Hospital systems are among the nation’s biggest polluters. A sector dedicated to saving lives will lead the effort to sustain and save the planet. Health facilities account for 4.8% of the total area of commercial buildings and use 10.3% of total energy consumption, making hospitals the second largest energy-intensive consumer of US commercial buildings. EMRs and telemedicine can (and will) reduce paperwork and in-person patient visits, and the carbon reduction can equal 19,200 acres of forest saved. Digital health information technologies will be time and cost savers in the carbon-zero movement where health systems can lead.
The rush to implement generative AI in healthcare will hit a pothole as it runs up against government regulations, user skepticism, and poorly trained systems. It still holds great promise as a tool to assist well-trained clinicians. Without proper training and testing, these systems can injure patients and produce the moral and legal consequences that follow.
Here are my personal prognostications, predictions and hopes … perhaps not sufficiently tempered by reality. Maybe 2024 will be the year of health data platforms seamlessly serving patients, carepartners and clinicians with integrated, timely, relevant, actionable insights. Maybe this will be the year of federal legislation and regulation addressing data privacy in the digital health space in a manner consistent with HIPAA and rationalizing differences across state lines. Perhaps we will see federal legislation addressing artifical intelligence in a manner consistent with global approaches so as to promote easy acceptance of technologies across geographies. Maybe we will see real steps towards development of health data exchange through QHINs (or the next set of acronyms to be let loose from DC), and all the cool and useful things that can be built with data liquidity in our collective back pocket. It is possible that regulatory flexibility in pathways for approval of medical technologies will continue to be promoted. If all of these things come to pass in 2024, then we may experience a sea change in efficacy and efficiency of health care services, and in patient and provider satisfaction. There is so much promise, and we have seen so many improvements to date. Even though we are often disappointed at the pace of change (some of us have been singing the same song for decades now), we’re still here. Looking forward to continuing the conversation!
The hype cycle in digital health is coming to an end and single point solutions will be shunned as well as the healthcare system looks for clear outcomes and interconnected solutions. It will be up to the vendors to sponsor true clinical studies and not the ones they pay big consulting firms or do internally. Even AI/ML will be going through RCTs.
On the other hand, once products or services are approved and have gone through initial RCTs and the FDA, payers will begin to use Real World Evidence to inform their continued use of and the price they are willing to pay for digital services as well as pharmaceuticals. The development of standardized RWE data and study design will be a key focus on 2024.
The continued push to Value Based Care will be a bumpy road as the legacy FFS approach is just too rich for most in the healthcare system to change. And while we continue to discuss Value Based CARE and Accountable CARE Organizations, our choice of words is hindering our movement to true system reform focused on health. It’s to rename these approaches Value Based Health and Accountable Health Organizations, to demonstrate that those in the healthcare system recognize and clearly state the need to broaden their focus, integrate their services with community, individuals, non-profits, schools and others and work collaboratively to move upstream to health promotion, health improvement and the reduction of preventable diseases and conditions.
Prior Authorization and Denials: While the health plans continue to inappropriately impose bureaucratic prior authorization policies that conflict with evidence-based clinical practices, waste vital resources, jeopardize quality care and harm patients the backlash is gaining steam, especially in Medicare Advantage programs misbehavior is seen as profit motives deliberate delay while patients decline. Meanwhile, in the background, a nuclear arms race of AI technologies will grow as companies use the technology to fight the denials and the health plans use the same technology to introduce new and unique hurdles
Healthcare IT Today: 2024 Healthcare IT Predictions
Hosts John Lynn and Colin Hung discuss 2024 Healthcare IT Predictions.
Coming of Age: CCM & RPM Hit Their Stride in 2024
Many of us have worked across our communities, states and even Capitol Hill to create and optimize chronic care management (CCM) and remote patient monitoring (RPM) programs over the past decade. I predict that 2024 will be the year that realizes the fastest growth of care providers implementing these value-based care programs as well as the most patients managed by CCM & RPM overall.
Tangible Results: The Proof is in the Pudding
In a recent survey by our friends at Sage Growth Partners, 94% of respondents said that RPM programs have improved patient outcomes, while 73% said they have yielded a positive return-on-investment (ROI).
Not only that, but survey respondents also indicated a positive ROI associated with CCM programs. Around 78% said that chronic care management ROI comes from additional revenue, with respondents saying they have experienced an approximate 29 percent reimbursement increase after the program was implemented.
My personal experiences over the past several years have led to similar results as 100% of the care providers that I have worked with have experienced reductions of unnecessary hospital readmissions, improved patient outcomes, a positive ROI, and significant Medicare reimbursement increases.
Encouragingly, because of this overwhelming success, CMS is investing in more CCM & RPM programs than ever before, and research shows that almost half of healthcare executives are either examining or implementing these programs today.
Safety Net Success: A Positive Shift for FQHCs/RHCs
Also starting in 2024, a pivotal change is set to empower FQHCs and RHCs—allowing the billing of multiple instances of the general care management code G0511. This transformative move by CMS enables FQHCs/RHCs to bill for Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) services per patient, transcending the limitations of a one-time G0511 service per month.
Unleashing the FQHC/RHC Potential: How It Works
Under the new regulations, providers can bill for CCM time, RPM time, RPM device usage and other care management codes per patient, provided that patients meet the requisite criteria such as consent, two chronic diagnoses, utilizing an RPM device for 16 days, and accumulating 40 minutes or more of CCM/RPM care management time, leading to billing for multiple G0511 instances.
With all this success and momentum, I wholeheartedly predict that 2024 will be the year that chronic care management and remote patient monitoring programs become center-stage with a majority of care providers that treat applicable patients, and we will experience the “tipping point” for these programs in our nation’s healthcare system!