A top CommonSpirit Health executive weighs in on likely trends for this year.
In 2023, there are four primary predictions for clinical care, a CommonSpirit Health executive says.
Ankita Sagar, MD, MPH, is system vice president for clinical standards and variation reduction at the Chicago-based health system. Prior to joining CommonSpirit in November 2021, she was an attending physician at Northwell Health, where she held two leadership positions: director of ambulatory quality for medicine service line and director of the COVID Ambulatory Resource Support program.
HealthLeaders recently talked with Sagar about her healthcare predictions for 2023. The following transcript of her comments has been edited for brevity and clarity.
1. Annual wellness visits
''One of the top predictions for 2023 is getting back to annual wellness visits and getting patients into the doctor's office again. We need to make sure that we are talking about routine vaccines, cancer screening, [and] managing chronic conditions such as heart disease, diabetes, and kidney disease because there has been a lot of prevention missed over the past few years due to the coronavirus pandemic. There are also patients who move from state to state, and they need to establish connections with new providers. It is important to get people in to prevent disease and keep chronic conditions from getting worse.''
2. Behavioral health
''Heightened efforts to address behavioral health concerns is another prediction for 2023. Statistics show that depression, anxiety, insomnia, and substance use dependence have worsened over the past few years. Part of the issue now is that we are having to manage people who have gone longer without care for behavioral health conditions, and we are trying to bring them back into the fold. We need to make sure we have made the right diagnosis and are doing the right treatment. We also need to focus on surveillance to make sure patients are doing well after treatment has started.
''There is a significant need to address behavioral health disorders—specifically depression, anxiety, and insomnia. First, we need to remove barriers from care such as having physicians and advanced practice practitioners provide care at the top of their license. Primary care physicians and advanced practice practitioners need to be able to manage mild to moderate illnesses, with coaching from behavioral health teams. That way, the behavioral health teams can manage the more severe conditions. We also need to improve insurance coverage of behavioral health conditions, which is currently a barrier to care. It is difficult for some people to access behavioral health care if their insurance does not pay for it.''
3. Health equity
''Healthcare providers are going to be doing more to address equity in 2023. We need to make sure we are addressing disparities that have been in the healthcare system for years. We need to come at equity in a more meaningful, patient-centered, and community-centered way.
''At CommonSpirit, we have had a long journey on equity. We have a mission-driven approach to make sure we are addressing the needs of vulnerable populations. We are making sure that equity is part and parcel of everything we do on a daily basis.
''For 2023, one of the main areas for equity concerns is going to be around preventive care. If no-cost preventive care under the Affordable Care Act ends, it is going to make it more challenging for us to ensure that our vulnerable populations and people of color are given the appropriate care, especially when it comes to cancer screenings, vaccines, and chronic disease prevention. So, conditions such as obesity, diabetes, high blood pressure, heart disease, and kidney disease are going to be key considerations for equity concerns.
''The concern is that if the Affordable Care Act requirement for no-cost preventive care goes away, there will not be a guaranteed way for health insurers to cover preventive health services for patients. There could be high cost-sharing, which will create more disparities for patients who are at the lower end of affordability for healthcare.''
4. Healthcare worker burnout
"In 2023, there will be a renewed emphasis on caring for our physicians, advanced practice practitioners, and other healthcare workers. We need the care providers to be well in order to take care of patients. CommonSpirit is working diligently on multiple fronts to ensure that the well-being of our physicians and advanced practice practitioners is top of mind. We recently signed on with the Dr. Lorna Breen Heroes' Foundation and the National Physician Suicide Awareness Day to be a supportive organization and bring to light that our physicians and advanced practice practitioners are cared for in a supportive manner.
''We want to make sure that our physicians and advanced practice practitioners have access to healthcare—whether it is physical, emotional, or mental health—and can cope with stress and moral injury in a comprehensive and supportive manner.
.''Prior to the pandemic, when healthcare leaders talked about burnout, we talked about physicians, advanced practice practitioners, and clinical teams including nurses being resilient. It was an individualized approach to burnout. What we have all learned nationally is that burnout is not an individual problem—you need systematic change, particularly in the culture. At CommonSpirit, we are involving the physicians and the advanced practice practitioners to help us make cultural change happen. You cannot wave a magic wand and make burnout disappear—it is a journey that requires continuous improvement over time.''
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Healthcare providers are expected to step up efforts to conduct annual wellness visits with their patients.
With behavioral health conditions spiking during the pandemic, healthcare providers are expected to treat more patients with emotional and mental health concerns.
This year is expected to feature amplified initiatives to address health equity.