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In 2021, Healthcare Leaders See Lingering Challenges and New Opportunities

Analysis  |  By Jack O'Brien  
   January 01, 2021

To start the new year, HealthLeaders reached out to four healthcare leaders for their thoughts on what the industry should be focused on.

After a year dominated by the coronavirus pandemic and its effects on healthcare, industry executives are looking for a rebound and new opportunities in 2021.

To start the new year, HealthLeaders reached out to four healthcare leaders for their thoughts on what the industry should be focused on.

Below are their insights on the year ahead and what dynamics could be at play in a post-pandemic landscape.

Dave Terry, CEO of Archway Health, a Boston-based payment solutions company:

"[Value-based care] might be a consistent theme that continues in 2021; focusing on where the quality and value is. There's so much variability in performance in healthcare; in quality outcomes, patient experience, and total cost of care whether you're looking at it on the population level or at the episodic level."

"I think the biggest change we're about to see is just how much information is becoming available on what variability looks, like where it is, where there are quality and value, and how to go find it. Historically, our industry hasn't been great from the provider network perspective or from the plan network perspective on helping the consumer find high quality, high-value providers, whether it's in primary care, especially care, chronic care." 

"I think we're about to have a big shift on that front and we're looking forward to that."

Paul Shorrosh, CEO of AccuReg, a revenue cycle management (RCM) company based in Mobile, Alabama:

"I think the main thing that [the pandemic] has done is to increase the level of fear and uncertainty for both providers and patients."

"The patients need to interact with providers and vice versa. But it's dangerous to be in unnecessary contact. So, there's fear and certainly not just for infection, but also for nonpayment. The two issues that [COVID] has brought to the top of the list are safety and payment."

"Safety and payment will always be important. [Patients] want their hospital to be clean, disinfected, and all that, but now it's like super important. And then payment is also a higher level of importance now, too, because there are so many people unemployed now and therefore uninsured. There are people with little to no savings because they're all barely making it. The general population of patients and potential consumers that might be approaching the healthcare system for services are in a difficult financial situation. So, there's fear about that. Can I afford to pay my bill? Will my insurance pay it?"

"The other fear is more about safety. Will I get sick by going to the hospital or going to the doctor's office because that's where all the sick people are?"

"The fear of safety and the fear of payment are the two big things that I think should be at the forefront of every revenue cycle management (RCM) leader's mind because of the fact that there are things they can do right as RCM leaders to mitigate that fear and uncertainty for both the patient and the hospital."

Doug Wolfe, founding partner of Wolfe | Pincavage, a Miami-based law firm:

"We're seeing [hospitals] are kind of in limbo, still in a bit of a holding pattern."

"There are some strategic plans that I know have been put on hold because clients don't know what next year is going to look like. How effective are the vaccines going to be? When are the vaccines going to be delivered? How quick is the demand for healthcare stuff going to pick back up? What's the long-term impact of telehealth, is the migration of healthcare services to telehealth going to be permanent? There are a lot of unanswered questions that our clients are grappling with."

"I think that there's a light at the end of the tunnel, but this year may have resulted in some lasting changes that the clients need to plan for more on a long-term basis. I don't think anybody knows that we're going to get past this month and it's going to be great. I think [hospitals] are still waiting and seeing, and I'm not quite sure what to expect."

Brian Colburn, senior vice president of corporate development & strategy at Alegeus Technologies LLC, a health technology company based in Waltham, Massachusetts:

"[We expect] the trend toward value to continue and accelerate. I think there are several different factors. One is that we've been on this trend for a while, and it's one of the few things that we saw from the Obama administration to the Trump administration continue and even go a little bit faster with the Trump administration. I think the Biden administration is going to continue to accelerate moving toward value for a couple of reasons."

"For one, the economy needs it. Budgets are under pressure everywhere, the federal budget, state budgets, and employer budgets. There will be pressure on healthcare costs, and we think that will continue to grow. Providers are kind of demanding it more now."

"Obviously, we saw a kick up in fee-for-service in because of COVID. If you're in the Oncology Care Model and had a capitated payment stream, that was obviously much more stable cash flow than if you were just pure fee-for-service."

"The other thing we're seeing is that more providers get more revenue from fee-for-service still [compared] to value-based care, but there has certainly been a much bigger uptick in the infrastructure and capabilities that providers have in value-based care. There are many programs that Medicare has put out there; there are over 50 different value-based care programs. [Providers] have had some success, they built some infrastructure and they're starting to see that they can perform within these programs. Knowing that, combined with the experience through COVID and the continued growth in the programs, we think we're going to continue to see these programs grow."

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.

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