Top 5 Most Read Innovation Stories of 2024

HealthLeaders’ most-read stories of the past year highlighted an interest in virtual care and care management, especially when connected to CMS coverage

The growing market for virtual care dominated HealthLeaders’ most-read innovation stories of 2024.

Coming out of the COVID-19 pandemic, healthcare providers were fighting for the attention of empowered patients/consumers and facing competition from employers looking to control health plan costs and disruptors eyeing the convenient care market. The resulting battle for primary care saw a proliferation of virtual care platforms, giving patients access to primary care at the time and place of their choosing.

2024 saw an expansion of that strategy, with virtual care platforms for specialist consults, chronic care management, remote patient monitoring and other services.

The top story for the past year focused on one of the biggest disruptors in that market, Amazon, which launched Health Condition Programs in January. The online platform matches consumers to relevant health and wellness companies based on their browsing and shopping habits, enabling consumers to create managed care plans based on their health concerns and health plan coverage.

“Amazon wants to make it easier for people to get and stay healthy, and part of that is making it easier to discover the products, services, and professionals that can help them do that,” Aaron Martin, Amazon’s vice president, said in a press release issued by Omada Health, a digital health company that is partnering with Amazon to offer diabetes prevention and care  and hypertension care services through the new platform. “Many aren’t aware of the healthcare benefits they are eligible for, that are typically no cost or subsidized by their employer or insurance plan. When customers are shopping for health-related products on Amazon, we can surface these benefits to provide even more support in improving their health, at no additional cost.”

Healthcare providers are bullish on care management as well, and they want to use virtual care and digital health to create those services for their patients. The traditional sticking point has been reimbursement: providers won’t fully embrace new technology unless they’re paid to use it.

The second-most popular story this year was the Centers for Medicare & Medicaid Services’ (CMS) new program to support providers using virtual care and digital health to create value-based care programs. The Advanced Primary Care Management (APCM) model, with HCPCS codes included in the 2025 Physician Fee Schedule, incentivizes clinicians to use technology to create care management pathways around their patients, a key strategy on the journey to value-based care.

“While these new codes come with a number of administrative requirements, the APCM codes provide additional opportunities for practitioners to collect reimbursement for care management services, some of which they may already performing,” Alexandra Shalom, senior counsel with the Foley & Lardner law firm, said in a November blog. “HHS has long noted that effective primary care services and relationships are critical to improve health equity and access to care and as early as 2014, CMS recognized care management as a key component of primary care. As such, CMS’s goal in offering these codes is that it will allow practices to enhance or expand their care management services, which in turn will improve population-level mortality and reduce disparities.”

The third most-read story veered off in a different direction, though still focusing on the idea that providers are using virtual care and digital health to beef up their patient engagement efforts. A panel session at the HIMSS24 conference and exhibition this past March centered on how smaller health systems and hospitals, struggling to make ends meet and faced with competition, are changing their business model to focus on care management and preventive care, rather than ‘sick care.’

“A great deal of our future is in the outpatient side,” Tressa Springman, SVP and chief information and digital officer at LifeBridge Health, a five-hospital system based in Maryland, said during a panel session.

She noted that more than 50% of the health system’s quality-based reimbursement score for the state is focused on the patient experience, making that more important than actual clinical care. So they’re now setting their sights on access, convenience, and outpatient interactions.

“We’re really focusing on the community,” she said.

The fourth most-read story focused on CMS’ draft 2025 Physician Fee Schedule, which was released in July. That draft unveiled the APCM model (the subject of the second most-read story) as well as other improvements in coverage for telehealth and digital health.

The draft and final PFS also gave advocates of digital therapeutics some good news: New HCPCS codes that will enable providers to seek reimbursement for some behavioral health treatments that use FDA-approved devices.

On the other hand, CMS did include some small improvements in telehealth coverage, but also said it wouldn’t extend most pandemic-era waivers to telehealth coverage and access. The news stunned telehealth advocates and led to coordinated lobbying efforts to have Congress extend those waivers. That lobbying will continue into 2025, as Congress only extended those waivers for three months in its year-end, stopgap funding bill.

The fifth most-read story of 2024 centers on perhaps the biggest lesson learned this year in healthcare innovation: Disrupting the status quo to achieve true transformation is hard. This past May Dollar General, the nation’s largest retailer by number of stores, announced that it was ending a two-year partnership with digital health provider DocGo.

The news wasn’t exactly, well, new. Walmart, Walgreens and CVS Health had all recently rolled back their primary and virtual care ambitions, highlighting the challenges that the retail and pharmacy chains were having in cracking the healthcare market. The lesson to be learned, perhaps, is that healthcare isn’t an easy nut to crack, and while new ideas from outside the industry may look great on paper, they aren’t scalable or sustainable.