The future of USA’s health care system is highly unsustainable. A look into the stats says it all. Come 2060, and the U.S. will be spending as much on health care for those over 65 as it is spending in all of health care today. GDP wise, the amount dedicated for healthcare will rise from 20 percent in 2020 to about 60 percent in 2060.
To sustain such a fragile system, the health care system needs large scale changes. It is the need for this urgent requirement which will trigger the single greatest set of opportunities for innovative and game changing solutions. These opportunities do not lie as much in the medical side of health care, such as diagnostics, therapies, etc. Instead, the opportunities lie in the reengineering of the most untenable aspect of the health care system – administration. These solutions will also change the process of healthcare delivery from stem to stern. This blog delves into the imminent changes that are waiting sweep the healthcare sector in the next 10 years:
Dependence on Healthcare Service Providers
According to a recent survey, in the next five to 10 years, every health care provider will make an exit from the business of healthcare administration making way for the growth of a $500 billion industry by 2030.
This is because of the increasing complexity of healthcare processes. The complexities will become unmanageable because much of the administrative burden will fall on clinicians. The same survey found out that a primary care doctor in the U.S. spends half of their time with administrative activities related to billing and patient management.
It has been proven over the years, a primary care physician in the US can bring down a patient’s annual health care expenses by 30 percent. This means, if every American had had a primary care physician, the savings figure would add up to an average $70 billion every year. Since that the country has failed to add more physicians to the total count it had in the 70s, hospitals and clinics need to find improved ways for physicians to spend more time with the patient.
To ensure this, hospitals and clinicians should keep doctors away from the business of healthcare administration. Instead, it should be delegated to centers specializing in managing administrative functions. These centers are health care services providers including healthcare BPOs. These service providers are private establishments with immense knowledge of critical aspects such as scheduling, billing, medical coding and claims processing. They have gained this knowledge by serving hundreds of health care providers and insurers in the US. Some of these providers have offshore presence and get the work done from other countries. In turn they also pass on the cost and time advantage to providers.
| Did You Know The healthcare BPO market is expected to grow at a compounded rate of 9.6% per annum i.e. from USD 296.4 billion to USD 468.5 billion by 2026. |
Reliance on Third-Party for Data Management
By 2030, the majority of data that contributes to the US health care system will be stored and managed by healthcare service providers. This is because data will grow in such epic proportions that managing them will be way beyond the capacity of healthcare providers.
On an average, patients over 65 years of age have interacted with nearly 30 different physicians in their lifetime. For each of these doctors and patients a separate set of data is generated that has to be managed till the patient’s lifetime. Furthermore, the data is disconnected in nature and need to maintained in silos. No single person, including the doctor and patient, has instant access, to the records.
Added to this is the problem of ageing population and rising emergency visits. Given that half of all health care visits are emergency visits and that aging population require to visit diverse specialists, clinicians need to make decisions without the right context about the patient. This can be risky and loaded with implications. Certainly, an on-premise or government-owned health record cannot be a feasible solution. Instead, what will work is a patient-owned health record that is as accessible and as secure, permanent and flexible as a bank account.
This trend will push patient record creation, storage and upgradation outside the ambit of the health care provider. The expertise of private service providers will be required to take care of these needs. Within the next 10 years, third- party apps and devices will manage individual patient data. Patients will be able to access this information on their iPhone. The easy access to prevailing conditions, medications, and biometrics, such as, blood pressure, heart rate and sleep patterns, will make it easier to treat patients in the right context.
| Did You Know The five most important requirement for data management in healthcare are: 1. Data Governance 2. Data Integration 3. Data Enrichment 4. Data Storage 5. Data Analysis |
Automation of Treatment Interface
In the next 15 years, bots will play a big role in assisting healthcare providers to deliver improved services to patients. The application of bots will transcend its present data usage of answering common health related queries to meet the more important need of treatment precision. Bots will be used to track, analyze, and deliver real-time patient information to providers. Besides bots will be used in the industry to perform critical tasks like symptom checking, checking coverages and even repetitive tasks such as marketing sending emails, lead generation, result analysis, etc. The established advantages like 24×7 availability and enhanced patient experience will make it indispensable for the industry.
This is likely to take place in the next few years, when the country’s universal health care record gets integrated with advanced wearables and sensors. In the process, it will create a new industry consisting of enterprise specializing in developing customized AI-driven bot solutions, designing and finetuning a bot strategy and bot security. In such a scenario, health care service providers will also have a big role to play. Providers will bank on them entirely to manage all patient data and records.
| Did You Know Venture capital has invested more than $800 million in at least 14 promising startups to develop chatbots to support healthcare support features. |
Virtualization of Hospitals
The healthcare industry is hurtling towards its next big development i.e., hospital in the Cloud. It will help deliver personalized services that patients can avail irrespective of their location. This will reduce the number of in-office visits and will also help in patient acquisition and retention. It is one big development which will bring virtual health and robotic surgery withing the realm of possibility. It combines personal health and public health to deliver world-class health care services as easy in a remote part of the US as in New Jersey.
If we go by the merger and acquisition stats in the US, then the concept of a freestanding hospital is all set to go in the next few years. As per the stats, every year, over 10 smaller hospitals merge with one larger hospital. In the same way, almost 30 hospitals or clinics or private practices shut their doors every year.
A health care system in which the basic building blocks of hospitals are virtualized and made available in the cloud will revolutionize the way care is delivered. Therefore, all that which leads to friction and roadblocks, in the running of a hospital will get eliminated, thereby creating a wholesome and cohesive delivery environment.
| Did You Know After the pandemic, about 65% of U.S. hospitals connect practitioners with patients remotely. |
Conclusion
While the above-mentioned changes were waiting to happen, Covid-19 has accelerated the move towards the change. The pandemic has exposed how fragile the healthcare system can become under severe stress and the need to extend external support to put in on a sustainable trajectory.
Who We Are and What Makes US an Experts?
This article is brought to you by Medbilling Experts, a leading healthcare BPO service provider in the US. We have over 10 years of experience in supporting a range of back-office needs for hospitals and clinics based in the US. Among all the services we provide, Revenue Cycle Management is our forte. Driven by a team of experts we specialize in aspects like billing, coding, claims submission, claims denial management, and accounts receivable management. If you are looking for back-office support services get in touch with us now.
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