As healthcare change accelerates, two constants remain: Data & dollars

Feb. 2, 2018 / By Clark Cameron

For most of the past century, health care has been a somewhat straightforward proposition. People get sick or injured, visit a doctor or hospital, receive treatment and settle up via their health insurance, direct payment, debt or some combination of the three. The players in this system have remained quite predictable as well – patients (all of us), providers (physicians and facilities) and third-party financers (payers). However, as with much of life, things are always the same…..until they’re not.

Nearly a decade ago, the Affordable Care Act introduced 2,000+ pages of change to the U.S. healthcare system, but that was peanuts compared to the flurry of private sector activity that’s taken place in the last 60 days alone.

Since December 1:

• One of the nation’s largest health insurers (Aetna) merged with one of the nation’s largest retail pharmacies and PBMs (CVS).
• The nation’s largest health services company (Optum) owned by the nation’s 6 largest corporation (UnitedHealth Group) spent $5 billion to acquire the nation’s largest dialysis provider (DaVita).
• Four of the nation’s largest non-profit health systems (Dignity-Catholic Health and Advocate-Aurora) consolidated into to mega health systems.
• The nation’s largest retailer (Amazon) joined forces with the nation’s largest conglomerate (Berkshire Hathaway) and the nation’s largest bank (JP Morgan) to reduce rising healthcare costs.

That’s a lot of change for a year, much less 1,500 hours!

See a theme emerging? Things are no longer predictable in health care. Providers are becoming payers, and payers are becoming providers. Titans of non-adjacent industries aren’t timidly dipping their toes into healthcare waters, but instead are cannon-balling into the deep end of the pool with cutting-edge technology, bottomless pockets and supreme confidence. It’s only a matter of time before your next doctor’s visit will take place from your sofa during the commercial of your favorite sitcom or your next outpatient procedure will be conducted at Whole Foods, while a personal shopper collects your groceries after which an autonomous Lyft vehicle whisks you home.  Health plans that have largely ruled the healthcare universe since WWII may become less influential or even obsolete as providers and employers package and market their services directly to consumers. We are awash in healthcare disruption, and the pace is accelerating.

That said, there are two constants which will stand firm as the winds of change howl – data and dollars. Despite who ultimately delivers care to patients, data will always be needed to diagnose, treat, measure and improve. Likewise, providers of service, whomever they may be, must be paid. A century ago, healthcare payment often consisted of a dozen eggs and a bushel of peas. Within a decade healthcare payment may consist of virtual currencies like Bitcoin or Ethereum. Regardless of the specifics, information will continue to drive clinical decisions and payment will continue to change hands. The healthcare industry participants who fix their focus on the “unmovables” of data and dollars will both survive and thrive the seismic changes to come.  

Clark Cameron is manager of payer market strategy and development for 3M Health Information Systems.

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