Healthcare is in the midst of a dramatic shift, as new players surge into the business of health.
The latest step in this evolution came Friday, with reports that Walmart is in discussions to partner with—or perhaps even acquire—Humana, one of the nation’s largest insurers.
If these reports come to fruition, it would represent the latest in a series of new companies showing renewed interest in consumer health—a divergence in the way that the nation has treated health in years past. The move away from sick care to health preservation is built on six trends—and of those, a unifying theme is that the technological acumen and infrastructure is in place to support this shift.
Consumerism
It’s taken a while, but consumer-patients have taken more responsibility for their own care. For a generation now, an increasing number of people no longer rely solely on what they’re told by their medical providers. They’re researching medical conditions on the Internet and wanting to know more about their treatment options. Consumers also are demanding control over their medical information and seeking to add their own patient-reported data to it.
This involvement is no accident, nor by the thoughtfulness of patients. Anyone seeing a physician or admitted to a hospital sees how busy providers are, and much of the medical information and is automated. Machines have great memories but do not exercise executive life or death decisions.
This evolution came about when someone asked: "why can't medicine work like an airline or a bank" Everyone said, "yeah" great idea, then along came the gurus of information systems. Then they did it. No one asked are the cultures the same? Information technology came to medicine late in the game. Medicine is one of the last bastions of the pen and paper. Our cognitive processes of writing by hand and typing on a keyboard are very different. This may very well be the major factor in physician burnout. The conversion takes time and energy to discard a time-worn process into a new paradigm.
Patients are rightfully concerned about the accuracy of their records, even if the provider knows who they are. They correctly ask questions, do research before the visit and are careful to remind their caregivers who they are and what their conditions are. It is even worse for the nurses and paramedical assistants who screen the patient robotically recording their findings.
Business migration
New players are casting an eye at healthcare as both opportunity and business imperative. The recognition of the rise of consumerism is reflected in the companies now looking for a place to play within the health industry—Amazon, Apple, CVS, Walmart, and Walgreens, to name a few. These companies have deep experience and data systems necessary for dealing with the customer as a consumer. Similarly, traditional health insurers see their long-time business approaches changing. For decades, insurers have primarily served as care purchasers—the entities through which patients’ bills were filtered, often in a contentious duel with care providers. Increasingly, health insurers see their roles changing, because they are no longer the only entities taking on the actuarial risk of care. To a greater extent, consumers and providers are taking on those roles. Insurers increasingly want to see their roles morph, providing data and services that improve patient care and optimize consumer health. Hence, they are seeking partners that enable them to take on a broader role in health.
Price frustration
Initiatives intended to slow the rise of healthcare prices over the last three decades have ultimately failed to slow the rise in healthcare expenses. That’s why the U.S. spends more than $3 trillion dollars on healthcare annually, and why it’s no longer acceptable for solutions to aim to only slow the rate of growth. Healthcare currently consumes 18 percent of the gross domestic product, and the trendline is not good, especially as more Baby Boomers retire and are likely to see their medical needs—and costs—increase.
Why six trends are pointing to a revolution in healthcare | Health Data Management: The Walmart-Humana combination is the latest of a series of moves that point to an abrupt change in the industry.
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