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Today in health it 13 trends shaping the health economy. We're going to go further into the economics of health care. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health set of channels, dedicated to keeping health it staff current. And engaged. We want to thank our show sponsors who are investing in developing the next generation of health leaders.
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All right. I'm coming back to the economics of healthcare. The, , trillion health puts out studies. I think to deep analytics on all the data, they pulled together, claims data and as well as, , other data across our, , economic data across our system. And they marry all that together and they come back with a ton of information. Let me see how many.
This, , entire documents, 141 slides. Okay. So it's in depth. It breaks it down and a lot of different ways by. , demographic by a surge. Bye. Type of procedure by a psychographic profiles. , you name it, it breaks down these, these stats in a lot of different ways. , I'm just going to share with you some of the conclusions it's actually in the beginning, it sort of sets it up.
They break this thing into 13 sections. And the 13 sections are identifying 13 trends that they see in the industry. And they labeled us the 2022 secular trends shaping the health economy. And each one of these is going to be broken down in a little bit more. I will put a link of this, , to this, , episode or to this document.
And the show notes, you can go ahead and click on it and take a look at it. It's really worth. Looking at because it questions some of the. Let's just say a current thinking in healthcare and healthcare leadership and this, these are things that have significant impact. So trend number one. The total available market.
Of commercially insured patients is shrinking more and more people are going to Medicare. Our population is getting older and the commercially insured patients is shrinking. Why is that important? Because that is the highest margin for any health system. That is the first trend that's going on. And again, if you go into this thing, you'll see nine slides that break this down.
Into detail. Trend number two. Care forgone during the pandemic is permanently lost. And the observed rebound is illusory. One of the things we were thinking is as we're going through the pandemic and people were staying out of the hospitals, they were afraid of infection. They, they were eventually going to come back.
Either their problems were going to be exacerbated or they were going to just come back when it was safe to come back into the hospital, they were going to come back. And they're not as what we're seeing, we're looking at the numbers and it's fairly flat and we're looking at 2019 numbers. , comparatively speaking to 2023.
So, , all that, that big bubble that we lost during the pandemic, there is not going to be a bubble post pandemic. , people coming into the hospital, that's essentially what that trends about. Trend number three, higher patient acuity is likely to materialize eventually. So the thought was people will stop going in for tests. They stopped doing their screenings and those kinds of things. And eventually we're going to see that.
Turn out in higher acuity patients showing up in the hospitals that hasn't happened yet. There's still a strong belief that that is going to happen. Trend number four, projected growth in demand for healthcare services is tepid. In other words, the demand in general, across the board is still not coming back.
And I will talk a little bit about where it's going, even the demand that is there, where it's going, because it's changing. Trend number five, how individuals access the healthcare system varies and it varies. Based on psychographic profiles, much more than demographic. Profiles. And if you're not familiar with psychographic profiles, it's worth taking a look at.
Because second graphic profiles are, are fascinating. So this is when they put people. Into groups such as. Again, demographics is, is age population where they live. Have they gone to, , colleges or universities, those kinds of things. But the reality is that we are made up of a lot of other things. Like, are we a researcher? Are we looking for the best value? Do we value premium brands? Are we always looking for first in class? Are we sort of the life of the party? Are we not the life of the party and then breaks down into sub groups within that?
Of. They create these categories, willful endure. They live in the here and now, and believe there's more important things to focus on than improving their health. Not necessarily unhealthy, but do what they like when they like, and typically do not change their habits. They're self-reliant. Then they have the direction taker. Believe their physician is the most credible resource and ask more details. The priority juggler, very busy with many responsibilities and may not take time to invest in their own wellbeing.
You have the balance seeker generally proactive in their health and wellness. And then to self achieve, Cheever's the most proactive when it comes to their wellness, they invest what is necessary towards their health and their appearance. All right. So. Essentially, what they're saying is. Based on those profiles will determine how they access healthcare, how they, , identify where to go and what type of care they will do.
, I'm going to keep going. Trend number six, individuals are increasingly making healthcare decisions like consumers. So we thought the consumerization of healthcare was going to happen and that people were going to start making those decisions. They are making those decisions because they have more choices.
There are now a whole bunch of competitors and we'll get to that. And one of the later trends, there's a whole bunch of competitors that we can now go to. As we begin on our health journey, we might not look to the local health care provider or even our primary care physician. We might look at other options that are out there in the market.
, trend number seven, increasingly unaffordable increasing unaffordability is suppressing healthcare demand. People are staying away from the hospital because they're afraid of surprise bills. They're afraid of big bills. They're afraid of medical debt. They've heard the stories, the stories are getting out there. They are starting to be a marketing force that is impacting how people make decisions around healthcare.
So unaffordability is a problem that is suppressing healthcare demand. If I were doing marketing for a health system, I would stress affordability of care. I would stress. , I don't know. , transparency in bills would be one thing. But even fixed price bills would be even better. This service, this fee period, no surprise bills, no bills for the next six weeks. That kind of stuff.
Trend number eight. Migration of care delivery to lower acuity. Ambulatory settings is accelerating. And we talk about that a lot on the show that we're just seeing more and more go to these. , low acuity, low acuity ambulatory settings. , some of which our retail partners, , the CVS is the, , wall Walgreens Walmarts of the world that are out there.
Trend number nine, low acuity health care services are increasingly being commoditized. Okay. So if you look at the pricing of some of these things, if you look at some of the things you can get done at Walmart, they are a fraction of what they cost at CVS, which is a. Percentage of what they are at the local hospital or health system.
So those services are being commoditized. They're being packaged and people can get them at their local Walmart trend. Number 10, the impacts of commoditization are predictable. Meaning. , it's driving changes in behavior and how people select. And choose where they're going to go. Go for healthcare trend. Number 11, provider burnout is exacerbating the longstanding physician supply shortage.
So we're losing people at a faster rate than they're coming into the industry. That's creating a problem as well. For the economics of health care number as well as clearly the humanity of healthcare trend number 12. Only in healthcare can a monopoly lose money and regulators went to prevent more of them.
All right. So yes, there's an awful lot of things that go into the, , , economy of healthcare. And quite frankly, a lot of health systems are losing money. Again, this reports late 20, 22. And then trend 13 more providers are competing for fewer patients. So, and the conclusion is every stakeholder will be impacted.
By a reduced yield moving forward. You know, why don't we talk about the economics of healthcare in a, this week health. Show that is really about the intersection of technology and healthcare. It's because we believe that technology offers solutions to these challenges. If we are identifying the right challenges as leaders within the health system, if we are having the right conversations, technology has ways for the healthcare provider to act as the trusted resource for health in the community.
I'm starting a health journey myself. If I had quick access to my primary care physician at my local healthcare provider, I may have started there. But if they don't think about me, they think about. Me as somebody that's eventually going to use higher and higher acuity services, which is where their margin is made. And therefore they, they have no outreach.
To me as the 55 year old, fairly healthy individual. And technology has a way to increase the number of touch points. We have with our patients, even when they're healthy, especially when they're healthy. Marketing, isn't done to people on the exact moment that they need, that service marketing is done to people over time to convince them to change their habits when they start the shopping journey.
Right. And I'm not going to change my habits because the local health systems haven't changed their habits. And so when I step back and think, what am I going to do for, , for weight loss and health and that perspective? Well, I don't look at my local health care provider. And when I look at things like, what am I going to do for, , maintaining my muscle mass and those kind of things.
I don't think about my healthcare provider when I think about. It just, it just goes on and on anything related, , you know, nutrition. I don't go to my local healthcare provider. I found a nutritionist that is a, essentially a trained, licensed nutritionist, but operates their own facility and, , and does their own thing. So there's a whole bunch of things that are happening, where people are finding alternatives to going to.
The trusted source of information for health, which is the local health system, but the health system is not providing the services. I believe technology has. There's a lot of different ways that technology can play a role. I believe understanding psychographics is important. Because as we design our applications, as we design our interfaces into our system,
As we design. Our, , intake forms and those kinds of things, we should understand psychographics. It will impact how people fill out those forms that will impact. If people choose to engage with us in a digital way, it will, it will impact. How they, , How we should think about putting our services together to make them.
, appeal to different groups. And it's really going to depend on what your group looks like by the way. There's a ton of information in here in terms of the migration of people. Around our country and where they're migrating from and to, and what that means for healthcare as well. So just a lot of great information. I believe technology offers solutions to a lot of these things.
I talked a couple of weeks about. , back about identifying the right problem and solving that problem. I think it's important for health systems. To be having the right conversations with the right data in hand. You know, it's understanding that care for gone for gone during the pandemic is permanently lost. It's not coming back. If we were waiting for that to come back in order to determine what our new run rates are going to be, we should not be waiting for that to come back. In fact, we should be looking at adjusting our business models.
To the trends that are happening in the industry right now. Okay. That's probably enough. And I promise not to talk about economics for another month. If, , we will talk only technology for the next couple of months and technology topics, but I think it's important to understand the economics of things that are going on.
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