Today on Insights. We go back to a conversation Host Bill Russell had with Mike McSherry the CEO at Xealth. The topic of discussion was What Will the Consumer Experience in Healthcare Look Like in 2025? And Bill and Mike discuss what digital health means for patient education, decision making and the quality of the care experience.
Hello and welcome to another episode of Insights. My name is Bill Russell. I'm a former CIO for a 16 hospital system ???? and creator of This Weekin Health IT. A channel dedicated to keeping health IT staff current and engaged. Our hope is that these episodes serve as a resource for the advancement of your career and the continued success of your team. Now onto the ???? show.ce in healthcare look like in:experience will look like in:
There's certainly going to be more proactive care delivered regardless. The payers own the insurance, they own the risk mitigation, which is proactively engaging with patients before they start reaching a level where they have to go to ed visits or I don't know, injured things that could have been dealt with on a PT, OT, results in surgery because of lack of intervention, et cetera.
And I think with the rise of RPM, be it, your Fitbits, your Apple watches, your in-home sensors along with the rise of RPM kits that manage CHF for, recovery or more higher acuity levels. And all of the monitoring against that is going to lead to signals that provide more proactive intervention.
And the payers have been capitated. The insurance most employers are capitated against their members. They want to pay for all this hospital systems because they lost such large chunks of procedural revenue this year. Are now trying to aggressively move into the capitation risk management. And so they themselves are going to have to get into this more proactive.
It's going to take longer for them to adjust their business model, I'd say but I think that is an absolute and some people might see that as an intrusion of their privacy and over my dead body, nothing's tracking me, et cetera. But I think there's going to be financial and business models and incentives that for the majority of Americans, they're going to say yup, you can monitor, you can reach out to me. You can try to intervene with my care because it's cost effective and worthwhile to me against these high deductible plans or kind of other out-of-pocket expense and considerations. So I think that's probably where things are going and don't discount Amazon's rise. I mean, I think even just this week they announced, or there's rumors that they're now licensed to operate their Amazon Cares, their virtual primary care and their nurse care delivery in home in all 50 States. And I'm fairly convinced that Amazon's going to eventually get into the insurance game.
And provide all those economic incentives and proactive measurements and device accompaniments. And they're going to have a financial business model that most people like we've done with most of our consumer lives, I'm willing to give up a degree of my privacy, be it Facebook or Google or whatever other big tech, kind of mechanism we use for free because of the convenience and cost savings that benefits me. And I think Amazon's going to crack that nut pretty wide-scale here over the coming years. What's your take?
That's interesting. I wrote an article a little over three and a half, four years ago that said the next move for Amazon is to essentially what they built out, which is Amazon Care for employers.
And then again, into the insurance game. So I agree with you a thousand percent on that. The announcement I read last week is that they have licenses in 19 additional States. And they are going to expand. I think they are a significant player. And when people ask me, you know, what does it really look like for Amazon to be in care?
And I said, well, think about it from vaccine distribution standpoint. If they'd given a hundred percent of the vaccine to Amazon, how efficient do you think that would have been? I mean, my guess is they would have had people come to your door and vaccinate your entire family and they would have just knocked it off by zip code.
It would have been a completely different experience because they have a ton of information. They have the logistics capability. They could have handled the deep freeze for Pfizer, the moderate freeze for Moderna and the distribution of J and J.. And I think between now and:
It's funny, cause I say CVS and Optum and people are like, Oh, they're two totally different companies, whether or not. They're both two the largest payers in the country who have significant presence in terms of primary care and direct and care. And that's where they want to get to a digital care platform and whatnot.
To go one step further on that, I'm in Seattle. Providence is headquartered in Seattle and in this market Optum bought several large clinics. So they're vertically stocked up. You've got Kaiser here and now you have Amazon telling all a hundred thousand of their employees independence in this region to start with their primary care experience.
So any gain of any of those three new entrants towards market share utilization or verticalization becomes a net loss for Providence. And to the blues here. So they're going to have to become bedfellows to more effectively compete against the verticalization of those services. So I think you're going to start to see a number of different partnerships and entities and payvider kind of collaborations, cause it's all going to be about scale and these individual hospitals systems with their geographic monopolies or strong physicians don't. That's great for surgery and the a hundred mile radius of, high acuity care treatment but things that can be done in lower cost settings or virtually they're going to have a hard time stacking up a digital platform that meets the patient expectations against more convenience options. And at the end of the day, convenience always wins.
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