What’s Next in Health Care? Panelists Highlight Data, Partnerships Post-COVID-19

For stakeholders involved in the delivery of health care services to millions of Americans nationwide, policy, infrastructure, and investment strategies post-COVID-19 will build on the efforts already made toward public health issues spotlighted amid the pandemic.

Issues that grew in prominence during this time, such as social determinants of health, health equity, and mental health, were a few of the topics reviewed by panelists during the AHIP session called “Emerging Stronger: A Vision for What Comes Next in Health Care." Speakers noted these subjects are core to their organizations' vision and goals.

Efforts toward equitable health care access and quality have been made in the past to address these challenges, but Sarah London, CEO of Centene Corporation, noted that what the pandemic helped reinforce was the importance of engagement between provider partners and communities and the value of the patient as that “north star” to inform decision-making and health care transformation strategies.

“We were all forced to think differently, act differently, and operate differently. A lot of that sort of forced change, some of those really fast structural shifts are in line with where we think the industry should be going and being able to prove that out at scale in a statistically significant set of data in a really fast time is actually exciting in thinking of the strategic efforts to come,” said London.

As health care utilization dropped substantially amid the pandemic, London described the growth in creativity and aptitude among providers and health plans who acknowledged the need to align incentives, both financially and operationally, to drive better outcomes. Eric C. Hunter, president and CEO of CareOregon, added that these different levels of engagement between payers and providers were nonexistent prior to the pandemic.

The shift from an “us and them” approach to a more collaborative dynamic was referenced by Hunter in the rollout of the COVID-19 vaccine. To improve vaccine availability for all Americans, which were initially distributed primarily to hospitals and clinics, his organization worked to connect community-based federally qualified health centers and independent and safety net providers to these health systems to ensure entire communities were provided with equitable access.

“Those kinds of things were critical at a necessary phase, but beyond that, what we’ve noticed more than anything else is there’s a different sense of how we have to engage with the government…if the government is not going to step up and do what I believe they should do then somebody has to. So we said let’s find those areas that the board will agree to where we take our assets, our resources, our people, and invest in the community partnerships, with government entities thinking downstream a little bit,” said Hunter.

“We've shown leaders and politicians, this is what can be done. There's return on investment (ROI) here—it helps the department, helps the community, helps the individual, helps the payer, helps the system, and those are the guiding things I think we are looking for more of, because if we want to change anything, you have to change something.”

Discussing care innovations emerging out of the pandemic that have long-term implications for health care quality and cost improvement, London pinpointed data, value-based care, and convenience of care as 3 key buckets of note.

In the 1-year span from 2019 to 2020, telehealth visits grew markedly from 800,000 to 19 million. Necessity and strategies such as telehealth waivers were significant factors in this surge, and utilization has reverted to a projected 12 million visits for this year.

London said one of the interesting questions on telehealth is how much structural change it will have on the future of health care delivery, particularly as a care modality for the rising mental health crisis and as a primary care alternative in rural communities. Moreover, questions regarding its application across different care management programs warrants increased data collection and adequate infrastructure and investment to track these quality and cost metrics.

“We've started thinking about designing products where we are proactively covering telehealth so that you have that sort of ease of access and conversation…then the question is of well, how many telehealth visits should we do a week to create a stable monitoring kind of baseline?,” said London.

“I think the pandemic highlighted the degree to which we need more real-time data and connectivity, and the ability to aggregate that data and understand what's happening. At the fundamental transactional level, that whole infrastructure is still nascent in our industry. We now have data in pockets, and we start to have that connectivity—we have to figure out how to protect data as it is exchanged because we have to get to different levels of fluidity or we won’t make any decisions.”

Concluding on the importance of partnership and collaboration, Hunter highlighted how creating opportunities for communication between payers, providers, vendors, and even government can have a major impact in aligning strategies to address many of the pressing health issues facing individual communities.

“When we talk about data transfers, and trusting the data, those things melt the way when the people who have the most at stake, who control the organizations coming in, and say: look, it's not about my ego or my bottom line or my shareholders at the end of the day, It's about serving the population.”