Prior to March 1, we had been talking so much about healthcare “disruption” during the past five years, I felt like the term had just about lost all meaning. In fact, I had relegated it to buzzword status. Almost all conversations about healthcare disruption focused on new entrants into the industry transforming parts of the traditional service model and taking market share. Politically, most of the conversation centered around whether we would dismantle the ACA, build it back up or move to Medicare for All.
Despite all the noise about disruptors, politics and consumerism, I felt like incremental change was the most likely scenario. Although the industry had been changing – digital experiences and telehealth for instance – a revolutionary, wholesale change to our industry seemed far off to me. The odds of the system being truly disrupted – something like Medicare for All happening within the next decade – felt highly unlikely.
And where are we know? It truly feels like there are forces brewing that could result in radical transformation and a complete, ground up rethinking of our entire system. As the COVID-19 crisis has unfolded, it has raised many serious questions that we’ll need to grapple with over the next 12 to 18 months. Where we land on these issues will have a profound effect on what healthcare in this country becomes for the rest of our lives.
Here is what I’m wondering about most:
How many uninsured people does this situation create?
Will those people be able to get their benefits back in a timely fashion?
Will a combination of more uninsured people and more people needing to be treated for COVID-19 drive major rate increases to cover costs?
What happens to 2021-22 insurance premiums in the individual and commercial markets?
How many hospitals and health systems will require financial bailouts?
In the interest of public health, will the government realize that it needs to support rural hospitals (maybe all hospitals) to allow them to operate at negative margins?
If many hospitals can’t survive independently and the government does not support them, will we see massive consolidation resulting in three to five mega healthcare systems serving the entire country?
How strongly will COVID-19 accelerate the burnout and retention challenges already being faced in the healthcare industry? Will it be a point of no return?
I think the first four questions have the opportunity to really drive major change. A combination of fewer people having insurance combined with economic uncertainty and an unprecedented health crisis seem like the exact ingredients that could create a groundswell of people calling for a whole new system.
I’m not advocating for anything here, but rather calling attention to the moment. What’s happening now is going to have a profound change on our industry. This is the disruption we didn’t see coming.