No Normal Show by BPD

A review of Joe Public 2030 predictions

Episode Summary

Need something to hold you over until your order of Joe Public 2030 arrives? Preview the book's five bold predictions now.

Episode Notes

Takeaways

• Our new book, Joe Public 2030: Five Potent Predictions Reshaping How Consumers Engage Healthcare, is now available for pre-order.
• Joe Public 2030 is Chris Bevolo’s 7th book. His writing journey started when an industry publisher came to him to write a book on brand for health systems.
• To write the book, Chris assembled a team of Revivers – Team 2030 – to collect as much research as possible. The team identified trends across literature, which evolved into Joe Public 2030’s five predictions.
• These findings were supplemented by in-depth interviews with healthcare industry leaders across verticals, including health system CEOs, venture capitalists, entrepreneurs, researchers, and physicians. Interviewed thought leaders come from some of the top brands in healthcare, such as CVS, Geisinger, Intermountain Healthcare, Optum, Johns Hopkins University Medical Center, and Mayo Clinic.

Prediction #1: Copernican Consumer

• Enabled by sensors, AI, and other technology, consumers are becoming the center of their own health universe.
• Potential results could include a dramatic reduction in the need for primary care clinicians, an entirely new sector devoted to personal health management, and true precision medicine combined with health management.
• The Copernican Consumer prediction is more than just patient-centric care. Instead, the Copernican Consumer is a prediction that places consumers as the central force in their own health, with physicians, health management tools, and other health-related services “orbiting” around them. Consumers will rarely go anywhere to receive health support or care – it all will come to them.
• Another difference from today is the frequency of consumer health engagement. Consumers will be able to continually monitor their health using aggregate health data. Instead of seeing a primary care doctor once per year, consumers will be able to access all the data they need and will be empowered to make care decisions.
• More sensors are being developed to enable this trend but are not yet in a place where they are sophisticated enough to support a Copernican Consumer.

Prediction #2: Constricted Consumerism

• Consumers will become increasingly responsible for their own health and use of healthcare services. Yet, they will actually become less and less empowered in the choices they have for care, especially in higher-acuity, higher-cost situations.
• While many in the industry will continue to sing the praises of choice, the reality is that most consumers will have far fewer choices moving forward, often in ways they might never consider or see.
• The biggest spender of healthcare money in the United States is the federal government. Employers are the second biggest healthcare spenders as they support employee health plans. For this reason, the federal government and employers are the consumers with the most power to determine how and when consumers receive care.
• For example, PBMs don’t always work in favor of the consumer. Instead, they work to control costs for the payor. Similarly, 72% of ACA health plans are considered “narrow networks.”
• Health insurance companies are the driving force behind these restricted networks and benefit from them. For example, UnitedHealth just reported a 12% increase in revenue for 2021.
• This prediction, in some ways, conflicts with the Copernican Consumer prediction, which places consumers in control of their health.
• The tension between predictions comes from consumers’ current inability to interpret and take action on their health data. How do we ensure that experts guide consumers in understanding their health information?
• This new advisory role may allow industry players to monetize this service, which would significantly impact the market landscape.

Prediction #3: Funnel Wars

• Non-healthcare organizations such as Walmart, CVS, Walgreens, Amazon, and Apple are entering healthcare through low-acuity services like primary care and urgent care.
• Health systems may not currently perceive these organizations as a competitive threat because low-acuity services are less profitable.
• These new entrants pose a competitive threat because they control referrals to higher acuity services – which health systems need to survive.
• Moving forward, we could see the splitting of the health system model, with some systems moving even further to the larger, more comprehensive “health” organizations, others retracting into solely acute-care destinations – the “giant ICU on a hill” – and others somewhere in the middle.
• How does the aging population fit into this? What will health systems’ role be in the future?

Prediction #4: Rise of Health Sects

• Challenges to and skepticism of the mainstream medical field have exploded in the past two years because of the pandemic and political tribalism in the United States. Taken to its potential, this trend could result in multiple “health sects” that coalesce around people’s political affiliations and worldviews.
• These sects will not only follow the medical thinking that best fits their worldview, but may also create their own reality through alternative research, diagnosis, treatment approaches, and models for care delivery.
• Health systems, built to serve entire communities, will find it increasingly difficult to deliver care due to splintering care ideologies. Health systems have a duty to provide science-backed medical care yet face resistance from those who don’t believe in mainstream medical practices.
• A significant factor in The Rise of Health Sects is the loss of trust of health experts. Some medical schools train students to build a thought leadership presence online to combat this loss of trust in the healthcare system and disseminate mainstream medical thought.

Prediction #5: Disparity Dystopia

• The pandemic shone an ugly light on the disparities that have plagued the U.S. healthcare system for decades, and unfortunately, that health gap is more likely than not to expand.
• This shift will be compounded by the mental health crisis, which disproportionately affects systemically disadvantaged populations and groups outside traditional healthcare access channels.
• While those entities that might address these disparities increasingly struggle financially, others lack the incentives to focus on the growing issue.
• The CommonWealth released a report that found that healthcare is better for white people in nearly every state. At the same time, we see a growing list of trendy startups looking to disrupt primary care, with many companies focusing on healthy, relatively well-off patients.
• Looking at the availability of PPE, ventilators, COVID-19 tests throughout the pandemic, you can see that populations with higher incomes are favored in resource distribution.
• According to Rand Corporation, the bottom fifth of low-income households are spending nearly 34% of their income on healthcare.