Spotlighting Top Health Care Issues to Monitor in 2021

Several factors will have a significant impact in the health care industry in 2021, such as management of disparities in vaccine administration, greater investment in telehealth, and potential mergers and acquisitions between hospitals, said Gurpreet Singh, MBA, US Health Services Leader at PwC.

Transcript

AJMC®: Hello, I'm Matthew Gavidia. Today on the MJH Life Sciences’ Medical World News, The American Journal of Managed Care^® is pleased to welcome Gurpreet Singh, US Health Services Leader at PricewaterhouseCoopers, or PwC. Great to have you on. Can you just introduce yourself and tell us a little bit about your work?

Singh: Hi, Matthew, thanks for having me today. My name is Gurpreet Singh, a partner at PwC. I run our health services practice in the United States. I cover a lot of the issues that are occurring today and some of the investments that some of our health services, payers, providers, and pharma will be making in 2021. Happy to share some ideas today!

AJMC®: Can you speak a little bit about PwC Health Research Institute’s (HRI) annual Top Health Industry Issues report?

Singh: Every year, PwC conducts a top issues for health care report. The purpose of doing that is really just to stay ahead of the trends and the investments that are going to be made in the marketplace. This year is different, as you said, than most years. In past years, we've covered a lot of the strategic issues, some of which are actually relevant for today, like virtual care, telemedicine, digital therapeutics, even deals and activity with mergers and acquisitions. And actually, many of those issues we'll talk about today are relevant for today's market.

One difference I would say is that a lot of the issues are much more acute, meaning to actually stay ahead of the demand flow, to stay ahead of the forecasting necessary for serving patients as we know we need to, some of the investments will need to be made a little more aggressively and more quickly. So, we'll talk a little bit about what some of those issues are.

AJMC®: A takeaway from this year’s report was the reception to telehealth, which has emerged significantly to provide necessary care without the threat of infection. While more health care providers are using telehealth for primary care services, appointment issues have been reported by over 60% of minority groups during a telehealth visit, including Black and Latinx consumers.

Based on the report, how can telehealth be better optimized to address communities who may not be technologically proficient or have the necessary resources available?

Singh: Telehealth and virtual care really expanded rapidly and very quickly over a short period of time. For many years, we had been hoping that there was a catalyst for virtual care, in many ways to actually create efficiency. And last year, we talked about convenience, access, and choice for consumers.

Now, with the pandemic, obviously, we've been forced into using new channels, and if I put a silver lining on 2020, and hopefully in 2021, there's now an opportunity to create a platform for virtual and telemedicine. Just some specific examples, in talking to one of the large national health care providers, they said in the month of February, they did 3000 virtual visits that month, prepandemic. In May, they did 270,000 virtual visits. So, that's an incredible growth from a demand standpoint, but as you would imagine, some of the growing pains of moving that quickly create some of the experience issues that you and I see as consumers.

Some of the things that we are starting to see are what I would consider to be consumer experience–oriented issues. As an example, when you go physically into a doctor's office, usually you're doing the appointment, and then when you check out, there's a formal process for checking out, there's a formal process for getting your labs or your next appointment. In the virtual setting, that workflow, that process, that experience that we had in the physical is not there in the virtual. And so what most health care providers and payers should be thinking about are, what are the tactics that you can put in place to actually create a unified experience that goes not just from start appointment to end appointment, but actually everything from when I start feeling sick and I need to make an appointment to the point at which I need to consider a follow-up.

Those are some of the things that we're starting to see. It's exacerbated, as we're also seeing with different demographics. What we see in social determinants, for example, is that some people don't have access to all the computing and smartphones, or what have you, that many of these platforms run on. And what we're finding is, it's important to really make the investment in those technologies and maybe even communicating and educating where the health care literacy isn't as good.

We found a little over 50% of technical issues occurring during the virtual visits, and we expect in 2021 a significant investment from third parties, from technology companies, and from payers and providers.

AJMC®: What aspects of this year’s report should also be spotlighted as major issues to monitor in 2021?

Singh: So, one of the things that we also conducted as part of the study is, we did a consumer survey as well on who is willing to take the vaccine. As we know, in 2021, we’ll spend much of the year vaccinating individuals and working through the population in the severity that we need to.

We did a study to look at who would be willing to take the vaccine in the first year, and found some pretty fascinating results, I would say. What we found is that most people are willing and prefer to actually get the vaccine in a physician's office. However, for Black and Latinx consumers, they had slightly less trust with physicians and the physician offices. In fact, 27% and 28%, respectively, Black and Latinx consumers, said they would go to a physician or physician office.

On the flip side, we're seeing a demographic and an age group shift in the 18-to-24 category, many of them want to go to urgent care clinics to actually get their vaccination, which may not be completely new or surprising. But when you look at now male vs female, we found that more men (73%) were willing to take the vaccine in the first year versus women (53%).

So, what does all that mean? Understanding your customer, understanding what their wants and needs are, and maybe even educating them through customer relationship management, through being more proactive, through targeting them with the channels that they would prefer is going to be really important in this upcoming year.

AJMC®: Lastly, do you have any other concluding thoughts?

Singh: Yeah, maybe one other thing that I would suggest, that is going to happen in 2021, is because of the profitability issues and because of the rapid change in 2020, we would expect to see portfolios adjusting as well. What I mean by that is, we've even started to see in 2020 some mergers and acquisitions between hospitals, maybe an academic medical center with a faith-based institution, to cover the community in a more equitable way, if you will.

We'll see some deal activity pretty significantly in the health care provider space, but we'll also see it in the payer space. I mentioned a little bit earlier that in order to understand that demand within the communities, it's really important to understand the workforce that you have.

One of the things that we found early in the pandemic is that there were hotspots. New York, for example, was a hotspot early in the pandemic, and there were some really great stories about other regions like Cleveland, Minneapolis, Minnesota, and Pittsburgh sending health care workers to New York to help solve for some of those capacity gaps, but now we're all in a hot spot, right? And so it's difficult to actually move resources from one region to another. So, what that means is you have to stay proactive with some of those activities, and being proactive means understanding the demand and understanding what's going to happen in 2021.

AJMC®: To learn more, visit our website at AJMC.com. I’m Matthew Gavidia, thanks for joining us!