Solving the Cost of Care Dilemma

Healthcare costs will rise by an average of 5.5% per year over the next decade, growing from $3.5 trillion in 2017 to $6 trillion by 2027. Undoubtedly, cost of care containment strategies continue to dominate conversations across the industry.

Whether healthcare professionals are planning for an international health outbreak, implementing large-scale care management programs, or simply directing consumers from the ER to office visits, healthcare entities have tried numerous methods to reduce, or at a minimum, maintain healthcare costs.

In our last panel, Sue Knudson (Chief Informatics & Health Engagement Officer at HealthPartners), Troy Simonson (Chief Executive Officer at Twin Cities Orthopedics), and Chris Cronin (Chief Executive Officer at MOBE) shared their perspective on cost of care pre- and post- COVID and future implications of value-based care partnerships.

COVID’s Silver Lining

By this point, we are well aware of the negative aspects of the COVID-19 pandemic, but there are some positives also. Thankfully, the healthcare industry can point to a few silver linings:

• COVID is rapidly accelerating healthcare’s pace of change across the collective industry and independently for organizations. Learning to maintain this pace and sustain change in the future will be critical.
• Virtual visits are here to stay. State and federal policy changes loosened restrictions that previously held back growth in telehealth, plus providers and consumers were both motivated to adopt.
• There is a renewed focus on basic public health measures, like washing hands and staying home when sick. Focusing on these simple actions will improve the overall cost of care in the future.
• More consumers are educating themselves on healthcare, which has a direct impact on cost of care. For example, patients question where surgery will occur, whether at a surgery center or in a hospital. This interest pushes physicians to be more efficient and opens a transparent dialogue with patients to potentially select a lower cost of care facility.

Virtual Visit Benefits

Virtual visits aren’t a new concept, but COVID has distinctly accelerated their adoption and appeal.

• Telehealth adoption is taking place across the spectrum of demographics, including a high proportion of the senior population.  Virtual visits work particularly well for post-op care where no imaging is needed and physical therapy. Therapists know their patients well and can predict who will follow-through and who needs an in-person visit to ensure the right outcomes.
• There is an increase in virtual visits for recurring and new behavioral health patients, which is a positive indicator of people being acutely aware of their health needs throughout the pandemic.

Value-Based Care Partnerships

We see several unique partnerships, surprising alliances, and new methods of operation across the healthcare industry.

• As an industry, healthcare has only scratched the surface of value-based care. Most healthcare financing is still fee-for-service, but innovative models are developing that use a combination of value-based benefit design while ensuring a high-quality experience.
• Balancing patient data outcomes and experience while managing cost is what defines value-based care. The goal is to change care delivery to be more competitive.
• Prospective bundles are an increasingly popular method to provide up-front, transparent pricing that details the total cost of care. This year, Twin Cities Orthopedics will perform almost 2,000 prospective bundles in the total joint and spine space, equating to a savings of $20 – 25M in the market.

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Closing Thoughts

Cost of care is a longstanding conversation in the healthcare industry. Despite all the downsides of COVID, it has positively impacted transparency in cost of care, increased the pace of change in healthcare, and accelerated consumer interest in telehealth and basic public health measures. We hope the pandemic will continue to encourage people to refocus on their health, educate themselves, and sustain healthier lifestyles to reduce care costs in the future.

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Extra Credit

TCO Reports Significant Reduction in Opioid Pain Medication Prescriptions. Twin Cities Orthopedics surveyed and tracked 3,000 patients’ prescriptions counts, satisfaction levels, and disposal habits of unused pain medications to develop findings to reduce opioid reliance following an orthopedic procedure.

2020 Chronic Care Action Index. In partnership with YouGov, MOBE commissioned a study to ask consumers and healthcare providers across the country what’s standing in their way when it comes to improved outcomes and what factors would put them on the road to better health.

Telehealth Company Amwell Spikes in Public Debut with Outsized $742M IPO. Telehealth provider Amwell went public during the pandemic and saw a stock spike of 42% on the first day of trading.

Pivot Podcast: Tesla’s “Battery Day,” the DOJ prepares for Google, and Scott’s prediction on “algorithmic e-commerce.” Pivot Podcast co-host Scott Galloway predicts Walmart and TikTok could introduce a new field called “algorithmic commerce,” which goes from one-click shopping to zero-click shopping. Healthcare could similarly preempt patient needs.

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