Panelists in an AHIP 2022 session discussed how future public health policies, infrastructure and investment strategies will reinforce efforts already underway during the pandemic, with partnerships and engagement essential to maximize innovation.
For stakeholders involved in delivering health services to millions of Americans nationwide, post-COVID-19 policies, infrastructure, and investment strategies will build on efforts already underway to address public health issues brought to light amid the pandemic.
Issues that have risen to prominence during this period, such as the social determinants of health, health equity and mental health, were some of the topics discussed by panelists during the session. ‘AHIP titled “Emerging Stronger: A Vision for What Comes Next in Health Care.” Speakers noted that these topics are central to their organization’s vision and goals.
Efforts for equitable access and quality of health care have been made in the past to address these challenges, but Sarah London, CEO of Centene Corporation, noted that what the pandemic has helped to reinforce is the importance of engagement between provider partners and communities and the value of the patient as that ‘North Star’ to inform decision-making and healthcare transformation strategies.
“We’ve all been forced to think differently, act differently, and function differently. A lot of this kind of forced change, some of these very rapid structural changes are in line with the direction we think the industry should be going and be able to prove that at scale in a statistically significant data set in one very fast time is really exciting thinking about the strategic endeavors ahead,” London said.
As health care utilization has dropped dramatically amid the pandemic, London described the growth in creativity and ability of providers and health plans that have recognized the need to align incentives, to both financial and operational, to achieve better results. Eric C. Hunter, president and CEO of CareOregon, added that these varying levels of engagement between payers and providers were non-existent before 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 the availability of vaccines for all Americans, which were initially distributed primarily to hospitals and clinics, his organization worked to connect federally qualified community health centers and independent and safety net providers to these health systems to ensure equitable access to entire communities.
“Those kinds of things were critical at a necessary phase, but beyond that what we noticed more than anything else is that there is a different sense of how we need to engage with the government…if the government is not going to step in and do what I think they should do, then someone has to. So we said, find the areas that the board will agree on, where we will take our assets, our resources, our people, and invest in community partnerships, with government entities thinking a little bit downstream,” said said Hunter.
“We have shown leaders and politicians this is what can be done. There’s a 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 elements that I think we’re looking for more of, because if we want to change anything, you have to change something.
Discussing healthcare innovations emerging from the pandemic that have long-term implications for healthcare quality and cost improvement, London identified data, value-based care and convenience of care as 3 key buckets worth noting.
Over the one-year period from 2019 to 2020, telehealth visits increased markedly, from 800,000 to 19 million. Necessity and strategies such as telehealth waivers have been major factors in this surge, and usage has returned to the 12 million visits forecast for this year.
London said one of the interesting questions about telehealth is what structural change it will have on the future of health care delivery, particularly as a modality of care for the growing mental health crisis and as a primary care alternative in rural communities. Additionally, questions regarding its application in different managed care programs warrant increased data collection and adequate infrastructure and investment to track these quality and cost measures.
“We started thinking about designing products where we proactively cover telehealth so that you have that kind of ease of access and conversation…so the question is how many telehealth visits should we do per week to create a kind of baseline stable monitoring?” London said.
“I think the pandemic has highlighted the degree to which we need more real-time data and connectivity, and the ability to aggregate that data and understand what’s going on. At the fundamental transactional level, all of this infrastructure is still nascent in our industry. We now have data in our pockets, and we’re starting to have that connectivity. We have to figure out how to protect the data when it is exchanged, because we have to achieve different levels of fluidity, otherwise 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 on aligning strategies to solve good many of the pressing health issues facing individual communities.
“When we’re talking about data transfers and trust in data, those things melt away when the people who have the most at stake, who control organizations, come in and say, look, this isn’t about my ego or of my results or my shareholders ultimately, it’s about serving the people.