Top 10 healthcare trends for 2023

After a tumultuous three years, the time has come to stop reacting to pandemic disruptions and embrace the potential for a vibrant, data-driven, and fiercely human healthcare system. We asked healthcare leaders from across Slalom about their predictions for 2023 and how leaders can navigate trends to advance healthcare. These trends combine hard truths with bold aspirations and incremental progress — all captured with the goal of building healthier tomorrows for all.

1. The healthcare workplace reckoning

Escalating provider shortages and clinician burnout have led industry groups to call for a “reboot” of the practice environment, with recommendations for innovations in nurse-led care; payment policies that reflect value; and investments in workplace wellness, flexibility, and diversity. American Nursing Association (ANA) President Jennifer Mensik Kennedy noted that recent strikes are indicative of a “systemic breakdown” and nurses everywhere need “definitive and transformational action immediately.”

Efforts including ANA’s Reimagining Nursing initiative and the Institute for Healthcare Improvement’s (IHI’s) Joy in Work program are seeking to address longstanding challenges, but the entire healthcare system must prioritize leadership and funding for these efforts to prevent an escalating public health crisis.

2. Escalating demands for direct care

Older adults will soon outnumber children in the United States, driving the long-term care market to exceed $779 billion by 2030. According to AARP, a whopping 77 percent of adults ages 50 and older plan to age in place, despite the reality that many lack the physical accommodations and support network they need for long-term wellbeing.

Longstanding shortages in the direct care workforce have already reached crisis levels, and the inability to support people with disabilities and older adults is quickly becoming a civil rights issue. In response, the Administration for Community Living recently launched a Direct Care Workforce Capacity Building Center to provide resources and support for direct care employee recruiting, training, and retention. Organizations like the John A. Hartford Foundation are also working to improve care for older adults through initiatives like the Age-Friendly Health Systems and the National Strategy to Support Family Caregivers.

Beyond these efforts, we expect leading health organizations to continuously pilot and adopt innovations including expanded telehealth, remote-patient monitoring, and AI-powered personal health care assistants to augment in-person care. Together, these innovations are enabling a hospital-at-home delivery model that has been shown to reduce costs, improve outcomes, and enhance the patient and caregiver experience.

3. Policy-accelerated health equity

Despite challenging economic headwinds, government and advocacy organizations will continue to invest heavily in health equity. The recently released CMS Framework for Health Equity outlines priorities that are already being reflected in policy measures.

For Health Plans: The proposed 2024 rule for Medicare Advantage Organizations includes a Health Equity Index (HEI) reward for ratings in 2027 and beyond. The proposed measure would also: 1) expand the list of populations that must receive culturally competent care, 2) require health plans to provide education for medically necessary telehealth services, and 3) require plans to include cultural and linguistic capabilities in provider directories.

For Hospitals: In August, CMS issued a final rule for inpatient and long-term care hospitals that includes a measure to assess commitment to health equity across five key domains: 1) strategic planning, 2) data collection, 3) analysis, 4) quality improvement, and 5) leadership engagement.

While multiple groups have introduced frameworks and measures for health equity, the proposed CMS HEI may answer industry calls for national health equity measures. Health plans and hospitals can get a head start on future policies by prioritizing education and adoption for Social Determinants of Health (SDOH) Z Codes, which facilitate improved screening and management of key health drivers.

4. Fixing the broken mental health system

More than 50 million Americans are currently experiencing a mental health illness, including 2.7 million youth experiencing severe major depression. According to Mental Health America, the growing demand for mental health services is rapidly outpacing the availability of mental health providers, which is further exacerbated by increasing out-of-network participation.

The Consolidated Appropriations Act passed in December includes several policies aimed at addressing the mental health crisis, including re-authorizing mental health programs and adding policies to improve behavioral health coverage, coordination, and integration. States are also taking initiative to address the mental health workforce shortage, with a recent KFF analysis concluding that emerging policies focus on four key areas: increasing rates, reducing burden, extending workforce, and incentivizing participation.

Tools including the American Medical Association’s Behavioral Health Integration (BHI) Compendium and the American Psychiatric Association’s Collaborative Care Model (CoCM) provide evidence-based resources for physician groups seeking to improve whole-person care. The resources also align with AHIP’s Vision for Improved Mental Health Care Access, which focuses on care navigation, integration, and workforce capacity.

Regardless of where an organization falls within the healthcare system, adapting to meet the needs of people experience mental health illness will be a critical part of the path forward in 2023 and beyond.

5. Re-inventing rural healthcare

Nearly 30% of rural hospitals nationwide are at risk of closing, according to the Center for Healthcare Quality and Payment Reform. Industry wide challenges are exacerbating the circumstances that have long challenged rural hospitals, such as the higher prevalence of uninsured patients, dependence on Medicare and Medicaid, and greater proportion of medically complex care.

Fortunately, the industry’s rallying cry to extend two critical funding programs has increased awareness of the role rural hospitals play for millions of Americans as well as the broader U.S. economy. Congress extended the programs for two years in December, but the patchwork solutions fall short of addressing long-term sustainability. Industry groups have also had mixed reactions to key measures, including a CMS program that would require hospitals to eliminate inpatient services to avoid closure.

This prediction may be overly optimistic, but a combination of renewed rural health programs, investments from larger hospital networks, and intriguing industry entrants could help revitalize this vital part of our healthcare ecosystem. Elements of this transformation could include revised payment systems, using telehealth and hospital-at-home models to distribute volume, and taking advantage of the “live and work from anywhere” era to support workforce development and patient acquisition.

6. Evolving toward the healthcare data mesh

In recent years, healthcare leaders have begun the painstaking process of modernizing legacy data warehouses and integrating data from disparate IT systems into extensible data platforms. Moving forward, the focus will shift toward data mesh architecture to address ever-present data and management challenges. Gartner defines data mesh as a “solution architecture for the specific goal of building business-focused data products.”

Technology platforms are promoting data mesh as a solution for decentralized data management to improve data agility and avoid the bottleneck of a central data team. However, it’s important to note that data mesh is primarily an organizational change. The data then becomes a product, well defined by the domain teams themselves and exposed through a set of APIs interoperable with external systems.

Our experience on large data transformations has shown the key factors for success often fall outside of the technology ecosystem. Leadership continuity, trust, and predictability are all necessary to create a Modern Culture of Data, and successful transformation may even require re-alignment around a data science operating model.

7. The clash of economics and expectations

Consumerism in healthcare is rising, but the convergence of rising inflation and provider shortages are making it hard for health organizations to invest in transformation. Kaufman Hall warned that sustained 2023 headwinds will challenge every component of the healthcare business model, including faster and deeper erosion of healthcare resources.

Economic resilience in 2023 and beyond will require healthcare leaders to balance resource management across functions with selective investments toward care innovation and quality. From a technology perspective, we anticipate a greater focus on Health IT rationalization to streamline care experiences while reducing long-term technical debt.

8. Recommitting to holistic wellness and preventive care

More than 40 years ago, the New York Times ran an article entitled Holistic Healthcare Gaining Support. The article defined holistic medicine as a “concept, a treatment of disease, and a promotion of well-being through full development and integration of mind, body, and spirit.”

While this “trend” may at first appear more like a middle-aged maxim, increasing distrust in the medical system, deferred care, and unhealthy lifestyles have necessitated renewed investment in the fundamentals of wellbeing. Tech-enabled services and experiences can help facilitate healthy behaviors, but rebuilding trust from the ground-up will be critical to improving outcomes. Based on her work in global health, Melinda French Gates offers insights into grassroots strategies for engaging people with deeply entrenched beliefs:

• Seek out leaders who have courage and influence.
• Understand knowledge, attitudes, and practices.
• Present ideas to people within the context of their values and concerns.
• Distribute tools and resources in ways that encourage people to use them.
• Engage with the utmost care, transparency, and respect.

9. The fledgling role of payers as stewards

The evolution to value-based care is fundamentally changing the relationship between health plans and their members. Now more than ever, providing a frictionless member experience has a direct impact on member retention, revenue, and ultimately, member health outcomes. However, health plans must address the trust gap with both patients and providers to truly influence health behaviors. A recent study by Ribbon Health revealed that while 53% of consumers said that their health plan was the most important factor in their overall health system experience, only 32% of consumers would trust their health plan when searching for care. Our experience shows that three fundamental factors of any healthy relationship can help health plans improve member experience and outcomes:

Trust: Find a way to give members a robust and accurate provider directory. Give those providers the power to make decisions for the patient sitting in front of them, and commit to 100% accuracy in claims processing — even if that means putting a “human in the loop” to address errors before a decision is made.

Communication: Every touchpoint a health plan has with its member sends a message. Use omnichannel communications to reach and engage with members in their homes, workplaces, and communities. Be ready to provide timely and empathic support when they need it and find ways to resolve conflicts in a healthy way.

Respect: Understand that members are unique people with individual healthcare needs and preferences. Use data and experience design to tailor services to their needs and reduce time spent navigating care.

10. The rise of the healthcare marketplace

Gartner predicts that digital commerce platforms or “healthcare marketplaces” will connect 20% of all consumers, payers, and providers by 2025. These platforms will enable members and patients to seamlessly discover, access, and manage healthcare services while improving business value for payers and providers.

Hims & Hers Health demonstrates a novel approach to personal wellness marketplaces that seamlessly integrates over the counter wellness products with prescription drugs and on-demand care. On the other end of the spectrum, commercial healthcare megasystems like the United Health Group and CVS/Aetna will work to activate their expanding portfolios through digital marketplaces that connect their resources and services.

Leading healthcare systems, large health plans, advocacy organizations, and government agencies all have an opportunity to galvanize innovation and education through platform-enabled consortiums that would extend to regional hubs and communities. As we have observed with industries including retail, finance, and entertainment, the healthcare organizations most adept at creating a digital marketplace will be the most likely to succeed in the next decade.

Our vision for fiercely human healthcare

Sometimes when you think about these challenges, the healthcare outlook can feel dire. However, it’s important to remember the incredible progress made in recent years. The national uninsured rate reached an all-time low of 8 percent in 2022, and advancements in digital health are making care more convenient and accessible. Widespread health IT adoption has paved the way for data-enabled personalized healthcare, and the current tension in the healthcare system has the potential to open up innovative coverage and care delivery models.

We understand the complexities ahead, but we believe that a fiercely human approach to healthcare can make healthcare experience, economics, and outcomes better than ever before. As we move into 2023, we encourage healthcare leaders to define a north star, work with an inclusive cross-section of stakeholders to prioritize the experiences that matter, and continuously pilot, test, and iterate on solutions that improve both clinician and patient wellbeing.

Contributors

Deepika Bhatia, Columbus
Katherine Cabinian, New York
Sara Donally, Detroit
Mel Donatelli, Global
Matt Dubay, Minneapolis
Cabul Mehta, Boston
Jacque Myers, Global
Ellie Rice, Global
Arun Srinivisan, Washington, DC
Samuel Swarbrick, New York
Glenn Stolar, Minneapolis
Brenda Yoo-Young, Seattle

Slalom is a modern consulting firm focused on strategy, technology and business transformation. Our healthcare and life sciences industry teams partner with healthcare, biotech, and pharmaceutical leaders to strengthen their organizations, improve their systems, and help with some of their most strategic business challenges. Find out more about our people, our company and what we do.