Looking Back to Look Ahead: Predictions on Healthcare’s Future

In this article, first published in BRINK, executives from Mount Sinai Health System, Blue Cross Blue Shield of Michigan, and Optum weigh in on their dreams and aspirations for healthcare's future.

The healthcare industry is sitting on the edge of disruption. What innovations can be expected next, and how can today’s executives, leaders, and innovators prepare for the unexpected?

At last month’s Oliver Wyman Health Innovation Summit, four executives at one particular session — Looking Back to Look Ahead: Where Do We Go From Here? — answered these questions and more. By analyzing past industry patterns and breakthroughs in population health, artificial intelligence, care accessibility, and beyond, they forecast where healthcare executives and leaders should focus next as the industry progresses.

Although popular buzzwords several years ago included population health, value-based care, and care models, today’s buzzwords revolve around topics such as artificial intelligence, affordability, health care consumers, and genomics, emphasized Sam Glick, partner in Oliver Wyman’s Health & Life Sciences practice and director of Oliver Wyman Health Innovation Center Leaders Alliance.

The healthcare industry is currently focused on operational work, such as revising old organizational models, retraining staff, and figuring out how to move forward while in the midst of progress, said Niyum Gandhi, executive vice president and chief population health officer at Mount Sinai Health System.

“I wonder which pieces of this will be the hard, operational work in a year or two and which ones will fade away, or stay innovative,” Mr. Gandhi noted.

“What’s broken in our industry is that the consumer and customer are different,” Mr. Gandhi said. “In pretty much every other industry, the consumer and customer are more tightly aligned. If you really define ‘value’ properly, you need to think about how you define ‘value’ for the consumer, while also defining it for the customer.”

Identifying Tomorrow’s Opportunities

There is great anticipation in today’s industry around exciting new topics, such as the yet untapped opportunities and potential around machine learning and artificial intelligence, said Michael Weissel, Optum’s group executive vice president. But engaging consumers must remain a top priority moving forward, he said.

“Technology is great, but at the end of the day, a person has to change their behavior in some way for the health care system to make a difference,” Mr. Weissel said. “I get a lot more excited about driving engagement than some of the more sexy stuff people love to talk about.”

Old-fashioned face-to-face communication across the industry must be a priority, Mr. Weissel said. This means pharmacists need to be more engaged in advising patients, and physicians must learn how to better understand gaps in care or whether or not a patient actually needs to go to an urgent care center, he explained.

Integration — With Boundaries

Although many companies are spending a lot of money on healthcare, they do not necessarily want to become healthcare companies themselves, said Todd Van Tol, senior vice president of health plan business at Blue Cross Blue Shield of Michigan. Companies are instead looking for healthcare companies to integrate with their own business models and make what they have to offer come to life, he said.

“At Blue Cross Blue Shield of Michigan, we’re fortunate to have demanding customers and big, diverse legacy workforces spread out around the country and internationally,” Mr. Van Tol said.

‘Technology is great, but at the end of the day, a person has to change their behavior for the health care system to make a difference.’ — Optum EVP, Michael Weissel.

“These are organizations that have gone under tremendous disruptive change. They’ve navigated it, they’ve survived it, and now they’re doing well in it,” Mr. Van Tol said, adding that these organizations therefore appreciate what it takes to make greater industry-wide progress.

For the healthcare industry to successfully advance, the way talent is perceived must change, Mr. Glick said, noting that the future of academic medical centers, for example, is shifting.

“Our CEO and our board back in 2010 or 2011 sat down and decided they didn’t want to be just an academic medical center,” added Mr. Gandhi on the evolving role of academic medical centers. “It was a deliberate decision, driven by the mission of the organization, which is to provide health to the community—the same mission on paper as a lot of other academic medical centers. But as an industry over the past 100 years, we’ve horrendously failed at this mission.”

The future of providing health to the greater community does not look like a bunch of hospitals, Mr. Gandhi said. Mount Sinai being considered as the local community hospital for East Harlem—and a respected and renowned hospital nationwide—is the new perception of health care, he said, adding that there are still over 1 million uninsured patients across New York City.

Because there is still a great deal of disconnect in health care, better integration of assets and stronger connectivity is needed, Mr. Weissel said. This includes, for example, integrating prescriptions and population health, population health and primary care, or primary care and ambulatory care. The patient experience and the social determinants demand better integration, he said.

When asked what he would do to change this if he were given all the money in the world, Mr. Weissel replied, “I would work hard to get all the components to line up with each other so when a person travels through the healthcare system, it feels like it’s a singularly oriented experience with consistency at each stage, depending on where you need to be.”

Mr. Van Tol added that healthcare cannot be fixed in a vacuum, as the industry is still struggling to focus on what to do next.

“I would be happy if as an industry and country, we could have a mature discussion about what we expect in healthcare, built around a consumer point of view,” said Mr. Van Tol, “and have the right type of debate and dialogue around what access to healthcare means, how we’re going to pay for it, how much we’re going to pay for it, and the means by which we’re going to deliver it,” he said on his dreams for the future of the industry.

Watch the full session of “Looking Back to Look Ahead: Where Do We Go From Here?”