Joe Public 2030

Predict-O-Meter

Joe Public 2030 makes five bold predictions about that future, which range from exciting and promising to ominous and discouraging. Through the Predict-O-Meter, we’ll continuously assess the state of the healthcare industry to track the accuracy of the five predictions.

The Copernican Consumer

Constricted Consumerism

The Funnel Wars

Rise of Health Sects

Disparity Dystopia

Five potent predictions reshaping how consumers engage healthcare

The Copernican Consumer

STATUS:
Winter 2022 Update

What influenced our latest rating?

It’s been a year since the predictions in Joe Public 2030 were baked, and for this one, things are looking a little better than our summer update. The shift of care away from hospitals and into the consumer’s home, phone or place of work continues apace. And consumers are finding more and more utility from wearables. Yet, a lot of the technology we cited as foundational to the future of The Copernican Consumer has been somewhat two steps forward, one step back. Take AI, which saw nearly $3B in start-up funding in first half of 2022, after $10B in 2021, but breakthroughs in healthcare have been slow. (And yet, the new ChatGPT is making a splash.) And who knows when blockchain will recover given the downfall of NFTs and the cryptocurrency meltdown this year.

Relevant news
Original Prediction

Consumers will become the center of their own health universe more than ever before, enabled by sensors, AI, and other technology, as well as services geared toward empowering them, leading to profound implications for both consumers and healthcare organizations. Potential results could include a dramatic reduction in the need for primary care clinicians, an entirely new sector devoted to personal health management, true precision medicine combined with health management, and more.

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Constricted Consumerism

STATUS:
Winter 2022 Update

What influenced our latest rating?

Unfortunately for healthcare consumers everywhere, this prediction stays right on “Nailed It.” At its essence, this prediction is about limited, and declining, power of “consumerism” in healthcare to drive choice, better care, and lower costs. One incredible statistic says it all about consumers losing out from consumerism: last year, for the first time ever, bad debt from insured patients replaced that from uninsured patients as the top source for hospitals. More than 58% of bad debt for hospitals in 2021 came from commercially insured patients who couldn’t cover costs from high deductibles, co-payments and other post-insured costs. That’s an increase from just 11% of total bad debt for this group only three years earlier. And we hear once again for the call to move consumers away from employer-sponsored plans, a potentially ominous future for “consumerism.”

Relevant news
Original Prediction

While consumers will become increasingly responsible for their own health and use of healthcare services, they will actually become less and less empowered in the choices they have for care, especially in higher-acuity, higher-cost situations. While many in the industry will continue to sing the praises of choice, the reality is most consumers will have far fewer choices moving forward, often in ways they might never ever consider or see.

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The Funnel Wars

STATUS:
Winter 2022 Update

What influenced our latest rating?

The Funnel Wars are in full thrall. What’s that, Amazon to shut down Amazon Care by end of year? Psych! Welcome to Amazon Clinic, a new virtual care offering. Or how about the already stacked Walgreens, fresh off its acquisition of VillageMD, closing a $9B deal to acquire Summit Health and its NYC-ubiquitous CityMD? Not to mention, CVS continues its push into primary care. On the other side of the battle front? Traditional providers are having the worst financial year in their history, making it that much harder for them to keep up with the retail and tech interlopers.

Relevant news
Original Prediction

Today we tend to consider hospitals and health systems as birds of the same feather in terms of business model, with variances based on size, scope of services, for-profit/non-profit, and other factors. Moving forward, we could see the splitting of the health system model, with some systems moving even further to the larger, more comprehensive “health” organizations, others retracting into solely acute-care destinations – the “giant ICU on a hill” – and others somewhere in the middle. These models may emerge based on core geographic/market differences such as presence of competitors, plan consolidation/power, regulation, and dozens of other market forces. Yet the primary area where this transformation would play out is with health, wellness and the lower-acuity care points – what we’re calling The Funnel Wars.

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Rise of Health Sects

STATUS:
Winter 2022 Update

What influenced our latest rating?

Pediatric systems targeted for their transgender care. Florida’s politically motivated surgeon general issuing COVID-19 vaccination warnings based on scientifically unproven research. The University of Idaho issuing communications to staff and students that under new state law, promoting services for the “prevention of contraception” could be a felony. The Republican candidate for Governor in Minnesota questioning the efficacy of the COVID-19 vaccines and claiming hospitals distorted the number of deaths from COVID. The hits just keep coming for organizations dealing with the further politicization of healthcare.

Relevant news
Original Prediction

Challenges to and skepticism of the mainstream medical field and science itself have exploded in the past two years because of the pandemic and political tribalism in the U.S. Anti-vaxxers, non-maskers and Covid deniers are just the start of an expansion of this distrust of experts, which taken to its potential end could result in multiple “health sects” – primary “schools” of medical thought that coalesce around political/world-views. Imagine “Mainstreamers,” who follow the establishment healthcare point of view, “Progressives” who follow minimal medical intervention combined with complementary and alternative medical solutions, and “Contrarians” who deny mainstream medical thought and create their own set of “alternative facts” on everything from vaccines to childbirth to end of life care, and everything in between. These sects will not only follow the medical thinking that best fits their world-view, they may in fact create their own reality through alternative research, diagnosis and treatment approaches, and models for the delivery of care itself.

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Disparity Dystopia

STATUS:
Winter 2022 Update

What influenced our latest rating?

We’re going to try to find the silver linings on this prediction wherever we can, because it’s one we’d love to be wrong about. Unfortunately, and not surprisingly, all the challenges are still there, and in many cases growing: climate change impacting health; women in the U.S. facing a reduction in healthcare rights and services; older Americans and those with disabilities facing bias and discrimination when it comes to healthcare. And, of course, people of color continue to fight deep inequities and disparities. COVID-19 is still wreaking havoc – 2021 saw the second year in a row with a drop in life expectancy for Americans (the first time in more than a century it dropped two years in a row). But, in some good news for those facing disparities, Black and Hispanic Americans saw their life expectancy drop by less than White Americans in 2021, a reversal of order from 2020. (The same, unfortunately, could not be said for American Indian and Alaska Native people, whose dramatic drop in life expectancy now matches what it was in the 1940’s).

Relevant news
Original Prediction

The Covid-19 pandemic shone an ugly light on the disparities that have plagued the U.S. healthcare system for decades. Unfortunately, that health gap is more likely than not to expand, as the “haves” gain access to increasingly more expensive medical treatments, health services, and personalized care, while the “have nots” will face growing shortages of basic health resources, from clean water and air to physicians and clinicians, rural healthcare, and more. This shift will be compounded by the mental health crisis, which disproportionately affects systemically disadvantaged populations and groups outside traditional healthcare access channels (teens, for example). All while those entities that might address these disparities increasingly struggle financially – health systems, health plans, state and federal governments – and others lack the incentives to focus on the growing issue.

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