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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.

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The Copernican Consumer

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Constricted Consumerism

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The Funnel Wars

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Rise of Health Sects

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Disparity Dystopia

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Five potent predictions reshaping how consumers engage healthcare

The Copernican Consumer

STATUS:
Summer 2022 Update

What influenced our latest rating?

It’s been six months since Joe Public 2030 was released, and nearly a year since the five predictions were baked. That means this is our first chance after the dust has settled to see how our predictions are shaping up. And more than any other prediction, this one feels a bit cloudy, thus the yellow rating. Not because we don’t believe the Copernican Consumer will become a reality – check out Apple’s deep report on how their watch alone is transforming personal health. But more because the odds of this coming true by 2030, given some of the understandable slowness of AI and blockchain adaption in healthcare, seem at this point like a stretch.

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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:
Summer 2022 Update

What influenced our latest rating?

Well, this is tracking right on schedule. Provider consolidation continues apace, with Q2 2022 a record quarter in terms of health system M/A revenue from announcements such as the Advocate Aurora and Atrium Health merger. But the biggest news continues to be the growing power of payors through moves like an increased scrutiny on unscheduled procedures and using the No Surprise Billing act as a motivation to clamp even further down on reimbursement. This includes the continued vertical integration of the biggest players. And of course, ramped up prior authorizations and deductibles from the industry leaders. Just listen to Dr. Glaucomflecken for a TikTok take on PBMs and constricted consumers.

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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:
Summer 2022 Update

What influenced our latest rating?

If there was a brighter shade of green or stronger validation than “Nailed It” on our scale, we’d use it here. The primary care space in particular has heated up. The CEO of Walgreens says their role is “keeping people out of the healthcare system.” Amazon buys One Medical. CVS Health to buy Signify Health. When Dollar General continues their push and wow, even ByteDance, the owner of TikTok, gets into the mix (albeit in China), we’ve really jumped the shark. Yes, Amazon did announce the closing of Amazon Care, but what that really means is an open question. On the other side of the battle? Recently, a CMO at a large health system shared the story of sharing the news on Amazon and One Medical with several C-suite colleagues. While most leaders understood the threat and implications, a few did not see the relevance of the story, wondering how the news would impact the system. And that perfectly summarizes where the legacy systems are today when it comes to the threat of The Funnel Wars.

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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:
Summer 2022 Update

What influenced our latest rating?

Another prediction that seems, unfortunately, clearly on its way to fruition. From the Supreme Court’s Dobbs decision reversing Roe v. Wade to some states restricting transgender care for minors, it’s hard to believe healthcare has become even more politicized in the past year, but that is indeed the case. This is impacting everything from healthcare providers to state and local elections, including proposed legislation that is a clear reaction to Covid-19 healthcare issues. What’s worse, given the mid-terms in November and the presidential election in 2024, there no foreseeable future in which the temperature on this issue doesn’t go higher.

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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:
Summer 2022 Update

What influenced our latest rating?

The good news? This situation hasn’t gotten massively worse, so we’re short of a “Nailed it” ranking. The bad news? Health disparities and inequities are still for the most part worsening and continue to impact millions in the U.S. For example, a widely published report issued in June showed that more than 100 million Americans live with medical debt. A report issued from the United Nations in March declared the bleakest picture of climate change yet, describing a “brief and rapidly closing window” to trying to solve for global warming. While global warming was cited in the book as one of the greatest contributors to the health gap, at least the passage of the Inflation Reduction Act marks “the largest investment in history to combat climate change.” So we have that going for us, which is nice. For us, this still feels like one step forward, two steps back (or 60 years back, based on this story.)

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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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