The hospital of the future

Economists say in an ideal world, different hospitals will specialize in different forms of care while others — particularly in rural areas — will focus on providing basic services.

Why it matters: 

The hospital of the future will likely mean a significantly different patient experience, in ways both obvious (it’ll have better technology) and potentially disruptive (it could require more travel).

  • “My own view of what it’s going to look like in the longer run is much, much fewer hospitals that are much, much bigger,” said Yale’s Cooper.

Where it stands: 

Many health systems are already cutting service lines — maternity care is a common one — or closing altogether, especially rural hospitals.

  • To some extent, that may be OK, some experts say. The reality created by shifting demographics is that some places just don’t have the population necessary to support certain services.
  • Not only do the economics not work, but a handful of specialized procedures every year probably isn’t enough to keep providers well-trained.

Between the lines: 

Instead of consolidation, there should be more of a divergence between hospitals that provide basic care to local communities and those that specialize in more complex care, Cooper said.

  • That model, of course, would mean many patients would have to travel for certain care instead of receiving it at their local hospital.

And as technology broadly changes the consumer experience, patients will have similar expectations for their care.

  • “People’s gold standard is buying stuff on Amazon at 2 in the morning, and when they compare their health care experience, they say, ‘Why can’t my health care experience be more like that?'” Kaufman said.
  • Emerging medical technologies will also impact the care that people receive, and hospitals are positioning themselves at the forefront of that change.
  • “Patients right now — and in the future — can expect more care delivery that is driven by 3D modeling; predictive analytics; advanced robotics for surgeries and treatments; and personalized therapies based on genomics,” American Hospital Association president and CEO Rick Pollack wrote in a blog post last year.

Yes, but: 

Hospitals that serve higher populations of vulnerable people, who are more likely to have lower-paying government insurance, are the most financially exposed.

  • That means if they don’t adapt, care could become even less accessible for these patients.

Some economists’ ideal version of the future may mean lower profits for health systems.

  • Hospitals “should do what they do best, which is inpatient care and emergency care … and other people should do things that they do best, like the physicians working together as a multi-specialty group but not part of the hospital,” said Johns Hopkins’ Anderson.
  • “They wouldn’t make the substantial profits they’re making, but for the nonprofits, that’s not the goal,” he added.

The bottom line: 

“Is there going to be disruption? Yes,” Cooper said. “I think there’s a romanticism about local hospitals. They’re where our kids were born and where our parents spent their final days.”

  • “But I firmly believe the local hospital of the future is not doing everything for everyone.”

Health Systems partnering with affordable housing developers

https://mailchi.mp/ea16393ac3c3/gist-weekly-march-22-2024?e=d1e747d2d8

Published last week in the New York Times, this piece highlights a growing trend in health system community benefit provision: partnering with developers to build affordable housing.

These partnerships have focused on a range of housing needs, from transitional housing for people experiencing homelessness, to housing for people who need special care, to affordable housing for hospital employees. Many of these projects also include co-located medical clinics to make it easier for residents to access healthcare services, and some are even being planned on health system-owned property. 

The Gist: Housing security has long been a significant social determinant of health, something that most providers recognize every day, given that a record number of Americans are currently experiencing homelessness. 

Among families with complex medical needs, stable housing was demonstrated to reduce adverse health outcomes in children by 20 percent. In addition to health systems, managed care organizations are also investing in different kinds of housing solutions, and at least 19 states are directing Medicaid dollars toward housing assistance.

Walmart partners with a health system and insurer in Florida

https://mailchi.mp/f12ce6f07b28/the-weekly-gist-november-10-2023?e=d1e747d2d8

On Tuesday, Walmart Health announced deals with nine-hospital system Orlando Health and Ambetter from Sunshine Health, a Centene subsidiary offering Affordable Care Act exchange plans, to become a preferred provider in the Ambetter Value Plan. 

Walmart Health’s 23 Florida-based centers will provide primary care services and care coordination in a narrow-network health plan that includes Orlando Health. The Ambetter Value Plan is available in seven counties, covering the Orlando, Tampa, and Jacksonville areas.

While this partnership is limited to Florida, Walmart Health operates 48 centers in five states, with plans to open dozens more locations and expand into three additional states next year. 

The Gist: With a strong foothold and customer base in states that haven’t expanded Medicaid, Walmart Health centers are well positioned to be part of low-cost, narrow-network plans targeted at individuals who don’t qualify for Medicaid, or who were recently removed from the program. 

While Walmart Health already works with major insurers, this first-ever network partnership with a health system is a notable step forward for Walmart, advancing its healthcare delivery business beyond meeting basic primary care needs into more complex care coordination. 

While other large retail and pharmacy chains have opted to buy their way into the primary care space, Walmart is thus far building its own retail store-based clinic enterprise, with plenty of room to scale.