As healthcare evolves, the question of what the future holds is increasingly looming. Among a sea of innovations and challenges, forty-six health IT and finance leaders shared their predictions on how healthcare delivery will change in the coming decade.
The 46 executives featured in this article are all speaking at Becker’s 9th Annual Health IT + Digital Health + RCM Meeting: The Future of Business and Clinical Technologies which will take place Oct. 1-4, 2024, at the Hyatt Regency in Chicago.
As part of an ongoing series, Becker’s is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Question: What will likely be different about healthcare delivery 10 years from now?
Edwina Bhaskaran, RN. Chief Clinical Systems and Informatics Officer at Mayo Clinic (Rochester, Minn.): Envisioning the future of healthcare, I see a landscape where patients are not just recipients of care but active architects of their health journey, being driven by their knowledge of their data. Empowered by access to their own data, patients can make informed decisions and engage proactively in their care. This knowledge-driven empowerment fosters a significant shift, propelling us towards a proactive stance on wellness and preventive care. In this future, data becomes a holistic lens, integrating psychosocial elements, genetic predispositions and clinical findings to craft personalized healthcare strategies that enable individuals to not only champion but drive their total well-being.
Michael A. Pfeffer, MD. Senior Vice President and Chief Information and Digital Officer at Stanford (Calif.) School of Medicine: In the next decade, healthcare delivery will undergo substantial transformation driven by technological advancements, changes in patient expectations, and shifts in healthcare policy. Treatments will be increasingly tailored to individual genetic, environmental, and lifestyle factors, leading to more effective and targeted therapies improving health for all in an equitable way. Virtual consultations and telemedicine will become standard practice as remote diagnostic technologies become commonplace, offering patients convenient access to healthcare providers without the need for in-person visits. Remote monitoring will expand, allowing continuous tracking of patients’ health metrics through wearable devices and sensors. The shift towards a more patient-centered approach to care will accelerate, where patients are active participants in their care decisions facilitated by better access to their own health information and increased emphasis on patient education and engagement through digital health platforms.
Artificial intelligence will be widely used for diagnostics, treatment planning, and administrative tasks, improving efficiency and accuracy. AI-driven tools will assist in interpreting medical images, predicting disease outbreaks, and personalizing treatment plans. More integrated and coordinated care systems will facilitate seamless transitions between different levels of care, and health information exchanges will allow better sharing of patient data across providers and systems. A greater focus on preventive care, with the use of predictive analytics to identify at-risk individuals and intervene early, will become prevalent.
All in all, it’s a very exciting time to be in healthcare delivery, and I look forward to the ways we can use technology to deliver a highly personalized, deeply compassionate care experience for every patient.
Miguel “Mike” Vigo IV. Chief Revenue Cycle Officer at UC San Diego Health: Healthcare delivery in 10 years will be much different in a number of ways. For less acute conditions or healthcare needs, business to business delivery for products, materials, devices, etc., will be handled more and more by non-traditional healthcare partners such as Amazon, retailers, and even through joint operating agreements with providers, payers and an established delivery system. In addition, medical check-ins for chronically ill patients will be more telehealth powered along with video check-ins, which can be supported by supplying new devices specifically designed for security, validation, encryption along with looping in and integrating the patient’s information, both medical and insurance wise.
For medications, I do believe in the next 10 years there will be more government involvement given the increasing high pricing for newer drugs as well as unchecked mark-ups for current or existing medications so that the patients that need them can have them. For more acute patients, although multiple market analysis over the course of the last 10 years shows declines in the inpatient spaces, overall symptoms and patient acuity is proving to challenge those varying analyses. Although inpatients do require much more direct attention by care teams and physicians, I do see more virtual care options, potentially more investments and strategy around micro-hospital type set ups to offset those in the traditional healthcare towers or larger capital set-ups that exist today.
ChatGPT and AI will of course play major roles in expediting tasks within the care delivery model to provide support for caregivers, and in addition, they will largely support and become more mainstream in supporting or automating non-clinical areas such as revenue cycle and finance, among other non-clinical divisions.
D. Matthew Sullivan, MD. Chief Medical Information Officer, Southeast Information Technology at Advocate Health (Charlotte, N.C.): Over the next 10 years, technology is going to allow us to personalize healthcare delivery. Instead of swimming in today’s ‘data soup,’ we’ll have deeper and faster insights around treatments, operations and more. Massive amounts of data will lead to the development of personalized treatments. We’ll be able to deliver healthcare in the way that fits your individual needs – whether that’s a virtual appointment, in-person visit or some other way we haven’t even thought of yet. And, thanks to data, we’re going to be able to personalize the experience of those providing the care. Standardization is the mantra right now in EHRs, and an absolute requirement to get to the next stage. The data from standardization will enable AI-driven personalization in the future.
Richard Zane, MD. Chief Innovation Officer at UCHealth (Aurora, Colo.): Ten years feels like a lifetime. Nonetheless, one quote sometimes referred to as Amara’s law comes to mind: we overestimate the impact of technology in the short-term and underestimate the effect in the long run. Perhaps overly aspirational, in the next decade given the exponential embracing and understanding of AI, we will see dramatic improvements in efficiency, quality, access and (going out on a limb) cost directly attributable to technology and intelligence. Fingers crossed that the FDA and other regulatory bodies can evolve as their current paradigm substantively impedes progress.
Cynthia Salisbury, RN. Enterprise Executive Director of Nursing Operations at Providence (Renton, Wash.): The application of technology and AI in healthcare will not be viewed as a threat, but rather embraced and appreciated as valuable tools that allow caregivers to practice efficiently at the top of their scope, expanding access to care across communities and populations.
Use of technology to support virtual care across disciplines and care settings will enable provision of high-quality specialty care in all communities. Rural and critical access facilities will thrive as expanded access to clinical experts allows patients to receive specialty care without the need to travel far from home.
Hospital readmissions will decrease as virtual technology, including wearables, allows virtual nurses who were caring for a patient in the acute care setting to follow the patient home in the immediate post-acute time, facilitating continuity of care and effective adjustment to health at home.
Functionality of courier robots in healthcare will expand, enhancing value to caregivers and operations. The presence of robots in healthcare facilities will be common as they serve as runners, assist in supply tracking and management, expedite the flow of care, and add efficiency to operations.
Nurse-to-patient ratios will be a term of the past. Staffing will no longer be based on the misaligned principle of equality, but rather on equity – ensuring that resources are allocated effectively to meet patient needs. Patient assignments will not be driven by number of patients per nurse, but rather determined by the care needs of the patients and capacity of the caregiver team, ensuring high-quality, safe care for all patients while facilitating joyful and fulfilling work environments for all caregivers.
Healthcare education across disciplines will adapt to prepare caregivers to practice effectively in this new model of care delivery. The career span of nursing will expand as virtual nursing allows highly experienced nurses to continue to lend valuable expertise to patient care and to mentoring newer nurses, thereby enhancing the confidence and competence of the nursing workforce overall. Virtual Nursing will be fully recognized as a nursing specialty with enhanced availability of advanced training and certification.
Benjamin Hohmuth, MD. Chief Medical Informatics Officer at Geisinger (Danville, Pa.): Consolidation will continue producing larger but fewer health systems. Workforce challenges will continue to play a major role in constraining capacities and accelerating automation. Digital front doors will improve and friction for patients related to interacting with healthcare will decrease, but access will remain a major issue despite decanting to virtual care and self care. Use of AI to assist with documentation and summarization will be routine and in line with standard workflows, as will be the ability to easily act on discrete data and predictions queued up from disparate data and free text. AI will assist with diagnosis in providers’ clinical workflows and may start to provide some substitute provider services rather than simply augmented services. Epic will continue to displace vendors with new products but will also continue to partner with other vendors where Epic provides the workflows and the other vendor provides underlying capabilities.
Kipum Lee, PhD. Vice President of Innovation and Product Strategy at University Hospitals (Cleveland): In 10 years, more attention and investment will be made to care delivery outside of the four walls of the traditional hospital. The venues of healthcare would not be limited to “sick care” but will include and perhaps even begin to prioritize “well care.” Instead of hospitals as the sole delivery vehicle for care, other sites and industries such as hospitality and transportation will have begun to offer superior and sustainable innovative solutions. Most importantly, the home environment – especially through AgeTech and passive monitoring – may become even more central to care delivery.
Nolan Chang, MD. Executive Vice President of Strategy, Corporate Development, and Finance at The Permanente Federation (Oakland, Calif.): The next frontier of value-based care will focus on patients engaging with healthcare outside the traditional medical office building. Today, both disruptors and traditional players are still figuring out the right mix of virtual and face-to-face care. Virtual options allow easier access to care but can create strain in a world where provider supply is limited. The future will rely more on asynchronous care, powered by big data, AI, machine learning, and more while also creating capacity for providers to be available to those who need a higher level of care. Over the next decade, social determinants of health, AI, and technology will converge, create new opportunities, and redefine what caring for a patient looks like.
Omkar Kulkarni. Vice President, Chief Transformation Officer and Chief Digital Officer at Children’s Hospital Los Angeles: Through the convergence of personalized data, artificial intelligence and digital access, patients in 2034 will be more empowered, knowledgeable and in control of their health and healthcare than they are today. They will be more informed about how to maintain and manage their health and the health of the ones they care for (e.g. their children). Healthcare services will be conveniently offered in the home, in schools, and on devices and when required, in clinics or hospitals.
Mark Townsend, MD. Chief Clinical Innovation Officer at Bon Secours Mercy Health (Cincinnati): In 10 years, healthcare must be prepared for the overwhelming majority of our patients to ‘believe that they know more about their health than physicians or healthcare experts do.’ Empowered by consumer-mediated technology that will ingest hundreds, if not thousands, of data-points per individual, patients will have tools at their disposal that will be more convincing than ever. How will we as health systems ingest that data to partner with our patients? What privacy and compliance related concerns will exist about storage of that data, let alone monetizing that data? How will we convince patients that technology is, at times, wrong? If healthcare delivery has not stayed ahead of the technology-trust curve, I can only imagine that we will have growing populations of patients who believe they no longer need a traditional physician relationship, let alone traditional healthcare delivery. In 10 years, the sickest of the sick will still need an ICU, but the era of technology-mediated ‘autonomous healthcare delivery’ will be upon us.
Ebrahim Barkoudah, MD. System Chief of Hospital Medicine at Baystate Health (Springfield, Mass.):
My predictions for 10 key ways healthcare delivery is likely to be different 10 years from now:
Karen E. Hunter, RN. Chief Nursing Informatics Officer at Adventist Health Roseville (Calif.): Healthcare delivery is poised for significant transformation driven by advances in technology and data integration over the next decade. One of the most impactful changes will be the automation of data and information intake, reducing the cognitive burden on clinicians and allowing them to focus more on patient care.
Here are some details in my vision of how healthcare delivery will evolve through automated data collection:
In summary, the future of healthcare delivery will be characterized by seamless data integration and intelligent analysis, enabling clinicians to focus on delivering compassionate, patient-centered care.
Tarun Kapoor, MD. Senior Vice President and Chief Digital Transformation Officer at Virtua Health (Marlton, N.J.): To be honest, I’m having trouble figuring out what things look like in the next three to four years, let alone 10 years from now. That stated, people will continue to get sick 10 years from now and they will reach out to organizations they trust to help them get better (and ideally reach out to those organizations before they even become ill). Some of those organizations exist today and will still be successful in 10 years, and some of those organizations will not. And a number of those organizations who will be amongst the most successful in 10 years haven’t even been created yet.
Garrett Olin. Chief Information Officer at Shasta Community Health Center (Redding, Calif.): AI maturity will see utilization increase in many areas, providing better insight into diagnoses, treatment, prescribing and health management, which will improve delivery and outcomes. Continued improvement in mobile technology will also see increased utilization for delivery. Virtual encounters with integration of remote monitoring and imaging will allow for easier access and engagement. Last, the EHR will be more automated and streamlined, reducing the stress and burnout of clinical staff. The production of orders, referrals, scripts and documentation will be integrated with automation and voice commands for ease of use.
Komal Bajaj, MD. Chief Quality Officer at NYC Health + Hospitals/Jacobi/NCB: My hope is that in the next decade, healthcare delivery will be revolutionized by advancements in personalized medicine, bolstered by artificial intelligence and breakthroughs in therapeutics. The proliferation of digital technologies and delivery of care wherever patients are should allow for more proactive management and improved diagnostic safety. Integrated health systems and value-based care models will lead to improved coordination as well as higher quality, planet-friendly care.
John Donohue. Vice President, Entity Services at Penn Medicine (Philadelphia): Other than the obvious changes driven by technology advancements, a few things come to mind that will impact the delivery of healthcare in 10 years. I see a world where telemedicine and remote care are even more prevalent. Providers will routinely leverage data analytics and AI for improved outcomes. Healthcare organizations will need to continue to shift towards a more personalized patient centric care. Lastly, I think the headwinds on patient facing staff will require an evolution of healthcare professionals.
Muhammad Siddiqui. Chief Information Officer at Reid Health (Richmond, Ind.): Healthcare will transform with personalized treatments using genomics and data analytics. Telehealth will integrate remote monitoring and AI-powered diagnostics for early disease detection. Seamless interoperability of electronic health records will improve care coordination, while smart infrastructure will enhance operational efficiency and patient experience.
The focus will shift from reactive treatment to proactive prevention, using predictive analytics to reduce chronic disease incidence and promote overall wellness. This transformation will lead to better health outcomes, improved patient satisfaction and a more sustainable healthcare system.
Rosemary Ventura, RN. Chief Nursing Informatics Officer at University of Rochester (N.Y.) Medical Center: In 10 years, I see a few key differences: we will have a much more informatics-savvy and educated workforce. Graduates of today’s clinical programs will learn differently and integrate AI and other advanced technical tools to develop their professional practice skills. Additionally, the way we provide healthcare will be different. We will see exponential growth in the telehealth space, along with computer vision and generative AI for better decision making and tailored healthcare delivery.
Brian D’Anza, MD. Division of Rhinology, Sinus, and Skull Base Surgery and Lead, Innovation and Digital Health, University Hospitals Ear, Nose & Throat Institute (Cleveland): Digital health technologies and AI in particular will be more mature and embedded in healthcare. If we do our jobs right for the next decade (along with some permanent legislative changes) we will have more data on how these technologies improve the actual wellbeing of our patients (and where they don’t). Instead of seeing AI as a replacement for providers or most caregivers, we will realize that care delivery works best when a human connection is augmented by AI whether it be diagnostic, therapeutic, procedural or administrative tasks.
Neel Butala, MD. Medical Director of Structural Heart Disease and Intervention at VA Eastern CO Healthcare System: I think the biggest change in healthcare delivery 10 years from now will be the use of AI to automate tasks to enable strategic workforce enhancement. Clinicians will be able to spend more time with patients if AI scribes can help with medical documentation. Similarly, non-clinical staff will be able to engage in higher order and innovative activities if AI helps streamline routine manual processes.
Nabil Chehade, MD. Executive Vice President and Chief Clinical Transformation Officer at MetroHealth (Cleveland): By 2035, healthcare would be influenced by the rapidly aging population in the US, the personalization of medicine, advances in regenerative medicine and the democratization of health care:
By 2035, the aging population in the U.S. will significantly impact healthcare, necessitating an evolved focus on chronic disease management, aging in place, and end-of-life support at home. This transformation will be driven by the integration of smart AI and machine learning technologies into homes and wearable devices, facilitating comprehensive and personalized care. Personalized medicine, empowered by advanced genomic technology integrated with electronic medical records, will enhance preventive care and enable curated treatment plans. The progress in regenerative medicine will further provide new treatments for previously incurable diseases. The democratization of healthcare aims to eliminate health inequities by shifting care from hospitals to outpatient settings, homes, and communities. This approach empowers care everywhere by removing barriers to access and making healthcare more affordable. It emphasizes healthcare consumerism and provides effective, accurate, and personalized self-service tools at minimal or no cost to the individual.
Thomas Maddox, MD. Vice President, Digital Products and Innovation at BJC HealthCare (St. Louis).: I believe (or at least hope) that care will be much more personalized, proactive and oriented to helping patients stay healthy. Health systems should evolve towards truly knowing a patient’s background, needs and risks, then designing a care plan with them that proactively provides the health care and education needed to maintain optimal health. To achieve this, health systems will need to continue to invest in their data and engagement capabilities, merging digital and physical touchpoints. In addition, healthcare reimbursement policies need to continue to move towards a value-based position, so that health systems are incentivized to maintain a patient’s health in an effective and cost-efficient manner.
Kerri Webster, RN. Vice President and Chief Analytics Officer at Children’s Hospital Colorado (Aurora): My hope is that technology will have a huge impact on the healthcare delivery of the future. I envision a landscape where we can leverage technology to deliver safe, equitable care for all. I see the personalization of healthcare delivery expanding to be responsive to individual clinical/physical needs, preferences and values. Whether through telehealth, wearables, remote monitoring, integration of data, access to information or advanced AI capabilities, I believe there will be a deepening in partnership of the patient with healthcare providers in shared decision making and collaboration. New technology will support more automation and direct feedback that will empower the patient to be more informed and responsive to their own health needs. I believe we will make inroads in data sharing practices that make it seamless for the patient when seeking care across the healthcare ecosystem, regardless of system or location.
Betty Jo Rocchio, RN. Senior Vice President and Chief Nurse Executive at Mercy Health (St. Louis): Healthcare will have a change in delivery model that is partially driven by opening up different sites of care. With the developments in AI, our most precious resource, people, will have information delivered in ways that assist with their critical decision making for patients helping to reduce workload on the care team and improve outcomes for patients.
John V. Prunksis, MD. Medical Director and Principal at DxTx Pain & Spine (Elgin, Ill.). In 10 years, artificial intelligence will be transformative in healthcare, making some specialties virtually obsolete as well as changing the healthcare delivery model in all medical specialties.
Zafar Chaudry, MD. Senior Vice President, Chief Digital Officer and Chief Information Officer at Seattle Children’s: The future of healthcare is likely to be much more patient-centered, accessible, and preventive. Artificial intelligence will play a bigger role in diagnostics, treatment plans, and even early disease detection. I expect widespread use of AI powered remote patient monitoring devices and telehealth consultations. Wearables and sensors will collect health data that AI can analyze to identify potential problems before they become serious. More advancements in genomics and treatments will be increasingly personalized based on an individual’s unique genetic makeup. There will likely be a greater emphasis on preventive care to keep people healthy and avoid costly interventions later. Managing and securing patient data will be crucial. Expect robust data security measures alongside increased transparency about how patient information is being used.
Robert Poznanovich. Chief Growth Officer at Hazelden Betty Ford Foundation (Chicago): Tech enable healthcare, well-being and care delivery will be the norm in 10 years with more in-home and whole patient care being drivers. Behavioral health, including substance use disorders, will be truly integrated (not siloed as it is today) into our health systems to realize the promises associated with treating the patient’s physical health, behavioral health, and social services needs.
Data will be used more strategically across the continuum to improve and reward outcomes. Of course, virtual reality and generative artificial intelligence will play a greater role in health education and well-being and in ways we can’t yet even imagine today. I expect the efforts we are making today to enhance/adopt consumerism and patient choice to be the expected norm and that we will continue to remove health equity barriers and further reduce waste efforts to adopt consumerism and patient choice, alleviate equity barriers and harness efficiencies while reducing time wasted.
Chris Rucker. Chief Strategy Officer at Valley Health System (Las Vegas): I believe we will continue to see advances in personalized medicine and personalized experience, largely driven by the advancements and proliferation of artificial intelligence. This work will ultimately converge to improve access, improve disease management and support patient driven self-care.
Stephen Parodi, MD. Executive Vice President, External Affairs, Communications, and Brand at The Permanente Federation (Oakland, Calif.): Adoption of value-based care has accelerated in recent years, and we expect this trend to continue as health plans, physicians, employers and the government continue to embrace this model. Value-based care emphasizes and rewards preventive care, effective management of chronic conditions and positive health outcomes while making care more affordable. Innovative technologies and processes will play critical roles in this transition as healthcare organizations move to providing greater access and delivering more care into patients’ homes, shift to team-based care models, and increasingly focus on data-driven, evidence-based medicine. I fully expect that the healthcare workforce’s efforts will be amplified and augmented by artificial intelligence whether it is ambient or generative applications.
Jason M. Raidbard. Executive Administrator of Ophthalmology and Visual Sciences at UChicago Medicine and Biological Sciences: Healthcare delivery in the next 10 years is likely to significantly transform the industry with the advancements in technology, key policy changes, and patient/market expectations.
Technology specifically will continue to change and grow the healthcare delivery process. Telemedicine will continue to grow providing patients greater access and convenience to care. Technology will also have a heavy influence on patient outcomes. Remote monitoring will increase allowing a care team to evaluate more than one or two diagnostic measurements performed at an office. As this technology expands and becomes more widely accepted the costs will go down for the consumer making the use of remote monitoring more appealing and accessible.
AI will continue to assist in helping a healthcare team diagnose patients, both on an acute, but also on a preventive basis, customizing suggestions and options based on the patients health history and family history. We will also see unified electronic medical record systems evolve ensuring seamless access to patient information and transitions of patient care between healthcare organizations.
Lifestyle medicine will also become a more integrated part of primary care, giving patients more healthcare options for their care, specifically in preventive care. We will also see the lowering of age ranges with various preventive tests (colonoscopy and mammogram as examples) to ensure diagnoses are caught earlier.
Policy changes will occur as we completely evolve from the paper medical record systems of 10-15 years ago to completely electronic healthcare systems. Federal and state policies will need to be updated to better ensure both patient privacy and security of their health information. Patients will also demand their healthcare insurance plan expand the provider network, which coupled with the integration of electronic medical record systems, should improve patient care coordination.
These changes will hopefully create a more patient centric healthcare delivery system, improving both healthcare outcomes and accessibility, in turn reducing the burden on our valuable healthcare providers and healthcare teams.
Novella W. Thompson. Administrator of Population Health and Post Acute Care at UVA Health University Medical Center (Charlottesville, Va.): In 10 years, healthcare delivery will be more technologically advanced, with AI and big data supporting predictive analyses to identify at-risk populations and provide targeted interventions, as well as diagnostics, treatment planning, and personalized medicine. Preventative strategies will be tailored to genetic profiles and improve efficacy while reducing adverse effects. Integrated and value-based care models will increasingly focus on value and quality, incentivizing providers to coordinate care facilitated by advanced health information exchanges and interoperable electronic health records. These substantial changes bring much to celebrate as we aim to enhance patient outcomes, improve access to care, and manage costs effectively.
Kaitlyn Torrence. Executive Director at MUSC Health Solutions (Charleston, S.C.): With the rapid transformation our industry is undertaking, it’s a challenge to know what our future holds in one year, much rather 10! I envision the healthcare delivery ecosystem as a whole to look much different, with a few key components:
Care will be constant, on-demand, and provided in a holistic manner focused on patient/consumer demand with greater focus outside of our hospital walls. This will be initially driven by virtual care, RPM and telemedicine, but quickly advancing beyond this to a variety of modalities, which will require both new technologies and an up-skilled workforce ready to embrace the changes (i.e. all medical training schools should and will have courses on telehealth, AI and tech adoption).
As a result of our shrinking workforce and access challenges, every role across healthcare will look different and (hopefully) be optimized by automation, AI and top of license policy changes.
Sicker, chronically ill and aging populations will drive us toward greater expansion of value-based care and enhanced focus on population health for capacity management, if nothing else (although we know the incentives are much bigger than this!). Precision medicine and genomics will have widespread clinical application both for treatment and research. They will be equitably deployed to create a new level of advanced care delivery and patient-driven decision making.
Reed Smith. Chief Consumer Officer at Ardent Health (Nashville, Tenn.): Tech will empower consumers to control their care journey, leading to significant changes in care delivery over the next 10 years. Care is already shifting to the home, enabled by technology. Healthcare providers must understand how the consumer journey will evolve, how technology will create new friction points, and how it will solve today’s needs. The consumer experience will differ with each visit, and looking 10 years ahead, it’s hard to imagine that today’s practices will remain unchanged.
Reid Stephan. Vice President and Chief Information Officer at St. Luke’s Health System (Boise, Idaho): In 10 years, healthcare delivery will likely be transformed by advanced technologies such as AI and machine learning, enabling highly personalized treatment plans and predictive analytics for disease prevention. Telemedicine and remote monitoring will become standard practice, enhancing access to care, especially in rural and underserved areas. Additionally, the integration of electronic health records with interoperable health data systems will streamline patient care and improve outcomes through seamless information sharing across providers and institutions.
Edward Lee, MD. Director of Clinical Informatics at California Northstate University College of Medicine: Bill Gates once famously said, “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten.” This underscores the challenge of predicting the future of healthcare. Up until a couple of years ago, most had never heard of generative AI, much less predicted the explosion of activity surrounding this emerging technology. The breakthroughs that will transform care delivery in the coming decade likely haven’t been invented yet. However, with focus on the quintuple aim, my hope and expectation is that care will become increasingly person-centered, with diagnoses and therapies tailored specifically to the individual patient, leading to personalized, high-quality experiences. Additionally, the clinician burnout crisis will see significant improvement through the optimized use and mastery of digital health technologies, including generative AI and other augmented intelligence tools.
Rahul Kashyap, MD. Medical Director, Research at WellSpan Health (York, Pa.): By 2035, there will be a major shift in healthcare economics. The value-based care models will continue to evolve with even higher focus on quality outcomes and cost-effectiveness. The use of technology such as virtual reality and augmented reality will be increased for medical training, patient education, and therapeutic interventions. Blockchain technology will be adopted to enhance the security and interoperability of health records and transactions. To address holistic patient needs, mental health services will be more integrated into primary care.
Jessica Schlicher, MD. Chief Medical Officer of Virtual Care and Digital Health at Providence (Renton, Wash.): In the near future, every human will have access to democratized medical knowledge, woven together with curated, human-in-the-loop AI. We will create a world where health disparities due to inequities in healthcare access will decrease. That’s the future we’re working to build with MedPearl at Providence.
Lisa Stephenson, RN. Chief Nursing Informatics Officer at Houston Methodist: I’d like to believe that the digital evolution and growth of AI within healthcare will improve the current issue of equitable access to healthcare. Increasing virtual care and remote monitoring trends will enable consistent care to those unable to physically get to healthcare facilities either due to geography, transportation or financial limitations. AI models will help to provide early detection for at risk populations and provide recommendations on care paths to ensure we reach patients more proactively and no one falls through the cracks.
Yoemy Waller. Chief Information Officer at Lake Health District Hospital (Lakeview, Ore.): The healthcare industry is poised for transformative changes over the next decade, driven by advancements in technology, data analytics, and personalized medicine. As a healthcare data scientist, envisioning these future trends is necessary for preparing and adapting to the evolving landscape. The integration of genomic data into healthcare will revolutionize how treatments are tailored to individual patients. By analyzing genetic profiles, healthcare providers can develop personalized treatment plans and preventive strategies that are highly specific to each patient’s genetic makeup.
Artificial Intelligence and Machine Learning: AI-powered diagnostic systems, treatment delivery and prevention will become commonplace, providing faster and more accurate diagnoses, prevention, and maintenance of wellness. These tools will analyze vast amounts of data to identify patterns and anomalies that may not be immediately apparent to human clinicians. Machine learning will play a huge role in predicting disease outbreaks, patient deterioration, and treatment outcomes. Predictive analytics will enable proactive healthcare interventions, improving patient outcomes and reducing costs.
Big data analytics will enhance clinical decision-making and operational efficiency. By analyzing large datasets, healthcare providers can uncover insights that improve patient care and streamline hospital operations. The use of apps and online platforms for mental health assessment and therapy will expand, making mental health care more accessible. Regulatory frameworks will adapt to keep pace with technological advancements, ensuring patient safety and the efficacy of new treatments and devices. These advancements will collectively transform healthcare delivery, making it more efficient, personalized, and accessible. As healthcare data scientists, staying at the forefront of these changes will be essential for driving innovation and improving patient outcomes in the coming decade.
Amy Zolotow. Director of Operations at Mercy Personal Physicians: Over the next decade, healthcare delivery will increasingly focus on personalization, leveraging advancements in genomics, digital health technologies and artificial intelligence. Genomic medicine will enable tailored treatment plans based on individual genetic profiles, predicting disease risks and optimizing medication efficacy. Wearable devices and continuous monitoring tools will gather real-time health data, providing personalized insights and early intervention strategies, even in the comfort of patients’ homes. AI algorithms will analyze extensive patient data to offer personalized recommendations for lifestyle modifications, preventive screenings, and treatment options. Virtual reality and augmented reality will further enhance patient education and rehabilitation programs, tailored to individual preferences and needs. Ultimately, these personalized approaches will empower patients, improve health outcomes, and redefine the standard of care across diverse healthcare settings.
Khurram Mir. Director of Innovation and UCI Health Ventures at UCI Health (Irvine, Calif.): The healthcare industry is on the brink of significant transformation, driven by innovative solutions that promise to reshape the delivery of care. Emerging trends are providing a window into what the future of health could look like in the near future.
Artificial Intelligence will be a critical enabler in both the front and back offices of healthcare. AI-driven systems will assist in managing logistics, from patient flow to supply chain management leading to creation of smart hospitals and clinics. Telehealth has rapidly evolved, especially during the pandemic, and will continue to find its place within the spectrum of care delivery. Advances in home health technologies will enable the safe delivery of more complex care at home. From hospital-at-home programs to home-based diagnostics and treatment devices, patients will receive high-quality care without leaving their homes. Seamless integration of health data across various platforms will allow for a holistic view of a patient’s health history.
For us to truly harness the potential of these and any future innovations in the next decade, it is imperative to rethink our current processes and policies. We cannot yield optimal returns if built on outdated or inefficient processes. Addressing the underlying issues, such as the interoperability of health records, data privacy, and the integration of new technologies into existing workflows, is crucial for realizing the full benefits of these advancements.
Brendan Lloyd, MD. Chief Administrative Officer at Providence Clinical Network: The shortage of physicians, and primary care physicians in particular, is a concern that keeps me up at night and is a problem that all of us in healthcare need to think through for the years to come. We are already starting to experience this shortage, and we are all having to do more with fewer physicians. We must test, refine, and scale alternative care models and technologies that extend the reach of each physician to more patients. Team-based care, telehealth, inbox management tools, and remote patient monitoring will continue to improve and have a positive impact on how we provide care a decade from now. Force multipliers such as these for physicians will be key to improving quality and patient experience without burning out physicians.
Benjamin Kummer, MD. Director of Clinical Informatics in Neurology at Mount Sinai Health System (New York City): I anticipate that in 10 years, face-to-face encounters with physicians and other healthcare providers will be no more, or virtually non-existent. Healthcare will have a fully connected suite of constant-monitoring, asynchronous technology products that will enable much more frequent communication between care teams and patients/families. Also, the “Uber/Amazon experience” will come to patient care. Patients and families will engage with technology platforms first and foremost much like they interact with Amazon and ChowNow for those services – and these will connect patients to care teams. There will also be a much more robust objective measurement technology for poorly quantified clinical states like neurological disorders using sensors, video, and geolocation. And LLMs and AI will have automated most of the rote, administratively taxing tasks like billing, documentation, prior authorization, and screening in electronic health records.
Walker L. Dupre. Director of Virtual Care Center at Ochsner Health System: Healthcare delivery will see a significant shift with the increased adoption of telemedicine, virtual nursing, and remote monitoring, providing more accessible and continuous care. There will be improved access to healthcare in underserved and rural areas and policies will evolve to address disparities in healthcare access and outcomes. These changes will lead to a more efficient, patient-centered healthcare system, improving overall outcomes and quality of life.
Paul Capello. Corporate IS Project Manager at Shriners Hospitals for Children: Predicting the future of healthcare delivery is complex given the rapid pace of technological advancements, shifting demographic landscapes and evolving regulatory environments. However, several trends and innovations are on a likely path to significantly transform healthcare delivery by the next decade. Here are some of the key areas that are expected to change:
Overall, the future of healthcare is likely to be more personalized, accessible, and integrated, leveraging technology to meet the challenges of global health needs and evolving patient expectations.
Mergers are providing hospitals with access to new and advanced EHR systems.
Here are the hospitals and health systems that are implementing new EHR systems or extending EHR systems to other facilities due to mergers or acquisitions:
Closing arguments are set to begin Monday at the bribery trial of New Jersey Sen. Bob Menendez.
The closings were scheduled to start in the afternoon as the trial enters its ninth week in Manhattan federal court. Prosecutors planned their initial closing to last about five hours so it was unlikely they would get more than half through it before the jury is sent home for the day.
Prosecutors are expected to tie together the evidence they’ve presented against the Democrat to support their claim that gold bars, over $480,000 in cash and a luxury car found during a 2022 FBI raid on Menendez’s residence are the proceeds of bribes paid by three New Jersey businessmen.
In addition to testimony from several dozen witnesses, prosecutors introduced hundreds of documents, emails, text messages, phone records and other factual evidence.
In return for bribes, prosecutors say, the senator took actions from 2018 to 2022 to protect or enhance the business interests of the businessmen. They say some of the crimes occurred while Menendez held the powerful post of chairman of the Senate Foreign Relations Committee.
Menendez, 70, and two of the businessmen have pleaded not guilty and are on trial together. A third businessman pleaded guilty in the case and testified against the others during the federal trial, the second the senator has faced in the last decade. None of the defendants testified.
An earlier trial against Menendez in New Jersey ended in 2017 with a deadlocked jury.
Nadine Menendez, 57, the senator’s wife, is also charged in the case, but her trial has been postponed while she recovers from breast cancer surgery. She also has pleaded not guilty.
As part of his defense, Menendez’s lawyers have argued that the gold bars belonged to his wife and that tens of thousands of dollars in cash found in Bob Menendez’s boots and jackets resulted from his habit of storing cash at home after hearing from his family how they escaped Cuba in 1951 with only the cash they had hidden in their home.
His lawyers have also asserted that Nadine Menendez, who began dating the senator in 2018 and married him two years later, kept him in the dark about her financial troubles and assistance she requested from the businessmen.
Menendez was born in Manhattan after the family moved to New York City, though he was raised in the New Jersey cities of Hoboken and Union City, according to testimony by his sister.
Menendez has held public office continuously since 1986, serving as a state legislator before serving 14 years as a U.S. congressman. In 2006, then-Gov. Jon Corzine appointed Menendez to the Senate seat he vacated when he became governor.
Several weeks ago, Menendez filed to run for reelection this year as an independent.
Defense spending, federal telework, and a measure to keep expelled former Rep. George Santos off the House floor are among the issues facing lawmakers this week, as both chambers face one of their busiest weeks of the year on government-funding bills.
The House is set to hold six markups in the House Appropriations Committee and vote on one funding bill on the floor. The Senate is set to hold its first markups of the year on three bills in the full Appropriations Committee.
This week will put a spotlight on the House-Senate rift over how much money to spend overall in the fiscal 2025 appropriations process. House Republicans reneged on an agreement to allow a 1% increase across the board, instead planning a 6% cut to nondefense funds. Senate Republicans, and many colleagues in the House, have said they’d like a bigger increase for the military. But Democrats in both chambers have said any boost to defense would have to be matched by an equal increase to nondefense.
Senate appropriators are set to mark up their Agriculture-FDA, Legislative Branch, and Military Construction-VA spending bills Thursday, and to vote on the full slate of top-line allocations for all 12 fiscal 2025 funding bills. Last year, Senate Democrats set the top-line allocations and the individual bills were negotiated in a mostly bipartisan way.
House Republicans aim to pass their Legislative Branch appropriations bill this week, which would be their fifth funding bill passed this year — a smoother start to the process than members saw last year.
Santos (R-N.Y.), the expelled former representative, would be kept off the House floor — and out of the congressional gym and dining facilities, among other restrictions — under an amendment offered by a bipartisan group of lawmakers led by Rep. Josh Gottheimer (D-N.J.). The provision, which doesn’t mention Santos by name, would broadly bar any former member of Congress who was expelled from office from the House floor, Senate floor, and other facilities typically provided to former members of Congress. It would also bar expelled members from the United States Association of Former Members of Congress, a nonprofit that includes the Congressional Study Groups, which organize legislative exchanges with US allies.
Another amendment, offered by Rep. Andrew Clyde (R-Ga.), would strike a provision to block an automatic raise for members of Congress. House appropriators initially left the measure out of the bill, allowing for the possibility of the first congressional pay raise since 2009, but they added it back in during a markup.
Reps. Pete Aguilar (D-Calif.) and Juan Ciscomani (R-Ariz.) offered a measure to allow immigrants under the Deferred Action for Childhood Arrivals designation to work for the Legislative Branch.
The House Rules Committee meets today to determine which amendments to the Legislative Branch bill will get votes.
House appropriators are set to mark up six bills: Commerce-Justice-Science, Interior-Environment, and Energy and Water tomorrow, and Labor-HHS-Education, Transportation-HUD, and Agriculture-FDA on Wednesday.
The bills cover a wide range of policy disputes. Democrats objected to the Commerce-Justice-Science bill’s cuts to the FBI and other federal law enforcement agencies. They also criticized the steep cuts to agencies under the Labor-HHS-Education bill, which add up to an 11% cut overall.
House Republicans also plan to include directives calling for more telework transparency in the report accompanying their Labor-HHS-Education bill. One provision would direct agencies to publicly post online how many employees come to work in person in Washington, and another would demand an accounting of Education Department and Health and Human Services employees who receive Washington-area locality pay but don’t frequently work in office.
The Agriculture-FDA, Energy and Water, and Transportation-HUD bills are also major vehicles for earmarks. The House Appropriations Committee has posted PDF documents with all the earmarks included in its funding bills.
Congress returns for a six-week sprint to address government funding and expiring authorizations.
House appropriators are on track to pass all 12 appropriation bills by the end of July and the Senate Appropriations Committee is slated to begin marking up its spending measures this week. Disagreements on funding levels and policy riders mean lawmakers will likely need to pass a stopgap funding bill before the fiscal year ends on Sept. 30 to avert a government shutdown.
The annual defense authorization, five-year farm bill, and expiring telehealth policies also face looming deadlines. Lawmakers are also seeking to finalize agreements on water infrastructure and workforce development measures by the end of the year.
The attached presentation outlines the congressional calendar for the rest of the year and dates to watch on key legislative items.
Dates to Watch in Sprint to End of Fiscal Year, Elections
House appropriators are on track to pass all 12 appropriation bills by the end of July and the Senate Appropriations Committee is slated to begin marking up its spending measures this week.
The IRS is getting granular in its look at whether tax-exempt hospitals are living up to their requirement to meet community benefit standards, examining whether nearly three dozen such institutions are providing a broad, loosely defined range of services.
The agency raised questions last month when it announced it will audit 35 tax-exempt hospitals this fiscal year as part of a stepped-up focus on the sector. The IRS has not historically gone after tax-exempt hospitals for their compliance of community benefit requirements. But after a $60 billion infusion from the Democrats’ 2022 tax-and-climate law, plus congressional pressure to apply greater scrutiny toward tax-exempt hospitals, the IRS is taking a closer look that could potentially ripple across an industry exempt from tens of billions of dollars in federal taxes.
“Community benefit” is described vaguely on the IRS’s Form 990, but is generally understood to encompass unreimbursed Medicaid services, research, and subsidized health services. The IRS is required to review hospitals’ community benefit activities at least once every three years, though a 2023 report by the Government Accountability Office found the agency’s enforcement on that front has been lacking.
The IRS declined to specify what triggered this new round of examinations. But the process could result in both a slap on the wrist for the few hospitals selected for audit, and also an effect of voluntary compliance from the nearly 3,000 other tax-exempt hospitals nationwide, tax experts said.
Ge Bai, an accounting and health policy professor at Johns Hopkins University, expects the hospitals being audited to receive a “do better” message. Meghan Biss, a former tax-exempt adviser at the IRS for over a decade who is now a partner in Loeb & Loeb LLP’s tax-exempt practice, anticipates the IRS will see a wave of tax-exempt hospitals not under review start complying.
The estimated value of tax exemption for the country’s 2,987 nonprofit hospitals totaled nearly $28 billion in 2020, according to KFF. Former IRS officials say this new round of audits could reverberate across the industry.
“When you look at 35 hospitals as a percentage of the total number of examinations, that seems like a much higher percentage and signals that this is a place where the IRS is taking things seriously and where organizations should be paying attention,” Biss said.
Preston Quesenberry, a former tax-exempt official with the IRS who is now a managing director in KPMG’s Washington National Tax Office, said he’s surprised the IRS is focusing on community benefit because he’s not seen the agency concentrate on the specific compliance category before.
Tax-exempt hospitals have been requested to provide the IRS information about how they calculate the cost of facilities reported under the community benefit section of their tax returns, particularly line seven on Schedule H of IRS Form 990, according to Quesenberry, who said he spoke with two tax practitioners involved with hospitals being audited by the IRS. Line seven is where hospitals report their “total financial assistance and means-tested government programs,” including Medicaid as well as other community benefits such as research, health professions education, subsidized health services, and cash contributions for community benefit.
“It’s not clear to me what the IRS could or would do in the end as a result of these exams,” Quesenberry said. “Even if they have an appetite to actually go around revoking the tax-exemption of hospitals, which I don’t think they do, it’s not that clear to me that they would have a legal basis to do so based on the community benefit percentage numbers.”
Keith Hearle, who assisted the IRS in drafting instructions for hospitals filling out Schedule H when that requirement went into effect in 2009, said he is aware of one medium-sized urban teaching hospital that’s among the 35 hospitals that received a request for information. Hearle, the president of Verite Healthcare Consulting, said he normally works with that hospital but is not advising it on the audit.
The IRS is trying to be constructive, not punitive, Hearle said, adding that hospitals have had longer than a decade to figure out how to report their community benefit on Schedule H, which was added to Form 990 in 2008. Hearle said the only way he could see the IRS generating revenue from these reviews is if it enforces a $50,000 fine looming over hospitals that don’t comply with their triennial community health needs assessments. He recommended the IRS update Form 990 to include more write-in answers for hospitals to be able to explain, for example, how many people applied for charity care and why some were rejected and others accepted.
T.J. Sullivan, a former special assistant for health care at the IRS now with Potomac Law Group, said that although it is hard to examine hospitals for community benefit, 35 is a significant number of audits.
The IRS, which said it will verify whether tax-exempt hospitals are submitting their assessments in addition to meeting community benefit requirements, did not specify which hospitals it is auditing or plans to audit, citing taxpayer confidentiality and disclosure laws.
“We have our tax-exempt division, they are organized to make sure that they have a strong enforcement program, that organizations are operating within their exempt purpose,” IRS Commissioner Danny Werfel said after addressing the Tax Policy Center’s June conference. “That is not necessarily looking exclusively at the tax gap and the dollars, because the important part of tax administration is building trust.”
The nonpartisan Committee for a Responsible Federal Budget said there is insufficient enforcement of nonprofit hospitals’ tax-exempt requirements and no “unambiguous federal statutory or regular definition” of community benefits, in a report released in June. The American Hospital Association, which represents nearly 5,000 nonprofit and for-profit hospitals, pushed back in June on the report, saying that to repeal a nonprofit hospital’s tax-exemption is irresponsible. The association declined a request for comment.
However, some wonder if the audits’ scope could expand beyond hospitals’ community benefit while many are skeptical about what such audits can lead to or whether the self-reported information and instructions to report it are sufficient.
“We don’t know yet,” Rep. David Schweikert (R-Ariz.) said, discussing whether the audits will lead to anything. “We can’t do that math,” he added, referencing the tax code that says community benefit needs to equate or exceed value of tax exemption.
Yet, the 35 audits still came as a surprise to some, including Jessica Lucas-Judy, the GAO director who led the 2023 report.
“I would be very interested to see what the IRS is able to do with audits of the community benefit because what they told us was that it’s not well-defined, kind of a ‘we’ll know it when we see it” sort of thing,” Lucas-Judy said.
House Republicans are proposing to take away billions of dollars from health care and social programs and slash funding in their budget plans for agencies responsible for enforcing worker protection laws.
The party’s appropriators unveiled Wednesday a $185.8 billion Labor-HHS-Education bill for fiscal 2025, which amounts to 11%, below current effective funding levels. The Department of Health and Human Services would receive $8.5 billion—or 7%—less in the next fiscal year while the Labor Department would shrink by 23%.
This particular spending package, typically controversial given the partisan divisions over social policy, didn’t even make it to a full Appropriations Committee vote last year given its deep cuts and programmatic changes. Republicans this year have proposed cuts that aren’t nearly as steep, but would still gut some federal programs.
Some policy riders that split lawmakers remain: Federal programs to research climate change, provide sex education, and gun violence would end under the bill. Planned Parenthood would be banned from receiving federal family planning grants.
Some health agencies, such as the National Institutes of Health, would see relatively stable funding under the proposal while others, namely the Centers for Disease Control and Prevention, would face a steep cut. The CDC would lose about 22% of the agency’s $9 billion budget.
Despite the opposition to such large funding cuts, Republican appropriators say they’re confident in their proposal.
This bill “provides needed resources to agencies for administering vital programs, while also reining in reckless and wasteful spending,” the bill’s author, Rep. Robert Aderholt (R-Ala.), said in a statement. “While we still have a ways to go, I believe this bill lays a strong foundation for the path to transparency and fiscal responsibility.”
Labor Department officials have long said the agency needs more money to enforce the nation’s labor laws. But they are getting no sympathy from House Republicans, who are looking to reduce federal spending and have expressed opposition to the department’s regulatory moves.
The National Labor Relations Board, a separate agency that enforces laws related to unionizing, would also be massively underfunded in the bill as Republicans say it has ruled mostly in favor of unions. The proposal would deal a $99 million cut to the NLRB in the fiscal year starting Oct. 1.
The main enforcer of child labor laws, the Labor Department’s Wage and Hour Division, would get $25 million less in the next fiscal year despite agency leaders saying they need more money to fight the dramatic rise in children working illegally.
Republicans are also proposing to cut the budget of the Occupational Safety and Health Administration, in charge of workplace safety laws, by 12%, reducing it to $557.8 million.
Meanwhile, the Employee Benefits Security Administration, in charge of enforcing worker benefits laws, would get $181 million, a $10 million cut in the next fiscal year.
US hospitals should proceed with caution in resuming the use of popular technology that collects user information while the Biden administration weighs a response to a court order greenlighting the practice.
The US Department of Health and Human Services had issued guidance requiring health providers to take extra steps to protect data that third parties could use to identify website users who look up online information about their conditions. Google Analytics, YouTube, and other technologies commonly used by hospitals were among those the HHS had tried limiting through the guidance widely opposed by healthcare providers, according to a person familiar with the industry response.
A federal judge in Texas on Thursday backed the industry, blocking the HHS effort by vacating the guidance and putting the ball back in the agency’s court for how to respond.
Thursday’s order “gives hospitals some reprieve from what has clearly always been an over broad guidance,” said Kirk Nahra, co-chair of WilmerHale’s Big Data Practice and Cybersecurity and Privacy Practice. He said that the HHS could have used its guidance to show hospitals “how best to approach a very common practice – instead it is using this guidance as a basis for enforcement proceedings.”
The HHS “created mass confusion and led hospitals and others to make changes that make it harder for patients to get information and use hospital web sites.”
The decision likely isn’t the last action on the guidance. HHS can appeal the ruling to the US Court of Appeals for the Fifth Circuit or release new guidance that fits within the scope of the judge’s ruling. Another option is proposing a formal regulation, though such a move may prove difficult to implement with the US presidential election only months away.
“The story’s not over yet,” said Leon Rodriguez, who led the Obama administration HHS’ Office for Civil Rights. “I have to think that HHS is not going to just sort of say uncle here and leave the issue.”
Authored by Judge Mark T. Pittman of the US District Court for the Northern District of Texas, the decision found that HHS lacked authority to issue its guidance.
That guidance laid out how health providers were to use online tracking technologies without running afoul of the 1996 Health Insurance Portability and Accountability Act, or HIPAA, a move that was targeted by hospital and health groups with litigation.
The case wasn’t “really about HIPAA,” but rather “our nation’s limits on executive power,” wrote Pittman, who was appointed by former President Donald Trump and has been identified as part of an effort for conservatives to “judge shop” for challenges to Biden administration policies.
HHS spokespeople didn’t immediately respond to a request for comment on the order.
However the HHS ultimately responds to the ruling, it could face resistance.
“There is this trend in the courts to really dial back agencies’ ability, not only to get guidance, but even to regulate,” said Rodriguez, pointing to the Supreme Court’s Loper Bright Enterprises v. Raimondo. A decision in that case is expected by the end of the month and could limit HHS and other agency’s ability to defend their policies in court.
Some attorneys said that the decision accurately highlights flaws in the HHS guidance.
The guidance was “very difficult to interpret” and “unclear and contradictory,” said Linn Freedman, chair of Robinson + Cole’s Data Privacy + Cybersecurity practice. The decision, she said, was validating for hospitals that were struggling with it.
“People surf websites for all sorts of reasons, none of which necessarily has to do with their own health. It is impossible for health care entities to know why someone is looking at their website,” Freedman said.
The HHS’s first stab at guidance was through a 2022 bulletin. In 2023, the American Hospital Association and others sued the HHS over the guidance. In March of this year, the agency updated the guidance to assuage the plaintiffs’ concerns, though it wasn’t enough to drop the case.
Prior to suing the HHS, the AHA had spent time meeting with the agency to work out a compromise, a person familiar with the meetings said. The negotiations with HHS’s Office of Civil Rights were ultimately unsuccessful, the person said.
Even though the HHS can no longer enforce its guidance following Thursday’s order, “advice across the industry” has likely remained to proceed with caution, according to Brad M. Rostolsky, member of the Health Care & FDA Practice in Greenberg Traurig’s Philadelphia office.
Likely, the decision “lets folks reset back to pre-original guidance times for the moment, with the caveat that we know that the Office for Civil Rights is really focused on tracking technology vendors,” Rostolsky said.
And while hospitals can at the moment rely on “certain basic understandings about HIPAA,” Rostolsky said the HHS guidance remains important as it shows “where the focus is with the regulators.”
“It’s a good reminder to make sure that your house is in order. Look at your vendors, look at the information your vendors are touching, make sure that you’ve got the right agreements with those vendors,” Rostolsky said.
Yet AHA general counsel Chad Golder said the technologies were “extremely valuable technologies for hospitals.”
The technologies allowed hospitals “to provide accurate, reliable healthcare information to communities, whether it was through YouTube videos, translation services, map technologies, ways to surge resources into neighborhoods and communities where they saw a lot of online traffic, looking for certain things like vaccines,“ Golder said.
And under the guidance, they had to switch to “less effective, more expensive tools,” Golder said. “Hospitals are strapped financially, so every dollar that they spend on these things is a dollar they can’t spend on patient care.”
Still, “it’s important for hospitals to not necessarily think that they can do anything that they were doing in the past when it came to tracking technology,” said Jason Johnson, partner in Crowell’s Health Care and Privacy & Cybersecurity Groups
“I don’t think from an agency perspective this would do anything to dissuade HHS from continuing to issue guidance or even new rules,” Johnson said.
“I think HHS is likely to find another mechanism,” Johnson said. “This isn’t necessarily sort of a get out of jail” for hospitals.
THE STATE OF TELEHEALTH — As lawmakers weigh telehealth’s future with broad bipartisan support, it’s becoming clear that it hasn’t yet made the impact on cost and access that some thought it would.
Usage has fallen — to the disappointment of Congressional leaders and the investment and tech sectors, some of whom thought it could fundamentally transform the U.S. health care system.
In 2021, former Rep. Fred Upton (R-Mich.), a leading voice in Congress on health care until his retirement last year, called telemedicine “one of the best things, probably, since sliced bread.”
Now, evidence is growing that telehealth hasn’t delivered the anticipated broad cost savings, and that trend isn’t expected to change soon. In rural areas, which many believed would disproportionately benefit from virtual care expansion, usage has also been lower than in other areas.
“It hasn’t taken off like we thought,” Upton, who chaired the Energy and Commerce Committee, told POLITICO. “It can be [transformational], but progress is not as fast as we thought it could have been.”
Harvard researcher Dr. Ateev Mehrotra, who Congress often calls to testify on virtual care, has found that expanded telehealth has led to slight increases in visits and spending and “modest” improvements in quality.
Still, despite negative headlines and falling stock prices on Wall Street, it’s certainly not all doom and gloom for virtual care. Telehealth kept the health care system afloat in the pandemic’s early days, and it’s continued to broaden access and boosted outcomes in some areas, particularly in mental health and substance use disorder treatment.
Telehealth advocates argue that comparing early pandemic usage levels — when in-person care was limited — to the present isn’t fair. Overall, telehealth appointments represented about 6 percent of visits in late 2023, according to Epic Research. That’s up from 0.2 percent in mid-2019.
“When you’re dealing with a health care system for hundreds of millions of people, any improvement in outcomes is definitionally transformational,” said Sen. Brian Schatz (D-Hawaii), one of virtual care’s longest-running backers. “It’s quietly one of the most important stories in health care in the last decade.”
Outlook in Congress: Lawmakers are poised for a temporary extension of pandemic-era eased Medicare rules but still have questions about cost and fraud and seek more data.
“I’ve never said it’s going to reinvent health care,” said Rep. Mike Thompson (D-Calif.), one of the House’s strongest telehealth supporters. “I have plenty of examples where it’s saved lives and money. … It’s still in that trial phase.”
Nurses at one of the nation’s largest hospital-at-home programs have unionized, a move they hope could influence the future of in-home acute care and encourage more people working in home healthcare to join unions.
The union vote at Boston’s Mass General Brigham comes as hospitals push aggressively to expand care outside of their walls, while a worker shortage and increased demand for healthcare contribute to rising labor strife among caregivers.
Approximately 80 Mass General Brigham home hospital nurses voted overwhelmingly on May 16 to join the Massachusetts Nurse Association. The National Labor Relations Board certified the union to represent the nurses on May 24 and they are in the midst of selecting a bargaining team that will begin negotiating a contract with the hospital system within the next few months.
Plans to organize began about six months ago, according to Nahall Rad, a registered nurse who has been with Mass General Brigham’s home hospital program for six years. He said the nurses wanted a seat at the table with health system management as the acute care at home program evolves. The hospital system is set to expand the number of patients the program can accommodate from 50 patients a day to 200 over the next few years.
“From a nursing perspective, we want to ensure that our patients are getting the highest level of care possible,” Rad said. “I think a lot of the nursing staff has felt there have been times when that hasn’t happened or their voices weren’t quite heard. There seems to be a disconnect between the people making the large decisions and the rest of us that are on the front lines.”
A spokesperson for Mass General Brigham said in an email the hospital is disappointed the nurses elected to organize, but did not think unionization would impact expansion of the home hospital program.
“As an organization dedicated to providing safe, high-quality care to our community, we recognize the importance of working collaboratively with our nurses, physicians and other healthcare providers to address the needs of our patients and community. We remain focused on that critical mission,” the spokesperson said.
Mass General Brigham’s home hospital nurses decided to organize about a year after the provider’s residents and physician fellows voted to join a union and at a time when interest in union membership is rising among healthcare workers. That interest is driven by increased workloads, worker burnout and changes in the way providers are delivering patient care, such as acute care at home, according to labor experts.
“Much of these organizing efforts are based on similar themes that healthcare professionals increasingly have no voice in the implementation of new care delivery models or other decisions that are made by larger and more consolidated health system executives that are far away from the actual delivery of care,” said John August, director of healthcare labor relations for the Scheinman Institute of Conflict Resolution at Cornell University’s School of Industrial Labor Relations.
Hospital-at-home programs could be fertile ground for unions. The concept is relatively new in the U.S. It took off during the COVID-19 pandemic when the Centers for Medicare and Medicaid Services launched the Acute Hospital Care at Home waiver that let hospitals treat some patients where they live, rather than in facilities. Patients participating in the program get twice daily nurse or paramedic visits and are also monitored through telehealth and other technologies.
The waiver expires at the end of this year, but the 330 hospitals across 37 states that offer home hospital programs are aggressively lobbying Congress to make the waiver permanent or extend it. There is bipartisan support in both chambers to extend the waiver at least another five years.
But National Nurses United, a labor union representing 225,000 nurses nationwide, wants the waiver to end and hospital-at-home discontinued. A report on the union’s website said the program, which it dubs “Home All Alone,” puts patients at risk by not providing 24/7 access to a registered nurse or other clinical and technical resources that in-facility care offers. The union also said nurses working outside of hospital walls cannot draw on the clinical expertise of other staff such as pharmacists and respiratory therapists, if a patient’s condition worsens.
National Nurses United did not respond to questions on representation of hospital-at-home nurses. The Service Employees International Union and the American Federation of State, County and Municipal Employees, also did not respond to requests for comment about representation of home hospital nurses at facilities beyond Mass General Brigham.
UMass Memorial Health’s 33 home hospital nurses are members of the Massachusetts Nurse Association and are covered under the same bargaining unit as its other nurses, according to a spokesperson for the Worcester, Massachusetts-based hospital system. The program’s five paramedics belong to the National Association of Government Employees. But nurses who work for other large in-home acute care programs, such as those run by the Cleveland Clinic and Peoria, Illinois-based OSF HealthCare, do not belong to unions.
Registered nurses in the U.S. are largely nonunion workers, with only about 17% belonging to labor organizations, according to August.
Rad thinks the Mass General Brigham home hospital nurses might influence nurses at other hospital-at-home programs to organize and help shape the future of acute care in the home.
“We hope the direction we move things in, in partnership with our management team, will set the stage for a way that we can positively influence other home hospitals that are either already started or those programs that are on the cusp of starting,” Rad said.
The Centers for Medicare & Medicaid Services said it will shutter a program in July that it launched to ease cash flow disruptions at health-care providers impacted by a cyberattack on a UnitedHealth Group Inc. subsidiary.
Atlantic Health System, an integrated health care system setting standards for quality health care in New Jersey, Pennsylvania and the New York metropolitan area, and Mevion Medical Systems, the leading provider of compact single-room proton therapy systems, have announced Atlantic Health System’s plans to acquire and install a MEVION S250-FIT Proton Therapy System™* at the Carol G. Simon Cancer Center, located at Morristown Medical Center in New Jersey. The proton system is scheduled to be installed in 2025, and once in use will usher in a new era of cutting-edge radiation oncology services.
Proton therapy is an advanced form of radiation therapy that targets tumors more precisely compared to conventional photon therapy, thus minimizing damage to surrounding healthy tissue and critical organs such as the brainstem, heart, and lungs. A recent randomized clinical trial demonstrated that proton therapy achieved similar survival rates to traditional radiation therapy, but with fewer side effects in the treatment of head and neck cancers, meaning less malnutrition and feeding tube dependence for patients. The MEVION S250-FIT system further enhances these benefits with its industry-leading features. HYPERSCAN® Pencil Beam Scanning for Intensity Modulated Proton Therapy (IMPT) with a proton MLC, ensures precise delivery of proton therapy, minimizing damage to healthy tissue. Upright patient positioning and a large bore diagnostic CT from Leo Cancer Care allow for real-time image guidance and adaptive therapy.
Along with the tremendous benefits for patients, this collaboration signifies a major achievement, as Atlantic Health System is set to become one of the world’s pioneers in transforming a conventional LINAC vault to install the FIT proton therapy system. The FIT Proton Therapy System is the first and only full proton therapy system that can be seamlessly installed in an existing LINAC vault, significantly reducing the size, cost, and complexity of proton therapy.
“Introducing proton therapy is a transformative step in advancing state-of-the-art cancer services for our patients,” said Trish O’Keefe, PhD, RN, Senior Vice President and Chief Nurse Executive, Atlantic Health System and President, Morristown Medical Center. “By providing our dedicated physicians, nurses and team members with the latest technologies, we continue to empower them to provide the highest-quality care to our patients, their families and our community.”
A survey of 1,025 consumers conducted by remote patient monitoring company Vivalink Inc. found that 84% of respondents would be willing to participate in hospital-at-home monitoring if it allowed them to leave the hospital earlier. Further, of those who had participated in a hospital-at-home program, 84% reported a positive experience.
Consumer openness to remote monitoring could suggest a way to control rapidly rising health care costs. Hospital spending in the U.S. rose 10% in 2023, to $4.8 trillion, the U.S. Centers for Medicare and Medicaid Services recently reported, increasing interest in less expensive options such as remote monitoring of patients and hospital-at-home (HaH) programs.
One challenge to expansion of HaH initiatives is the pending expiration in December of the Acute Hospital Care at Home program implemented during the COVID-19 pandemic and extended under the Consolidated Appropriations Act of 2023. Hospitals granted an AHCAH waiver can provide inpatient-level care for Medicare beneficiaries.
Hospitals have flocked to create “virtual wards” that use remote monitoring systems to stay abreast of emerging issues in patients receiving care or recovering at home. As of April 2024, more than 320 hospitals in 133 health systems in 37 states had established hospital-at-home arrangements, and others are keen to follow suit but many have put plans on hold because of uncertainty about extension of the waiver.
“In the long run, HaH programs should achieve economies of scale through the use of lower-cost remote patient monitoring (RPM) technologies versus traditional, more expensive hospital bedside equipment,” Sam Liu, vice president of marketing at Vivalink, told BioWorld.
“A more permanent of long-term approval of the CMS waivers is key for ensuring access to these services,” Liu added. “Another primary factor is to provide patient- and clinican-ready technology solutions designed to reduce the hurdles to adoption and increase ease of use. Vivalink is directly involved in this aspect with our Acute RPM solution.”
“Consumers are increasingly driving the trend towards receiving care in the comfort of their own homes. This shift, accelerated by the COVID pandemic, underscores the importance of providing flexible and convenient health care solutions that meet patients’ evolving needs,” said Jiang Li, CEO of Vivalink. “At Vivalink, we are committed to the development of advanced digital healthcare solutions in order to improve access and efficiency of the health care system for all.”
The survey found that more than three-quarters of respondents would trust their health care provider’s recommendations whether to stay in the hospital or use remote monitoring systems at home.
Of those who had participated in home-based programs, slighly fewer half said the remote patient monitoring devices were easy to use. Notably, the 16% who were not keen to leave the hospital said that difficulty using the devices was a primary concern.
Age was a key factor in concerns with technology and lack of awareness of home monitoring options. Respondents over the age of 70 were less likely to be familiar with HaH programs, with 42% of this age group saying they had heard of or participated in a hospital-at-home program compared to 77% of those in their 40s.
Rural respondents were also less aware of HaH programs, with just 25% saying they had heard of them vs. 71% of urban residents. Rural respondents, however, were almost twice as interested in completely remote primary care (36%) than their urban counterparts (19%), perhaps because the shuttering of many rural hospitals and a shortage of physicians has increased the distance these patients must travel to receive care.
In addition, respondents who used hospitals the most were the most receptive to HaH programs. Of those who had had three or more hospitalizations in the last year, 95% were willing to participate in home-based programs compared to 62% of those who had two or fewer hospitalizations. The frequently hospitalized group was also more likely to trust in their physicians’ recommendations as to site of care (95%) compared to 78% for those hospitalized twice or less often.
Cardiac issues were the most likely to be monitored at home (46%), followed by cancer treatment and neurological disorders (38% each). More than 30% of respondents who had participated in HaH programs were being monitored for diabetes, respiratory disorders or infectious diseases.
For patients, hospital-at-home programs offer shorter in-patient stays with consequently lower bills, reduced readmission rates and reduced risk of hospital-acquired infections and overall better clinical outcomes as well as more comfort and eased access to familiar settings and family, according to the Agency for Healthcare Research and Quality.
For hospitals, the models reduce overhead expenses, allow continued care for more patients with lower staff commitment and reduced infrastructure costs, particularly during peak utilization periods. Johns Hopkins Medicine estimated that HaH programs saved 19% to 30% compared to standard in-patient care.
WASHINGTON – Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.), former and current chairmen, respectively, of the Senate Finance Committee, are leading a bipartisan push to ensure proper implementation of their law to break up anti-competitive practices in the U.S. organ transplant system. Grassley and Wyden, co-authors of the Securing the U.S. Organ Procurement and Transplantation Network Act, are joined by the law’s original cosponsors, Sens. Ben Cardin (D-Md.), Todd Young (R-Ind.), Elizabeth Warren (D-Mass.) and Jerry Moran (R-Kan.).
In a letter to Dianne LaPointe Rudow, President of the Organ Procurement and Transplantation Network (OPTN) Board of Directors, the senators reiterated Congress’s legislative intent to ensure the OPTN carries out the law’s necessary reforms. The lawmakers specifically noted:
Read the full letter HERE.
Background
The OPTN, which is responsible for collecting organs from donors and matching donations to patients nationwide, has been run by the same inadequate contractor since its founding 40 years ago. Grassley and Wyden’s Securing the OPTN Network Act requires HHS’s Health Resources and Services Administration to expand OPTN’s contracting process for the first time in its existence, in order to ensure only the most competent contractors operate the organ transplant system.
Grassley and Wyden also wrote to HRSA last month to share their recommendations on the law’s implementation.
WASHINGTON – Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.), former and current chairmen, respectively, of the Senate Finance Committee, are leading a bipartisan push to ensure proper implementation of their law to break up anti-competitive practices in the U.S. organ transplant system.
Families USA is leading a new lobbying push for Senate action on site neutral payment reforms, pressing Finance Committee Chair Ron Wyden to follow through on an issue House Republicans addressed in their transparency bill.
Why it matters: Changing how Medicare pays hospitals for outpatient care is a tough sell in the Senate, so pressure from a key consumer group is important to keeping the issue alive.
Driving the news: Families USA and a range of groups including AFSCME are calling on Wyden and Finance ranking member Mike Crapo to hold a hearing before the August recess on health care affordability and hospital costs.
What they’re saying: Wyden told Axios on Tuesday he is “not up on the letter” from the groups. Speaking about site neutral in general, he said: “I’ve had lots of people talking to me about it. I’ve got to get more input with respect to the rural areas.”
Our thought bubble: A Finance hearing is highly unlikely before the August recess, but the real hope is to keep the issue on the table for a year-end health care package.
Between the lines: The letter calls for two policies that already passed the House as part of its bipartisan transparency bill.
The intrigue: Besides Wyden’s worries about rural areas, Senate Majority Leader Chuck Schumer, an ally of New York hospitals, also has concerns with both policies, as we previously reported.
The bottom line: Even these relatively small steps on hospital costs face major hurdles in the Senate amid hospital industry opposition.
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