As we head into a new calendar year, in the healthcare space it is worth reflecting on the events of the last few years, as a means of predicting what is likely to come. Last year, the focus in healthcare policy was very much on what will come after COVID; this year, we finally have the opportunity to review what that is. And we can confidently say that 2024 is likely to see a continuation of many of the trends in healthcare policy that we saw in 2023.
Probably the most significant will, paradoxically, be a continued focus on things outside of, but nonetheless important to, healthcare. For several years now, there has been an acknowledgment of the importance of health-related social needs (what we used to call social determinants of health) – things like food and housing, that are just as important to health outcomes as access to healthcare. This is obviously most important where people do not have access to these basic human needs. But the trend goes beyond that – even among the well-off, there is an increasing focus on how care is delivered. We see this in the rise of medical spas combining the delivery of traditional medicine with more relaxation-oriented services, and the general focus on “lifestyle medicine”, which seeks to achieve health outcomes through lifestyle changes rather than hard medical interventions. Nowhere is this truer than in the long term care space, where aging baby boomers are continuing to demand luxury options that look very different from the institutional services offered to their parents’ generation. Healthcare policy will need to change to keep up with this trend.
Closely allied to this is an ever-increasing focus on behavioral healthcare. Mental health issues have been front-and-center in the immediate aftermath of COVID, and while the fallout seems not to be as bad as we feared, the more we learn about mental health, the more we realize the profound connection it has to physical health. And of course, substance use disorders continue to be a concern – in fact, probably the primary healthcare concern now that COVID is waning. For now, opioid addiction continues to be the biggest concern; but it is not hard to envision new issues arising in this space. And both mental health issues and substance use disorders drive an incredible amount of costs in the healthcare system. As a result, providers of all kinds will be called upon to provide new options in both these spaces.
Healthcare policy will also continue to work to catch up to technology. As precision medicine – loosely defined as the increasing ability to target specific treatments toward the patients who will most benefit from them – advances, it will continue to challenge old ideas about the value of investments in additional testing and cures for rare and ultra-rare diseases. Similarly, our positive experience with telehealth during COVID has opened the door to new ideas in that space, particularly including new opportunities for remote patient monitoring, and new access to data, which creates all kinds of legal and policy issues.
The rise of artificial intelligence offers particular policy challenges. Anytime a machine “thinks” for itself, in the healthcare space that will raise concerns about data privacy and security (what exactly is that machine doing with your data?), patient autonomy and consent (to what extent can patients interact with that AI and be sure they are getting the answers they need?), and scope of practice and responsibility (what decisions are being made by AI rather than licensed professionals, and who is responsible when those decisions are wrong?). On the other hand, AI creates unprecedented opportunities in the area of precision medicine, and may even help to span the “disparity gap” by providing new avenues of access to healthcare services for populations who do not have such access now. But that only works if those populations have access to those AI options.
And healthcare policy in 2024 will also continue to include a strong focus on disparities. Providers of all types will continue to consider and implement new options for specialty care, including new options for women’s health, LGBTQ+ and disability services, and increased focus on cultural competency in general, including in regard to race and ethnicity. And there will be a continuing focus on making sure that all populations share access to all of the new developments in healthcare – including developments in health-related social needs, lifestyle medicine, behavioral healthcare, precision medicine and AI, among others. This means that these changes cannot just occur in the self-pay or commercial markets – Medicare and Medicaid need to be a part of that change.
While we can’t predict exactly what’s to come in the year ahead, we can anticipate new developments in all these areas – and we can predict that healthcare policy will continue to evolve to address them.