Month: September 2024

Patients Ready For GenAI, But Not For Everything

Posted on by Jason Barry

Bain & Company’s US Frontline of Consumer Healthcare Survey turned up the surprising result that patients are more comfortable with generative AI “analyzing their radiology scan and making a diagnosis than answering the phone at their doctor’s office.”

That’s quite the headline, but the authors were quick to point out that it’s probably less of a measure of confidence in GenAI’s medical expertise than a sign that patients aren’t yet comfortable interacting with the technology directly.

Here’s the breakdown of patient comfort with different GenAI use cases:

While it does appear that patients are more prepared to have GenAI supporting their doctor than engaging with it themselves, it’s just as notable that less than half reported feeling comfortable with even a single GenAI application in healthcare.

  • No “comfortable” response was above 37%, and after adding in the “neutral” votes, there was still only one application that broke 50%: note taking during appointments.
  • The fact that only 19% felt comfortable with GenAI answering calls for providers or payors could also just be a sign that patients would far rather talk to a human in either situation, regardless of the tech’s capabilities.

The next chart looks at GenAI perceptions among healthcare workers: 

Physicians and administrators are feeling a similar mix of excitement and apprehension, sharing a generally positive view of GenAI’s potential to alleviate admin burdens and clinician workloads, as well as a concern that it could undermine the patient-provider relationship.

  • Worries over new technology threatening the relationship of patients and providers aren’t new, and we just witnessed them play out at an accelerated pace with telehealth.
  • Despite initial fears, the value of the relationship prevailed, which Bain backed up with the fact that 61% of patients who use telehealth only do so with their own provider.

Whether you’re measuring by patient or provider comfort, GenAI’s progress will be closely tied to trust in the technology on an application-by-application basis. Trust takes time to build and first impressions are key, so this survey underscores the importance of nailing the user experience early on.

The Takeaway
The story of generative AI in healthcare is just getting started, and as we saw with telehealth, the first few pages could take some serious willpower to get through. New technologies mean new workflows, revenue models, and countless other barriers to overcome, but trust will only keep building every step of the way. Plus, the next chapter looks pretty dang good.

Value-Based Care Quality Measure Overkill

Posted on by Jason Barry

Value-based care has worked better on paper than in practice, and a new research letter in JAMA Health Forum offers a possible explanation for the disparity: administrative overkill.

The first-of-its-kind analysis tracked 890 primary care physicians in value-based care contracts from 2020 to 2022, finding that:

  • PCPs tracked an average of 57 quality measures.
  • The average VBC contract contained an average of 10.2 quality measures.
  • The average number of VBC contracts held went from 9.4 in 2020 to 12.3 in 2022.
  • This chart has the full breakdown.

The first bullet alone shocked the authors of the study, as well as most industry onlookers who  

expected payors to have some form of quality measure coordination.

  • The fact that the PCPs held an average of 11 VBC contracts with 10 quality measures each, and still managed to have 57 different quality measures shows how little coordination (if any) actually takes place.
  • Extrapolate that administrative burden to an average panel size of 1,309 patients, and it’s no surprise that more providers aren’t lining up to jump on the VBC bandwagon.

What would help the situation? Although out of scope for this study, a well-timed Commonwealth Fund focus group with 29 PCPs explored answers to that exact question.

  • The PCPs were concerned that many utilization and cost measures unfairly penalized them for outcomes beyond their control (ex. acute hospitalizations and total Medicare expenditures are also affected by other providers and specialists), and felt these measures should only apply to health systems or ACOs rather than small practices.
  • The PCPs thought measures of access (ex. appointment availability, wait times) and continuous care (ex. repeat visits with the same doctor, communication) would better reflect true high-quality care.
  • The lack of alignment across models and payors caused PCPs to use more time “meeting the requirements of payors than meeting needs of patients,” and they urged the government/employers to encourage consistent measures and reporting requirements.

The Takeaway

If value-based contracting is intended to promote high-quality care, does having doctors try to optimize for 50 different quality measures really accomplish that? An uncoordinated approach is not only unsustainable, but also counterproductive. Quality measures that amount to visit distractions and provider burnout aren’t a recipe for long-term success, and this study makes it clear that better coordination is a missing ingredient.

Spotlight on Employers, Thatch and Sounder

Posted on by Jason Barry

Help is on the way for employers grappling with rising healthcare costs after two separate startups closed funding to tailor benefits to the needs of employees.

Thatch raised a $38M Series A to dislodge health coverage from employment by providing individual coverage health reimbursement arrangements (ICHRA) that let employees choose their own benefit plans.

  • By blending fin-tech and health-tech tools, Thatch gives employers a way to “abstract away the complexity” of the ICHRA law that passed in 2020, which enabled them to provide a budget to employees for selecting health benefits based on their needs.
  • The Thatch platform streamlines budget setting, plan selection, and lowers costs through pooled purchasing power. If employees spend less than their budget, they receive a Thatch debit card to use for things like prescriptions, copays, and therapy.

Sounder Benefits hatched from the Redesign Health incubator with $7.5M to take a more hands-on approach to benefit design using AI-driven insights and strategic advisory services.

  • Sounder helps employers with <1k employees create a three-year benefit roadmap then guides their transition to level-funded and self-funded plans, providing HR teams with white-glove support and collecting revenue on a per member per month basis.
  • Using employee health data, Sounder identifies when employers have enough of a particular health need (like cancer support), then contracts with companies to provide access to solutions (like Jasper Health).

The back-to-back boost for benefits businesses arrives as employer healthcare costs are expected to spike 9% in 2025, surpassing $16k per employee.

  • Employers continue to bear the brunt of rising costs, and are looking for more ways to avoid passing expenses onto employees in a tight labor market.

The Takeaway

Most current health benefits solutions were designed for a workforce that stayed with a single company for most of their careers, and have had a tough time keeping up with today’s dynamic labor market. Thatch and Sounder Benefits are among a new pack of startups building the infrastructure for a modern benefits experience, and it seems like both employers and employees have a lot to look forward to.

Shrinkflation Hits Healthcare

Posted on by Jason Barry

Shrinkflation is hitting healthcare, and patients aren’t too happy about longer waits for shorter visits.

NYC Health and Hospitals rocked the boat last week after telling its primary care physicians to slash appointment times in half to 20 minutes, so they could squeeze in more patients.

  • The public health system is grappling with 50,000 new primary care patients since 2021, which caused wait times to double to an average of 22 days.
  • It’s a rough situation, and the physicians are understandably worried that shorter appointments will only hurt care quality and contribute to even more burnout as NYC HH was already struggling to compete with its private counterparts for clinical staff.

Nearly 1 in 5 patients now have to wait over a month before seeing a physician, with 43% reporting longer waits since the pandemic.

  • Rising patient volumes and pent-up demand were the stars of the show during health systems’ Q2 investor calls, but the supply of providers has struggled to keep up.
  • Ramping up physician training and recruitment hasn’t put much of a dent in the issue, and desperate systems are turning to shrinkflation to (temporarily) balance the equation. 

A vicious cycle gets created when the escalating needs of an aging population get answered with less care for individual patients. Worse care only causes demand to grow faster, which is why new solutions are needed to break the cycle.

  • Sutter Health told Axios that it’s investing in scheduling and referral tools to speed up wait times and streamline administrative workflows. Sounds better than 20 min visits.
  • Providence said that it’s been leaning in on capacity optimization software to identify scheduling gaps and ensure that its surgical suites are operating with limited downtime.

While not every health system has the same resources as Sutter or Providence, most could probably avoid some costly headaches by incorporating lessons from the success of their peers, like not trading short-term solutions – shrinkflation – for bigger problems down the road. 

The Takeaway

Times are tough, but shrinkflation is a brittle crutch.

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