Each year in the healthcare industry we see new ideas and technology rise up to meet society’s needs. In 2019, the healthcare industry saw $2.6B in funding go to virtual care while healthcare policy became more receptive to technological solutions, with 40 states adopting more substantive telehealth policies. These changes were arguably driven by evolving consumer preference for accessible healthcare as 61 million members of Generation Z entered the workforce, and nearly half of the 83 million Millennials shrugged off the traditional model for primary care.
What will it mean for healthcare in 2020? The industry is heading towards a complete integration of virtual healthcare. This year, we will see virtual care become an integral component of healthcare in policy, benefits, behavioral health, consumer experience, and platform consolidation.
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Hill Ferguson Hill Ferguson is Chief Executive Officer at Doctor On Demand. With nearly two decades of experience in mobile technology, Hill has led companies at all stages of growth, from being a founder to being a senior executive at PayPal, a high-growth public company. He holds a deep commitment to putting customers first by […]
The Patient-Consumer
Setting the stage for trends in 2020, it is important to first establish that there is a changing, consumer-driven expectation within the healthcare industry. Consumers are beginning to view virtual care as an integral part of healthcare, as opposed to an alternative.
This year, we will see that virtual care is no longer a separate concept, but a deeply embedded expectation in healthcare. As this happens, health plans and employers will need to think differently about the strategic importance of virtual care for their benefits design.
Policy & Regulatory
In 2019, more than 40 states adopted more substantive telehealth policies. One of these included finalizing the innovative telehealth benefit to Medicare Advantage. This year, I believe that CMS will promote policies that encourage virtual care in value-based models—specifically Medicare Advantage.
Medicare Advantage plans will have more options to enhance their provider networks and improve access to care via telehealth providers. This improved access hinges on CMS expanding the network adequacy criteria to include telehealth as a qualifying visit encounter. Medicare Advantage plans will also be able to improve diagnosis, treatment, and quality outcomes when CMS considers telehealth as a valid risk-adjusted source.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
We can already see this trend beginning, as CMS proposes boosting telehealth benefits for certain patients with specialty care needs.
Employer Benefits
Employers have often led the way when it comes to pursuing affordable, accessible virtual care options. A recent survey found that more than half of employees are confident in an employer-provided digital health solution. However, many employers are currently offering multiple point solutions—addressing individual health issues with separate virtual care options.
This year, the industry will see more companies seek all-encompassing solutions to consolidate benefits for their employees and reduce fragmentation in care. We are seeing large companies like Amazon and Walmart roll out innovative virtual primary care options for their employees. These options integrate virtual care into their network as a first stop for medical and behavioral health care, as opposed to providing an alternative for acute care. As CEO of Doctor On Demand, I have seen the impact of deeper employer partnerships and how these models will be prioritized in the coming year.
Virtual Behavioral Care
In 2020, we will see rapid growth in access to and patient utilization of virtual behavioral health care. The demand for behavioral health care is increasing and access is frustrated by a nationwide shortage of in-person behavioral health providers. Millions of Americans are currently waiting for an average of 25 days to schedule a visit with a mental health professional. Virtual care will reverse this trend.
As a convenient, private, and face-to-face video option, virtual care is uniquely situated to meet the needs of consumers seeking behavioral health. Based on my experience as CEO of Doctor on Demand, my prediction is that virtual behavioral health care will become an essential offering for health plans and employers.
Platform Consolidation
While there has been an emergence of point solutions designed around specific conditions and technology modality, these solutions will struggle to maintain market share on their own. This year, the industry will seek to consolidate integrated platforms.
This will move us to create a more seamless experience for doctors and patients, prioritizing usability around both EHRs and referral processes. The integration of platforms will mean better utilization and outcomes for all.
What Does It All Mean?
As virtual care becomes integrated into our various systems, its users will seek solid, outcome-oriented results. Those employing virtual care will want to visualize the utilization rates, tangible health outcomes, real cost savings and quantitative changes in their population over time. This will be true for employers, health plans, and consumers.
This year, we will see higher expectations placed on receiving results. This data will drive future decisions and the future of virtual care integration.
Photo: Courtney Hale, Getty Images
Hill Ferguson is Chief Executive Officer at Doctor On Demand. With nearly two decades of experience in mobile technology, Hill has led companies at all stages of growth, from being a founder to being a senior executive at PayPal, a high-growth public company. He holds a deep commitment to putting customers first by delivering the best possible products, a value that resonates with Doctor On Demand’s commitment to its industry-leading clinical quality and best-in-class customer experience.
Before joining Doctor On Demand, Ferguson helped transform PayPal into a more customer-focused technology company, leading the global mobile team and eventually serving as the company’s Chief Product Officer. Prior to joining PayPal in 2011, Hill was Vice President of Product and Marketing at Zong – which pioneered new technologies that enabled consumers to make payments quickly and easily using a mobile phone number. Zong built a vast network of over 250 mobile operators in over 50 countries while building a merchant network of leading digital goods and online gaming developers such as Sony, Sulake, Bigpoint and Facebook.
Hill holds a bachelor’s degree and an MBA from Vanderbilt University and lives in the San Francisco Bay area.
