HLTH 2024: 9 Key Observations Steering Healthcare into 2025

Every year, 12,000 leaders in the healthcare industry meet at HLTH. This year's conference covered all aspects of the healthcare ecosystem, and here are the nine that we should watch as we enter the new year.

1. AI, AI, AI – The topic of the day for the last few years is finally getting some real substance behind it. It has gone from “it’s coming and it’s scary” with players hiding their cards because they think they are the only people working on it to companies big and small showing the world what they are working on and the wins they are fostering. It is real and it helps people tackle routine tasks (scribes and chatbots) but also offers advanced solutions in imaging, condition modeling, and diagnosis assistance. My favorite quotes were “Short-term it’s all overhyped, but long-term it’s truly underhyped” and “AI is not going to help your fax machines - you have to get your house in order first.” 
2. Wearables and Connected Devices – With the recent advances in connectivity, miniaturization, and the post-COVID acceptance of telemedicine/telehealth, there are notable breakthroughs here. From the smart watches we all wear now to blood glucose monitoring devices, it is sneaking into the mainstream. This bleeds into home health and all devices that providers can use to track the well-being of patients at home. I've already seen scales and blood pressure cuffs that track your progress, and soon your cardiologist might send you a handheld ultrasound device to perform a heart scan on yourself while they observe via video conference.
3. Value-Based Care – A buzzword for 25 years now, it means something different to everyone who says it. No change there. Most people are focusing on the contractual routes: capitation, bundles, at-risk, and episodes of care. Forward-thinking organizations are now concentrating on the "value" aspect—improving efficiency, reducing costs, and avoiding unnecessary procedures. It appears that the most effective form of Value-Based Care is simply "doing better over time."
4. Call For Help – More than once, I heard a leader of a large organization admit defeat. Especially in the new world of AI everything, large well-resourced companies suddenly cannot produce their own version of this that competes. So, partnership is key. Decades ago, there was a trend of companies doubling down on their core competencies and letting go of the rest. I wonder if we will see more of that in this industry, which can be very controlling.
5. Access To Care – It is real, and it is universal. From low-income urban centers to rural communities, there is a mismatch of the right care at the right time even with the expansion of Medicaid. And it is getting worse with more hospitals throwing in the towel and communities losing ERs, OB, primary care and pediatrics. The famous quote is now “I can’t be the doctor for the whole town.” There was a lot of talk about approaches and attempts here but no groundbreaking solutions.
6. GLP-1 – This new class of weight-loss drugs is having an enormous impact on our world and usage is only going up. But there is a cost – up to a 15% increase in an employer’s entire pharma spend if they choose to cover it. So, do you cover it? What are the rules as to who gets it and why? Maybe it is worth covering it because it will decrease individual care costs over time. Is it just a band-aid on lifestyle issues? This is a fascinating topic because of its potential impact but at what cost? It pits giant pharma companies against big employers and the federal government and points out problems with the entire ecosystem. No easy answers here.
7. Disruption - Some actual inspiration worked its way into the sessions. For many years, providers, payers, and everyone in between have worked to figure out the best way to operate within the current systems. These systems were designed over time due to the needs/wants of the power players in the industry. But lately, some organizations are playing their own cards and saying, “No thank you.” They are telling Pharmacy Benefit Managers (PBMs) that they are not playing their game anymore. They are telling payers that prior authorizations just are not going to work that way any longer. And it is working. In the short term this may increase the complexities in the system, but long-term I can see this having a significant impact as all players start to apply some simplistic logic to things to drive cost out and improve the quality of care. This is exciting until you realize that most of the rules and bureaucracy were created by, and are enforced by, the same people who pay half the bills, and it is hard to tell the Feds “No.”
8. Election – Everyone was mostly polite talking about this timely topic. The consensus was that nothing regulatory was moving pre-election, and nothing substantial would happen quickly under the new administration. There are, of course, policy differences so things will change over time, but no one was willing to predict impactful orders, rules, repeals, or new legislation due to the various moving parts including the outcome of congressional elections. There are wish lists, but no guarantees, around the expansion or contraction of programs, modernization of care and coverage rules, and encouragement of innovation.
9. The Boring Stuff – What is not being mentioned on stage is my own personal elephant in the room that I love to point out. The healthcare industry thinks it is special because it is. However, an individual healthcare company must do all the normal corporate things that all companies in all industries need to do. They employ and pay people, they buy and pay for things, they run varying degrees of a supply chain, and the list goes on. From what I have seen over the years, healthcare companies can do themselves a true disservice because they do not focus on being world-class in these areas. No one is talking about it because it is not cool, but it certainly is at the heart of things like AI deployment, Value Based Care, and the ability of the industry to profitably provide care to all.

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