Q&A: How retail healthcare, telehealth developments may evolve in 2023

As one other 12 months shaken by the lingering COVID-19 pandemic ends, stakeholders are nonetheless exploring how digital care developments that accelerated in 2020 will have an effect on the healthcare business long run.

Although telehealth use spiked out of necessity through the early months and stays larger than pre-pandemic ranges, utilization has slowed over the previous two years. In the meantime, huge retail firms and pharmacies are providing extra care choices to sufferers.

Sanjula Jain, senior vice chairman of market technique and chief analysis officer at Trilliant Well being, sat down with MobiHealthNews to debate the way forward for digital care, how huge retail entrants will have an effect on the business, and the significance of care coordination between conventional well being programs and rising retail gamers.

MobiHealthNews: What are a few of your huge takeaways from 2022 whenever you’re interested by telehealth, digital well being and different tech-enabled care?

Sanjula Jain: A giant factor that I am considering so much about is that sufferers aren’t coming again to care, regardless of all of the investments in additional provide or entry factors, whether or not that be digital care entry factors or new retail entrants or conventional pressing care.

We have simply had this big mismatch between provide and demand. We’re form of post-vaccines; now we have Individuals returning to work to some extent. Plenty of of us are going into an workplace a few days every week, of us are touring, but they are not going again to see their medical doctors. We have tried to make care extra handy and extra accessible. And a few of these new provide factors are decrease price, and but, they’re nonetheless not partaking.

I feel there are lots of causes for that. COVID scared away lots of sufferers, and I feel we’re beginning to see indicators of extra mistrust within the healthcare system. After which price and affordability, with lots of the worth pressures and inflation and recession discussions. That is going to proceed to be an element. There’s lots of well being penalties for when sufferers do not truly have interaction in needed healthcare.

MHN: What do you assume is the way forward for digital care whenever you’re 2023 and past?

Jain: The marketplace for digital care is a commoditized market. So, we’re seeing that typically it is getting used amongst a discrete subset of the inhabitants. And now we have to consider, who’re the people who like to make use of digital care and what are they utilizing it for?

Primarily, as a well being economist, I feel so much about substitute items. We’re seeing that digital care is admittedly solely a substitute good for behavioral well being. It is each a medical and monetary substitute, proper? Clinically, having a long way between you and your supplier in a behavioral well being interplay might be most popular whenever you’re speaking about your emotions and being very susceptible. And there isn’t any lab work or poking and prodding that truly must occur. So it is a viable medical different. 

Financially, we have been speaking so much about cost parity. As a result of behavioral well being interactions usually do not want imaging and lab work, you are form of making the identical quantity for an workplace go to that you’re in a digital care atmosphere. For different use circumstances like major care, we see that is not truly the case. The affected person goes in for a digital care go to, after which what actually finally ends up occurring is the doctor says, “I want you to come back in to get some imaging finished or get some lab work finished.”

The cost parity, regardless of the coverage incentives to extend telehealth cost charges, it isn’t true parity. And so, that is why we do not see the complete substitute impact. While you boil the ocean down, you see that the marketplace for telehealth continues to be fairly discrete and concentrated to a handful of customers. That is actually the place I feel the long run is, interested by whether or not they’ll proceed to make use of it. The information exhibits that, within the pandemic, we have seen this tapering. When Individuals are given the choice for in-person or digital, they’re nonetheless preferring to go in-person with that exception of behavioral well being. 

So, I feel the market goes to should be extra practical concerning the whole addressable market measurement by way of discrete variety of customers, the variety of visits per person, after which make investments accordingly. I feel that is a big a part of why we have seen lots of struggling amongst some digital well being gamers, as a result of I feel they’ve overestimated the quantity of utilization of digital care modalities. However the variety of discrete customers simply is not as much as par with what people had estimated it to be.

MHN: Going again to these retail entrants, Amazon made a ton of stories this 12 months. Walgreens, CVS, Walmart — they’re additionally boosting their care supply operations. How do you assume these strikes will have an effect on the healthcare business total?

Jain: It in the end comes right down to, who’s your buyer or your client or affected person persona? 

Who’s Amazon truly going after? Who’s their goal affected person inhabitants, and for what companies? Amazon is admittedly specializing in extra low-acuity companies, and well being programs are significantly good on the larger acuity issues like surgical procedures. 

What Amazon and different new entrants imply is that they supply the buyer with extra care choices. However it additionally creates a must coordinate care higher and create these actually robust referral relationships.

To return to my earlier level about sufferers not coming again, of the sufferers we do see coming again, we’re seeing them actually search out care in these low-acuity, commoditized care settings. They are going in for flu and strep, however they are not getting their screenings. It will be actually essential for teams like Amazon to coordinate with well being programs to truly get sufferers to go observe up for these needed companies and determine refer them out. 

MHN: How do you assume the expansion of those retail gamers will have an effect on sufferers?

Jain: I feel it is a bit of a toss up. For some sufferers, they’ll view it as a greater expertise, as a result of they’ll get what they need when they need it. However I feel from a medical perspective, it creates lots of dangers and challenges for the well being of the affected person. There actually is not somebody proudly owning the care or steering the affected person via their healthcare journey. Have you ever gotten this lab workup? Have you ever gotten this mammogram? 

For a few of these extra retail gamers, it is consumer-directed. You possibly can stroll into pressing care and you’ll go to a telehealth go to, and it is actually as much as the buyer. However healthcare is difficult, and the common client could not have all the required info to go make these selections. 

I feel that there is lots of positives to retail gamers by way of catering to client preferences and offering care in a extra handy method. However for lots of complicated care, acute care — that each American goes to want in some unspecified time in the future of their life — there’s a little bit extra fragmentation. 

MHN: Do you assume there’s an urge for food amongst well being programs to accomplice with Walgreens or CVS or Amazon and say, “Should you see somebody, ship them to me once they want a most cancers screening?”

Jain: Completely. So, I truly simply this week was with one of many well being programs, speaking to their management crew. That is very a lot a dialog that’s occurring within the boardrooms — what’s the proper partnership construction with a few of these new entrants and first care suppliers?

I feel the problem is, you can have these nice partnerships. However in the end, it is the buyer and the affected person that is nonetheless having to make the choice. Are they going to observe up on these suggestions? The place are they going to go subsequent? So, I feel it is one thing that we will should spend extra time interested by as an business, coordinate that look after that affected person over time, however with extra selection and choices out there.