Future of Healthcare Delivery in America

What are external forces influencing healthcare delivery?

- Social and demographic

- Anthro-cultural

- Global

- Ecological

- Informational

- Technological

- Economic

- Political

What are examples of social and demographic factors influencing healthcare delivery?

- Aging

- Vulnerable population

- Government programs

- Immigrants

- Health-seeking behavior

How does aging affect healthcare delivery?

- Bigger population, older, and more diverse

- These shifts in demography affects practice

How do vulnerable populations affect healthcare delivery?

- Increase in high-cost health conditions

- People with extensive healthcare needs (ex. 3-4 chronic conditions)

- Spending increases by 1:4

How do government programs affect healthcare delivery?

Heading in an unsustainable path

How do immigrants affect healthcare delivery?

- Population shift

- Controlled vs. uncontrolled immigration

- Cultural mix

How does health-seeking behavior affect healthcare delivery?

- ER use

- Lack of health insurance

- 11.3 M - charity care

What are examples of economic forces influencing healthcare delivery?

- Household income

- Economic growth

- National debt

- Employment

How does household income affect healthcare delivery?

Affordability

How does economic growth affect healthcare delivery?

Unstable

How does national debt affect healthcare delivery?

- COVID-19

- Recessions

- 98% of GDP as debt (2020)

How does employment affect healthcare delivery?

- Job loss (ex. tech industry layoffs)

- Government initiatives

- Artificial intelligence

What are examples of political factors influencing healthcare delivery?

- Affordable Care Act

- One Big Beautiful Bill

- 21st Century Cures Act

- Department of Government Efficiency

- Ideological dominance

- Divided and one-sided agenda

- Hegemony

What are examples of technological forces influencing healthcare delivery?

- Tech innovations

- R & D costs

- Costs of unrestrained use of technology

- Self-reliance and cost efficient technologies are needed

- Telehealth

- Smart cards for healthcare

- Innovative IT applications

- Remote sensing and geographic information systems

What are examples of ecological forces influencing healthcare delivery?

- New diseases

- Natural disasters create psychological distress due to contaminated food and water (snow storms, wildfires, tornadoes, floods)

- Bioterrorism (wars, threats)

- Communicable diseases (ex. COVID-19)

What are examples of global forces influencing healthcare delivery?

- The trend toward globalization in healthcare will intensify

- Globalization, medical tourism, cross-border telemedicine

What are examples of anthro-cultural forces influencing healthcare delivery?

- Cultural beliefs and attitudes toward healthcare coverage

- Preventive vs. curative interventions

What are examples of ongoing debates regarding healthcare delivery?

- Healthcare coverage for all

- Socialized medicine with limited private players

- Adverse selection

- Health spending accounts/high-deductible health plans

- Regulations to promote competition

How can healthcare delivery be optimized?

- Astute leadership

- Care coordination

- Adoption of IT

How can astute leadership optimize healthcare delivery?

New models of care

How can care coordination optimize healthcare delivery?

- Ease the navigation through the system

- Patient-centered care

- Community-oriented preventive care

How can adoption of IT optimize healthcare delivery?

- Cost-saving tech

- Evidence-based care to improve efficiencies

- Telemedicine/telerehab

What are accountable health communities?

- Sponsored by CMS

- Aims to focus on multiple drivers of health while reducing costs

- Addressing population health by integrating healthcare, public health, and social services

- Ex. inadequate nutrition and unhealthy living condition causing chronic conditions requiring increased healthcare utilization

What does patient activation target?

- Patient skills

- Confidence

- Ability and motivation to actively engage in healthcare

What are future public health threats?

- Wars and terrorism

- Antibiotic resistance

- Natural disasters

- Disease and disability

What does comparative effectiveness research look at?

- Robustness of research studies

- Sound interpretation of their results

- Relevance to clinical practice

- Formulation of clear and specific clinical practice guidelines

- Performance measures

- Clinical decision support tools