In a keynote presentation at the Workers Compensation Research Institute (WCRI) Annual Issues and Research Conference, David Cutler, Otto Eckstein Professor of Applied Economics at Harvard University, discussed the current state of healthcare in the United States and his predictions for the future. Cutler highlighted the uncertainty in the healthcare environment, citing factors such as bankruptcies, budgetary issues, and workforce crises. He presented two frameworks for understanding the healthcare landscape: supply and demand, and “trended legal,” which separates long-term trends from short-term fluctuations.
And he did it with wit, as wellas a perfect balance of humility and self-deprecation. It was a very good presentation.
On the demand side, Cutler discussed the impact of COVID-19 on non-COVID medical care. He noted that non-COVID medical care “basically fell off and it has not really recovered,” with deferred care never seeming to have shown up again. This drop in utilization helped the medical system avoid additional burdens during the pandemic, but it also resulted in a significant loss of revenue for healthcare providers.
The revenue losses have led to increased variability in revenue projections, causing small providers to seek safety in larger groups. This trend has resulted in a wave of mergers and acquisitions as independent hospitals and physician practices join larger organizations.
Cutler also discussed the impact of telehealth on healthcare delivery. While telehealth saw a significant increase in usage during the pandemic, he indicated most telehealth visits have since reverted to in-person visits. Despite this, Cutler remains optimistic about the potential for telehealth to improve access to care.
Regarding the workforce crisis, Cutler noted that many healthcare workers have left the labor force due to burnout, long COVID symptoms, and increased workload. This has resulted in a spiraling effect, with unfilled positions leading to increased workload for remaining workers, leading to further burnout and attrition.
Despite these challenges, Cutler expressed optimism about the future of healthcare in the United States. He predicted that the system will become cheaper and better over the next decade, with improvements in areas such as automation, prior authorization, and the elimination of low-value care.
He also discussed the impact of telehealth on healthcare delivery. While telehealth saw a significant increase in usage during the pandemic, as noted most telehealth visits have since reverted to in-person visits. Despite this, Cutler remains optimistic about the potential for telehealth to improve access to care. He noted that telehealth has become the modal way in which people access psychotherapy, and that there is still potential for telehealth to be used in other areas of healthcare delivery.
Regarding the workforce shortage, Cutler suggested that addressing it will require a multi-faceted approach, including increasing training and education opportunities, improving working conditions, and addressing the root causes of burnout.
In conclusion, Cutler’s presentation highlighted the current challenges facing the US healthcare system, but also offered a hopeful vision for the future. Through adoption of AI and modern technology, and addressing issues such as workforce shortages, revenue variability, and the underutilization of telehealth, Cutler believes that the healthcare system can become more efficient, effective, and equitable. He cited a study conducted recently showing that the healthcare industry could save $265 billion simply by automating authorizations and administrative functions. One area he singled out were hospital call centers, which apparently spend a great deal of time with issues as simple as advising patients what address to use uin their GPS. Functions like that could be easily automated, contributing to those savings and freeing resources for more useful purposes. He predicted that the system, through technology, will become cheaper and better over the next decade, with improvements in areas such as automation, prior authorization, and the elimination of low-value care.
Overall, a fantastic launch to what is always a great event. I’ll have more on what is covered here – including their in depth look into psychosocial issues and the impact on outcomes that everyone in workers’ comp needs to pay attention to.
Artificial Intelligence was used to assist in the development of this article.