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My predictions for healthcare in 2023

I'll preface by saying that I am not a healthcare policy expert - but I do have a passion and interest in keeping up-to-date on healthcare policy, thanks to the magic of Google and podcasts. I also have a Masters degree in public health (MPH) but that does not make me a policy expert. Rather, having a MPH makes me someone who needed to learn something more big-picture than memorizing cell biology slides - and as someone who can handle a dual advanced degree courseload.

Let's add some context.

Healthcare workers are, as a whole, pretty burned out and more accurately, feeling dismayed from their inability to best care for patients. I hear it from my friends who are nurses, NPs, physicians, physician assistants, and pharmacists. We see it on the news and in our private physician Facebook groups. Also, COVID is still in the picture, as is the increase in respiratory viral illnesses this winter.

My Healthcare 2023 predictions:

Increased salaries and flexibility in hours/remote options

We will see more shortages of healthcare professionals and workers across the board. With the shortages, healthcare professionals will have more leverage in terms of hours worked, remote work options, salaries, and benefits.

The companies that are willing to offer healthcare professionals what will keep them from burning out will keep their staff and be able to recruit. The companies that are always hiring and relying on locums because the jobs are truly too much for one person, will continue to struggle to recruit.

Increased merging/acquisitions in healthcare

Continuing from 2022, mergers will continue and increase in frequency in an effort to lower costs. Healthcare systems are struggling financially - particularly those located in rural areas (low patient census, high Medicaid/Medicare population) and those that do not have their own health insurance plans.

Mergers in healthcare is controversial and media interviews with healthcare systems CEOs are quick to highlight the benefits that expanded access will have for the community but studies show that merging leads to the monopolization of healthcare - so, patients have no other choices for healthcare near them but to pay potentially higher costs.

Additionally, a Health Affairs study from May 2022 found that vertical consolidation led to a 12% increase in primary care provider prices and a 6% increase in specialist prices. Bigger is not always better.

Psychedelic assisted therapy (MDMA and Psilocybin) become legal and safe mental health treatments

As a ketamine assisted therapy practitioner, I've been closely watching the progression of legislative changes, ongoing clinical trials, and the increase in the output of research publications related to psychedelic medicine.

Conventional medicine will struggle to find its place (if any) in psychedelic assisted therapy, as a whole, since there will be separate state-wide treatment centers with a decided non-medicalized bend (probably for the better) for those seeking these modalities.

A move from fee-for-service to value-based care (VBC)

Value based care means a change in reimbursement so providers will get reimbursed more if their patients' health outcomes improve. Right now, our insurance system (and therefore, our healthcare system) operates in a fee-for-service model, where providers are incentivized based on the quantity of procedures, visits, interventions - whether or not a patient's health improves.

Honestly, I don't really know how this type of model can work in our system but I'm here for it.

Increase in healthcare systems hiring midlevel providers such as nurse practitioners and physician assistants/associates to decrease costs which will lead to a more prominent two tiered healthcare system

Another controversial issue in healthcare is the exponential increase in health care being provided by midlevel clinicians. This is a highly complex issue and I see the merits of both sides.

I do see physicians becoming nearly obsolete in the next 50 years in the current insurance-based healthcare system. And if we are still in the same healthcare system model then, there will be a much more defined two-tier system with NPs/PAs providing primarily care for those who use commercial insurance/Medicare/Medicaid/VA benefits and MD/DOs providing care for those who can afford to pay out of pocket.

I hope I'm wrong but the financial component of who provides care has very strong influence in our healthcare system.

AI solutions

Artificial intelligence will continue to guide decision-making and assist clinicians in diagnosis and treatment, as well as advance treatment innovations through big data/precision medicine.

So there you have it. I'm still hoping for complete disruption and innovation with the help of AI and pushed by the absolute dumpster fire that is the reality of American healthcare but I don't think we're quite at the tipping point yet!

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