At the start of 2024, Advisory Board shared its bold predictions for healthcare. The industry is undergoing seismic shifts that will change where care is delivered, who delivers it, and how it’s paid for. These shifts are projected to move the healthcare industry away from its hospital-centric, overextended clinician, and procedure-first past, while also ensuring that the future is radically different from where we are today. In 2024 and beyond, vertically integrated ecosystems will hold more market power, technology will be crucial for top-of-license care, and today’s pipeline of treatments and diagnostics will usher in a new era defined by bespoke care.

These changes are well underway and are accelerating. This means that the responsibility of today’s executives is not to decide whether these shifts will occur, but rather to shape the future in a way that serves their business and their community. It’s not just an opportunity; it’s a responsibility.

The leaders and the organizations that embrace their elevated responsibilities and support the broader industry as it navigates paradigm shifts are best positioned to succeed in 2024. Outlined below are the roles that stakeholders should play in 2024 and beyond.

With the increasingly rapid rate of clinical innovation, service investment and coverage decisions will set precedents for industry-wide access to innovative technologies and high-cost therapeutics.

How your role is key in ensuring industry success:

• Employers: In the wake of rising health benefit costs and high-cost drugs, employers must balance employee disruption, cost savings, and making sustainable coverage decisions. As individual employers make their own decisions, the industry will grapple with a patchwork of varying coverage standards. Employers must partner with health plans, pharmacy benefit managers (PBMs), life sciences firms, and providers to build coverage and financing structures that employers can unify around.
• Digital health: Technology firms decide which technologies to invest in, develop, and eventually make their way to patients. To maximize impact, technology firms should prioritize products that will address unmet, pervasive challenges, like tools that enable top-of-license care or streamline population health management.

As the patient journey becomes increasingly complex, individualized, and split across several disparate organizations, industry players will need to strengthen coordination capabilities and ensure that the value of partnerships improves care quality.

How your role is key in ensuring industry success:

• Plans: Emerging from the pandemic, plans will need to manage a pool of patients who experience worsening chronic illness, split their care across several partner organizations, and receive less-standardized, bespoke care. Plans must invest in infrastructure to track care coordination, financing, and data integration across disparate stakeholders and longer time horizons, to enable ongoing management after beneficiaries leave a plan. Simultaneously, they must address new data stewardship challenges, including legal requirements, and patient communication strategies.
• Medical groups: With the care journey becoming more and more complex, medical groups must prepare to manage patients longitudinally. This will require groups to redesign the care team holistically to reduce burnout for every team member – not just physicians. Further, they will need to invest in infrastructure to efficiently pool, harness, and share patient data across partner organizations.

In an industry marked by uncertain hospital economics, unwavering workforce challenges, and the entrance of prohibitively expensive but lifesaving innovations, stakeholders must dedicate themselves to protecting care access, specifically for underserved patients. This means experimenting with new technologies and payment models will ensure that patients get the right care.

How your role is key in ensuring industry success:

• Providers: As nontraditional players target more profitable customer segments, incumbent providers must dedicate themselves to protecting access for underserved patients. These providers can do so by partnering with other stakeholders who can help support their mission. With workforce shortages threatening care access, providers must strategically leverage technology to spur care team sustainability, efficiency, and engagement. Successfully embedding such technology means shifting care team roles, training, and compensation in response to new capabilities.
• Life sciences: Understanding how high-cost treatments pose existential challenges for purchasers, life sciences companies must be willing to experiment with payers on experimental financing models. Outcomes-based payment models and other experiments will require life sciences organizations to create evidence that is manageable to clinicians in real time and addresses performance requirements from payers.

While the stakeholders listed above should see themselves as most responsible for making each priority a reality, success will require cross-industry partnerships. Stakeholders across the industry should consider their own opportunities to collaborate with key players. This will help them better set coverage and investment priorities, expand coordination across an increasingly complex care journey, and protect access to care.