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Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.


Our Take

Four forces changing priorities for medical leaders in 2021

2020 was an unprecedented year for health care. Covid-19, the economic recession, the U.S. presidential election, and the boom in virtual care have already had a significant impact on customers. Many of these impacts are relevant regardless of therapeutic area, product, population, or geography, and their effects extend well beyond 2021.

Impact 1: Covid-19 will continue to impact payer, provider, and patient behavior even after mass vaccinations take hold.
Even with a widely available vaccine, health care stakeholders will continue to grapple with the effects of the Covid-19 pandemic, including:

  • Long-term financial strain from suppressed elective surgery volumes
  • Anticipated surges in high-acuity patients resulting from delays in care or diagnosis
  • New waves of patients with cardiovascular or neurological complications from a past Covid-19 diagnosis
  • Exacerbated preexisting health disparities and inequities

Impact 2: Providers will struggle to recover from financial devastation caused by the Covid-19 pandemic and the U.S. economic recession.
Because the pandemic and economic recession are inextricably linked, many health care stakeholders are feeling financial strain from:

  • Reduced funding from charitable donations and local, state, or federal resources
  • Decreased demand among patients for non-essential or non‑urgent care
  • Covid-19 patient treatment costs that far exceed reimbursements
  • Higher proportion of uninsured and Medicaid patients due to widespread unemployment
  • Uptick in hospitals’ bad debt from patients unable to afford medical bills

Impact 3: In 2021, President Biden’s administration will put significant resources towards Covid-19 vaccination and relief.
In the long‑term, it’s efforts will focus on expanding health care coverage and controlling health care spending. President Biden’s win signals the potential for significant changes to the health care landscape, including:

  • Federal control over the Covid-19 vaccine rollout and funding to support states’ vaccination efforts
  • A public option or expansion of the Affordable Care Act, which could increase access and affordability for millions of Americans
  • Proposed drug price controls, either in the form of international price indexing, imposed spending, or an independent review board to assess medicines’ value
  • Regulations favoring provider participation, rather than performance, in value‑based care

Impact 4: Despite uncertainty around reimbursement, widespread investments in telehealth are poised to disrupt the infrastructure of care delivery.
A pandemic-driven uptick in virtual care adoption—by patients, providers, and payers alike—is fundamentally changing the way health care is delivered, including:

  • Expanded access to care, which raises the bar for ensuring appropriate utilization
  • More frequent inclusion of devices (e.g., for remote patient monitoring) in care plans
  • Shifts in site of care, from physician offices to the home
  • More complex clinical workflows that incorporate a mix of in‑person and virtual care
  • Changes to providers’ diagnostic and therapy selection to favor lab tests and medical products that support patient ease of use

Ultimately, the combination of these four forces means IDNs, HCPs, payers, and patients are more resource- and time-constrained than ever, and the bar for proving value will only go up.

Key Takeaways

To support customers moving forward, medical leaders must become champions for:

  • Demonstrating holistic product value, especially through metrics like impact on total cost of care, length of stay, adherence, and patient-centered outcomes
  • Evaluating opportunities to incorporate beyond-the-product support, like remote monitoring, adherence tools, and educational materials about patients’ needs before and after treatment
  • Ensuring medical content is virtual-friendly, easily accessible online, and consistent throughout digital and in‑person channels
  • Encouraging field teams to be mindful of the ongoing challenges HCPs and their organizations face and listen for new ways to support customers

About Advisory Board

For more than 40 years, we've helped executives and future leaders in health care work smarter and faster by providing provocative insights, actionable strategies, and practical tools to support execution.

With 40+ years of experience, a team of 250+ experts, and a network of 4,900+ member organizations that span the payer, provider, and supplier industries, we support life sciences firms’ commercial and medical leaders with research and educational resources that develop market strategy, enrich customer insight, and more.

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