[Written by author, David Houle]. Healthcare in the United States has begun a radical transformation. What was, no longer is. What is will soon give way to what will be. Regardless of what politicians may think, say or do, this new transformation will not be stopped. It is perhaps the greatest time of sweeping change in U.S. healthcare history.
There are a number of dynamics driving this transformation. America has the highest per capita cost of healthcare anywhere in the world. The costs keep going up. A larger percentage of Americans do not have access to healthcare than any other developed country in the world. We have considered healthcare something we need when we are sick, injured or confronted with a disease. We wait until there is a problem and then we interface with the healthcare system to fix our problem. That is why costs are going up and people are struggling with poor health.
In a book I co-authored, “The New Health Age: The Future of Healthcare in America,” published in 2012, the future of our healthcare system was summarized by nine dynamic flows. These nine flows were divided by how we think about healthcare, the delivery of healthcare and the economics of health care. These nine flows, shown below, are the underpinnings of the transformation now occurring. As you look at these flows, keep in mind that we are moving from the left side to the right side. Practices, businesses and all healthcare related entities will be moving to the right side of these flows.
How We Think About Healthcare
Sickness -> Wellness
Ignorance -> Awareness/Understanding
Supplier Driven -> Payer Driven
How We Deliver Healthcare
Treatment -> Prevention
Reactive -> Proactive
Episodic -> Wholistic
The Economics of Healthcare
Procedures -> Performance
Isolation -> Integration
Non-Efficient -> Efficient
These nine dynamic flows are the underpinnings of change today. They are also creating new institutions and entities as a result. The old institutional model was simple. First the doctor, followed by the hospital, then recovery and rehab. When the healthcare transformation was triggered by the ACA legislation, the old models thought the way to prepare was to consolidate. Hospitals merged with other hospitals, physician practices were bought, sold and merged. The problem with this was that scale alone was not an answer when the fundamentals are changing. Merged hospital and practice groups were still operating the same way but had just scaled up so the only benefit was back office efficiencies.
A significant part of the New Health Age is the development of new entities that are created and organized around some or all of the nine dynamic flows. An example of this is the recent announced merger of CVS and Aetna [which, as of time of writing this column, has yet to be approved]. This is an integration that reflects at least six of the flows.
It occurred to me as I was preparing for a keynote speech to some 2,500 pharmacists several years ago, that they were the most trusted and most frequent touch points of the healthcare system. Think about how often you interface with your pharmacist relative to your doctor or surgeon. So, it makes great sense that combining pharmacists with an insurer will promote integration, efficiency, prevention, wellness and understanding.
Another type of entity that will inevitably be very successful are what can loosely be called wellness practices that are about wellness, prevention, proactivity, and awareness. These entities will be expansions of existing ones that add on services to focus on these qualities.
I have always thought physical therapy practices would be ideal for the New Health Age if they expanded their practice and offerings. The old thinking was that PT was for recovery from an accident or surgery. The new thinking is that PT can be a source of prevention and understanding. A good percentage of accidents or necessary surgeries are a result of non-aware poor health practices. Highly paid superstar athletes are always working with the trainer and physical therapists on a daily basis, not just for injury recovery. Have you ever truly watched how much warm-up and stretching NBA and NFL players do before a game? Much more than any of the rest of us. They know that being of good health and injury-free takes a great amount of conditioning, preparation, nutrition and prevention.
That is why I think that such companies as FYZICAL are perfectly positioned for the current transformation. Preventative physical therapy to find out the weak, inflexible and out of alignment aspects of one’s body will lower injuries and surgeries. I particularly am impressed with their developing “balance practice." I remember when my parents were living in a truly superior retirement community that had all levels of living, the one thing they feared most was falling. In the decade they lived there before their deaths, they lost a number of friends whose health rapidly deteriorated after a fall. Both my parents started to use walkers as a prevention against falls. With the aging of the Baby Boomer generation, any offered balance practice should have great appeal.
If companies such as FYZICAL also expand into the areas of nutrition, diet and fitness counseling, they will be filling a gap that the old system had and an essential one in the New Health Age.
On a personal level the key flows are: wellness, prevention and proactive.
Anyone reading this column has probably heard the proverbial phrases
“An apple a day keeps the doctor away”
and
“An ounce of prevention is worth a pound of cure”
Americans have had a “pound of cure” healthcare system. We are moving toward a much more preventative system that is based upon prevention.
As a futurist, I am always making forecasts. Back in August 2012 [https://davidhoule.com/forecasts], I forecast that
“Health care will be called health management by 2020.”
We have entered a new era of healthcare when active, informed prevention will take on an ever-greater part in our healthcare system. We will still always need treatment for a variety of maladies but an ever-greater part of how we think about and how we pay for good health will come from active prevention practices.
In this new preventative system, as the apple quote above suggests, better eating habits and better nutrition will be integral to better health. Several well-known doctors have firmly stated that the more we focus on what we eat and our nutrition, the less drugs and treatments we will need through life. We will increasingly move away from the reality of “big food” getting us sick so that we need the drugs from “big pharma." That old adage from 50 years ago “you are what you eat” will now become part of the structured preventative healthcare system.
FYZICAL and many other entities that are embracing many of the nine dynamic flows will be the emerging health centers of the future. Remember we are moving from “healthcare” to “health management." It will be necessary for all of us to find those we trust to help us better manage our health so we won’t get sick, injured or develop a chronic condition.
Welcome to the New Health Age!
-David Houle, co-author of "The New Health Age: The Future of Healthcare in America"
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