Five Digital Health Insights to Bring Into 2023

Historically, the pace of technological advancement and acceptance has been much slower in healthcare than in other industries.

I saw this first-hand as Chief Technology Officer at Candid - a high-growth oral healthcare startup in 2017. We ended up building our own care delivery stack from the ground up, including EHR, Patient Engagement, provider tooling, business intelligence, and everything in between. This was a frustrating (not to mention incredibly expensive) exercise.

Thankfully, due to tailwinds driven by the unbundling of care, legislation like the CURES Act, and a shift to value-based care, healthcare innovation has fast-tracked over the past few years and there are now API-driven digital solutions that lower overall cost of care delivery at scale, while maintaining clinical outcomes.  

While challenges remain in the development and adoption of digital health solutions, I am confident there are tremendous opportunities for growth.

The last two years have provided frantic investment and growth across all areas of healthcare. This has created a fertile environment for testing, discovery, and delivery of new care methods and business models.

At Capable Health, we helped launch a dozen new digital health services last year. I wanted to condense our top five insights from working with pioneering virtual care delivery organizations. These digital health insights represent trends that are expected to continue shaping the industry, and preparing for them will help virtual care delivery organizations stay ahead of the competition in 2023:

1. Telehealth has been proven to increase financial and clinical outcomes – and is here to stay. 

In 2020, COVID-19 saw a rise in telehealth by necessity, but many people weren't sure if it was just a trend or fad.

However, the past few years have proven time and again that telehealth is better for providers. Studies show that telemedicine reduces the odds that surgical patients will no-show by more than two-thirds. Additionally, the care is just as good as it is in person. With clinical and financial benefits for providers and patients, virtual care isn’t going anywhere… in fact, it’s only going to continue to rise. 

People are becoming accustomed to getting the products and services they want quickly and this expectation extends to the healthcare industry. Patients are demanding faster digital health product development cycles, a seismic shift from the traditionally sluggish stops and starts of the industry. Practitioners aren’t content with outdated modes of care delivery that don’t match the digitally enabled world we’re living in. 

To meet this demand, healthcare companies will continue looking for ways to reduce friction while building better virtual care and home care experiences that can get to market and scale faster. By collecting and analyzing data on how users interact with their products, companies can identify areas of improvement and make informed decisions about how to evolve their offerings over time. It’s not just what patients want, but also what practitioners want. 

2. Providers are shifting towards Value-Based Care as part of the paradigm shift towards paying for value.

Changes in treatment models are being driven by digital healthcare technology that closes the gap between patient and provider.

Traditionally reactive care delivery is giving way to a more proactive approach – the Value-Based Care (VBC) model. VBC aims to advance providing better care for individuals, improve population health management strategies, and reduce healthcare costs. 

The market is rewarding those who can deliver health outcomes. According to a McKinsey study, value-based plans are expected to “grow to 22% of lives insured by 2025,” up from 15% in 2021. Data from the Centers of Medicare and Medicaid Services show that value-based care can lead to cost savings of up to 30% compared to the fee-for-service model. 

In order to demonstrate improvement and report on specific metrics to payers, providers need to rely on data. Under a VBC model, providers are incentivized to track information on their patient population and ensure they are staying engaged through personalized care plans. When patients receive more coordinated, appropriate, and effective care, providers are rewarded. 

3. Risk stratification is core to the success of the VBC model. 

Risk stratification is the process of assigning a risk status to patients and then using that information to direct care. It enables care delivery businesses to optimize their healthcare resources by identifying the most accurate level of services needed for individual patients. This method helps support a value-based care model because it allows businesses to make an accurate assessment of whether outcomes are actually improving or if further intervention is needed. 

Digital health solutions can enable and automate it. Technology can be leveraged for capturing and using patient data to surface at-risk patients and reporting for population health management, smart scheduling to ensure patients are matched with the right practitioners at the right time, care coordination amongst teams across the entire patient journey, and much more.

4. Digital health providers are looking to take in-network payments from the start.

Standing up revenue cycle management used to be expensive and painfully complicated. Thanks to advances from startups like Candid Health, accepting insurance is now much faster and simpler.

Years ago, many prolific digital health companies who didn’t want to deal with contracting and claims processing with health insurance started out as direct-to-consumer businesses, e.g. Hims and Hers or Ro.

However, cash payments can be limiting – Statista findings show that 92% of the U.S. population pays for their healthcare through insurance. 

Digital health providers are looking to increase their patient population by taking insurance and it’s easier than ever to do so with revenue cycle management (RCM) solutions that lower the barrier for insurance billing and reimbursement in all 50 states. RCM helps manage the traditionally frustrating administrative and financial aspects of patient care and can help streamline administrative processes. With access to real-time insights into financial performance, care delivery businesses can identify trends and areas for improvement. 

5. The industry is finally ready to answer the buy vs. build question. Hint: don’t build what you can buy better. 

The pace of innovation coming from new players in healthcare has made it possible to choose whether you want to buy or build parts of your digital solution. According to Ellie Wheeler, a partner at Greycroft, Improvements to infrastructure offerings mean care delivery solutions can focus on the driving force of their business – improving health outcomes. 

The next generation of digital health solutions will depend on leveraging the best-in-class software. When partnering with an outside vendor, digital solutions can focus on what their differentiation is, all while mitigating risks and closing gaps that could come from providers building themselves. 

As technology continues to advance, we can expect to see even more innovative solutions that will help to improve the affordability, and quality of healthcare for all. Successful virtual practices will need to move beyond cash billing and encounter-based care models to improve patient outcomes and deliver value.

Capable’s extensible patient engagement stack for longitudinal care delivery empowers organizations to do just this.

Learn how Capable can help you meet the challenges and opportunities within digital healthcare, and stay ahead of the competition in 2023. Schedule time with our team today.