According to a recent peer-reviewed study, health spending is projected to grow 5.4 percent from 2022-31 [1] and account for roughly 20 percent of the U.S. economy by the end of that period. That would represent a welcome stabilization in the healthcare industry following the COVID-19 pandemic and its aftermath. Yet, in 2023, profit margins of individual hospitals and health systems still presented a mixed picture.

As hospitals and health systems set their budgets for 2024, a unique set of priorities has emerged. New digital tools bring the potential to increase health equity and improve patient outcomes in financially strained regions. Expanded access to ACA-affiliated insurance plans also bodes well for access to basic healthcare. Meanwhile, the looming threats of digital cyberattacks and increased violence against healthcare workers will force providers to remain vigilant on multiple fronts.

Here are five trends to watch in the business of healthcare in 2024:

Providers bringing AI into healthcare
Artificial intelligence and machine learning tools have been gaining gradual acceptance in healthcare for several years, but the full range of practical benefits and applications have yet to be realized. A few early examples of AI adoption underscore a growing sentiment within the industry: the positives outweigh the negatives.

Take coding. Without much heavy lifting, a medical coder can use an AI script to review 1,000 patient charts and flag any that meet certain criteria. In hospitals where coding errors have been costly, this is an especially useful time- and money-saving tool that reduces the burden on human coders. Such AI tools are relatively inexpensive, making them available to hospitals of all sizes and operating budgets.

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The potential for biased datasets to exacerbate disparities in medical outcomes through the use of AI is beginning to get the attention it deserves.[2] AI tools also have the potential to reduce disparities. Anyone with an internet connection can access ChatGPT and input a question focused on their personal healthcare needs. Providers whose services are constrained by staffing shortages, or long driving distances for patients within a broad area, can educate patients on how to use an AI-based app to pre-screen their own symptoms at home.

Addressing healthcare disparities
The effects of racial gaps in healthcare are well-documented.[3] African American communities are more vulnerable to severe weather and floods, and are at higher risk to experience asthma as a result of polluted air, than other communities. Black women suffer from three times the maternal mortality rate as white women. People of color face disproportionate barriers to accessing mental health services.

Adapting solutions to address these and other sources of health disparities will take on greater priority as a means to reducing the long-term burden on providers in socioeconomically disadvantaged regions. A May 2023 study estimated the cost of increasing healthcare disparities on the U.S. economy at $451 billion.

The Centers for Medicare and Medicaid Services (CMS) recently recommended more aggressive data collection to identify risk factors ― underlying health conditions, social factors, access to care, etc. ― to support providers’ business initiatives. For example, CMS recommends using data “to support health care organizations in building strategic relationships with other local community partners to better understand and meet patients’ unmet social needs.”

Expanded access to ACA insurance plans
One key driver in healthcare disparities is access to basic coverage. As of 2021, Native Americans and Hispanics were twice as likely to be uninsured as whites, according to a Kaiser Family Foundation survey. CMS recommends “addressing gaps related to health insurance network adequacy, opportunities to enroll in coverage, affordable, comprehensive coverage options, and provider availability and shortages.”

Some progress is being made on that front. According to the Department of Health and Human Services, an additional 9.3 million people gained Affordable Care Act-related coverage plans between 2021 and 2023. About 4 in 5 individual ACA-related plan enrollees are now subsidized through policies included in the Inflation Reduction Act of 2022. As awareness and access to these programs increase, look for ACA enrollment numbers to increase as well.

Preventing violence against healthcare workers
More than one-third of healthcare workers experienced some form of workplace violence between Jan. 2020 and March 2022, according to a recent study.[4] Healthcare workers are trained to “always do no harm.” But what happens when they are in the difficult position of being the target of abuse ― verbal or physical ― from the patients and families they serve?

While rarely fatal, attacks against healthcare workers are five times more common than in other workplaces. Post-traumatic symptoms among victims are common. [4] To maintain the quality of the work environment for healthcare staff and their patients, the American Association of Medical Colleges reports that hospitals are adapting their practices to prevent violent incidents before they arise.

As more hospitals experience this growing phenomenon first-hand, look for their policies and procedures to evolve in response.

Focus on information security
In January 2023, a data breach affecting nearly 2 million patients was the subject of a class action lawsuit Massachusetts. Later that month, a US $4.3 million settlement was agreed to in Montana. These cases came less than two years after a US $ 6.85 million class-action settlement was reached, compensating more than 10 million patients in Washington and Alaska.

What did each have in common? Sensitive medical information and other private data was accessed by hackers over a period of days, weeks, or months.

As healthcare systems consolidate via mergers and acquisitions, or consider reducing IT staff as part of cost-cutting measures, the importance of information security only increases. A data breach could be financially devastating to a healthcare organization ― and erode the public trust. Expect healthcare systems to be more vigilant in the cat-and-mouse game between hackers and security providers going forward.

[1] Keehan SP, Fiore JA, Poisal JA, Cuckler GA, Sisko AM, Smith SD, Madison AJ, Rennie KE National Health Expenditure Projections, 2022–31: Growth To Stabilize Once The COVID-19 Public Health Emergency Ends. DOI: 10.1377/hlthaff.2023.00403
[2] Mittermaier M, Raza MM, Kvedar JC. Bias in AI-based models for medical applications: challenges and mitigation strategies. NPJ Digit Med. 2023 Jun 14;6(1):113. doi: 10.1038/s41746-023-00858-z. PMID: 37311802; PMCID: PMC10264403.
[3] Riley WJ. Health disparities: gaps in access, quality and affordability of medical care. Trans Am Clin Climatol Assoc. 2012;123:167-72; discussion 172-4. PMID: 23303983; PMCID: PMC3540621.
[4] Sari H, Yildiz İ, Çağla Baloğlu S, Özel M, Tekalp R. The frequency of workplace violence against healthcare workers and affecting factors. PLoS One. 2023 Jul 28;18(7):e0289363. doi: 10.1371/journal.pone.0289363. PMID: 37506128; PMCID: PMC10381052.

Featured image:Doctors and nurse. Photo courtesy: 2916 -2023 Fotolia/Adobe.  Used with permission.

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