Technology, reimbursement equity needed to improve healthcare system

Healthcare was one of three topics discussed at the Northwest Arkansas Tech Summit held in Rogers, Oct. 28-29. It was the 11th year for the annual event that drew more than 1,200 people to discuss technology impacts on healthcare, retail and supply chain.

Marcus Osborne, chairman of RightMove Health, spoke about the challenges around delivering health care at a value despite the $3.8 trillion spent annually. He said escalating costs of medical insurance is a problem for small and midsize employers as costs are outpacing revenue growth by as much as four times.

He said as more people have adopted higher-deductible plans, they are less likely to go to the doctor. Overall, 81% of Americans are dissatisfied with their healthcare experiences. He said 55% of Americans have seen health care costs rise faster than incomes. Osborne said  45% delay vision appointments, and one in four don’t get annual screenings because of the time involved.

Osborne said a few years ago the industry doubled down on minute-clinics, more urgent care clinics for after-hour needs. Virtual care has also escalated to help improve access. Despite the industry’s attempt to expand access, consumers have more choices than ever, and yet they are hesitant to seek care. Osborne said the industry is trying to shift to value-based care but the payment structure is slow to make the move.

He said providers should work to improve their customer experience to a true omnichannel channel solution. He said when a patient goes to the doctor for the annual checkup the physician is in the dark about what is going on until tests are run and information is obtained about symptoms.

“Wouldn’t it be great if the doctor’s office contacted the patient to remind them to schedule the annual check-up? Then through a bot, ascertain any symptoms or issues the patient might be experiencing. A home sample test could be sent to the patient to collect a drop of blood, saliva or other samples with the help of a video. It could be sent back to the lab in the postage-paid package so the doctor knows what concerns and issues should be discussed before the patient arrives,” Osborne said.

‘NOT THERE YET’
Another session that featured commentary from Dr. Claude Pirtle, the new chief digital officer at the Heartland Whole Health Institute, and Dr. Cam Patterson, chancellor of the University of Arkansas for Medical Sciences (UAMS). Both have medical degrees, with Patterson being a practicing cardiologist.

Pirtle, who spent the bulk of his career teaching at Vanderbilt University and in medical/technical administration including two years at Walmart, said artificial intelligence is most useful in back office operations and health care education. Patterson said at UAMS AI is mostly used in patient recognition and automating back-office functions in areas like coding and billing.

“I would like to see it improve access to care, but we are not there yet,” Patterson said.

Pirtle said AI can move health care from reactive to proactive but scaling value-based care will also be crucial. Value-based care works to incentivize providers to help patients stay healthy, instead of getting paid only when they are sick. The move toward value-based care comes as regional healthcare providers are starting to lean into the model with insights and direction from Heartland Whole Health and the Alice Walton School of Medicine slated to open in July.

EQUITY PUSH
Patterson said it’s harder to recruit doctors and specialists to Arkansas because of the low reimbursement rates they are paid for medical procedures compared to the surrounding states. Patterson said reimbursement rates from Medicaid and Medicare are the lowest in the country even though Arkansas workers pay the same Medicare tax as anyone else in America.

“Poorer states are subsidizing the cost of care in more expensive states. One area of concern is OB. as our own obstetrics program is down 50%. We have been active in expanding midwifery and community healthcare workers to areas of need. In areas like El Dorado, there are two practicing OB-GYN doctors who are each over 75 years old and one other who works part-time. In other areas, the closest doctor or delivery hospital is more than 60 miles away. The low reimbursement rates are indexed to wages and adding more midwives could take the average pay lower. We need to actively work with legislators to fix this broken reimbursement system,” Patterson said.

Pirtle said part of the strategy at Heartland Whole Health is equity. He said technology allows patients to access care when and how they like. Given doctors and nurses are in short supply, virtual care through smartphones is one way to provide greater access. He said even though healthcare is fragmented, advances in technology are positive. Using smart bottles and Bluetooth technology, doctors can track whether or not a patient is taking their meds. Other wearable technology can track vitals and even muscle loss in elderly patients.

Pirtle said ambient listening technology is improving and physicians can use AI to record and transcribe conversations with patients into electronic medical records, saving valuable time for doctors.

Patterson said commercial insurers have long worked around the “keep them healthy until they are 65” model when Medicare coverage kicks in. He said providers need to look for partnerships like the Mercy and Mayo Clinic collaboration and also work with advocates who push for more equality in health care reimbursement.