Health Care's Three-Year Horizon

For most health systems, the post-COVID survivor mode has ended. Systems have reached some level of cost structure and workforce stability, and they can turn their attention once again to strategic investments and growth. But that doesn’t mean the coming years will be without challenges.

Top of mind for many is ambulatory growth and access, capacity management, new revenue generation, and scale and partnerships. Other big-picture issues facing the industry during this pivotal time include trends the industry has been anticipating for many years that are finally becoming reality, such as artificial intelligence and the silver tsunami. Over the next three to five years, three big themes—value, integrative health and aging—will persist, and health systems will need to account for these factors as they dive back into strategic plan development.

Create a Value Proposition for All Stakeholders

For more than a decade, when health care leaders heard the word “value,” their minds instinctively went (and, often, still go) to value-based care. But the imperative moving forward will be to think of value beyond the payer-driven definition of clinical quality and deliver on value as defined by each stakeholder group:

• Consumers. Be the market leader in patient navigation and proactive education.
• Payers. Blend clinical and pricing data to advance contracting discussions.
• Clinicians and staff. Improve recruitment and retention by making the value proposition the key differentiator.

Studies have found wide gaps between what providers think patient pain points and preferences are and what patients actually identify as pain points. As health system leaders work to establish and maintain value among disparate stakeholders, they must identify who is asking the tough questions today and tomorrow and then leverage the robust data assets available to them.

Move Past the System of CARE for True Differentiation

Twenty years ago, the patient journey was defined by procedures and individual encounters. With an understanding that care is more than a series of transactions and is, in fact, a journey that includes several sites and points of care (including prevention and post-event care), we evolved to a System of CARE approach. But as patient complexity increases, health systems struggle to address all patients’ needs within the confines of the traditional health care continuum.

Beginning as a market for supplements and vitamins, the wellness industry has diversified and expanded to include tools and solutions acting as the digital eyes, ears and resources that allow providers to monitor, manage and treat patients anywhere and at any time. This evolution has created an opportunity to evolve the patient journey once again to an integrated health approach underpinned by wellness solutions.

For example, platforms have been designed to improve patient engagement and care for cancer patients, including:

• An AI-enabled platform that engages cancer patients in real time between visits to assess their acuity and severity, manage their symptoms virtually or escalate to the ED if needed, avoiding unnecessary ED visits.
• A digital solution that can set an organization’s patient navigation capabilities apart by addressing the full spectrum of care for cancer patients, survivors and their families on a wide variety of issues, such as sexual health, cardio-oncology, genetics, child life services, smoking cessation, and recreation and pet therapy.

The current wellness market in the US is valued at more than $1 trillion and continues to grow. The past few years have seen growth in some segments as high as 20%, far surpassing growth in the US hospital acute care space. Now is the time for health systems to seize the opportunity to enter the wellness market with an eye toward alignment with existing strategic objectives.

Transform Care for the Population Aged 65+

Since the baby boom generation began turning 65 years old in 2011, the industry has been talking about the impending silver tsunami. Now it’s here, and the ripple effects will be felt for several decades to come.

Even as this large population ages, life expectancy is also on the rise. By 2035, older adults will outnumber children. The programmatic transformation needed to care for baby boomers will require much more nuance than many health systems are prepared to accommodate. To stratify boomers’ needs, basic questions must be asked: How old is the patient? How healthy is the patient? How wealthy is the patient? And as a growing number of older Americans continue to work well into their 70s, additional questions may include whether the patient is employed and what the patient’s insurance coverage status is.

STRATIFY THE SILVER TSUNAMI TO ADDRESS UNIQUE PATIENT NEEDS AND RESOURCE AVAILABILITY

Sg2 has identified four senior cohorts in a strategic framework that allows health systems to pinpoint specific needs within each quadrant, with the understanding that resources need to be distributed across all four groups.

Sg2 acknowledges that, given the breadth and scope of the challenges organizations will soon contend with, solutions may require a three- to five-year runway to develop. But health systems can take steps in 2025 to get started:

• Prioritize initiatives that deliver on a value proposition for each stakeholder segment.
• Identify holistic care goals and determine which partnerships are needed to build an integrated health ecosystem.
• Begin mapping out programmatic changes needed to care for the various segments of the aging population.

As a new administration enters the White House, much on the horizon has yet to come into view. Certainly, top of mind for members are Medicaid, the future of insurance exchanges, potential tariffs and immigration reform. Sg2 will continue to monitor these and other policy changes and initiatives.

Sources: Global Wellness Institute. United States wellness economy now valued at $1.8 trillion—the largest wellness market in the world [press release]. April 17, 2024; Global Wellness Institute. The global wellness economy reaches a new peak of $6.3 trillion—and is forecast to hit $9 trillion by 2028. November 5, 2024; Raths D. Moffitt Cancer Center partners with Reimagine Care. Healthcare Innovation. September 30, 2024; Hagen J. Reimagine Care extends partnership with Memorial Hermann Health System. MobilHealthNews. August 30, 2024; Marquez L. City of Hope and Reimagine Care collaborate to offer 24/7 monitoring and support to bone marrow transplant patients [press release]. City of Hope. September 28, 2023; US Census Bureau. The US joins other countries with large aging populations. March 13, 2018. US Census Bu- reau. Older people projected to outnumber children for first time in U.S. history [press release]. March 13, 2018; Duke Cancer Institute. Supportive Care and Survivorship Center. Accessed January 2025; Sg2 Interview With Reimagine Care, January 2025; Sg2 Analysis, 2025.