The COVID-19 pandemic has forced dramatic changes in healthcare delivery in the US. It has exposed the human and financial costs of the nation’s health inequity. And it has accelerated change — forcing us to shift to virtual health and more care delivery in the home. Yet the infrastructure and forces required to sustain this transformation continue to remain challenged – specifically, outdated payment models to seamlessly support in-home end to end care, disjointed patient (and caregiver) experience as patients navigate across different care settings, and the administrative overhead (aggravated by labor shortage) to solve for these limitations.
The technology revolution pre-COVID was more aggressive than the healthcare industry had an appetite for consuming, leading to lack of adoption – by physicians, payers & patients. COVID, not only mandated technology adoption by both patients and healthcare providers, but it has us challenging antiquated regulatory rules, rethinking prior authorization processes, activating and managing a remote workforce, and investing in technology.
In 2021, the HME industry’s historical challenges of regulations and reimbursement rates were further exacerbated by safety concerns, staff shortages and supply chain issues caused by almost two years of the COVID pandemic. In spite of these challenges, the HME industry has shown incredible resilience and demonstrated its value in the healthcare delivery ecosystem.
The good news is that the HME market is healthy, estimated to by around $56 billion and growing 6% annually – and it’s profitable. It is important to note the patient is paying an increasingly larger percentage of the HME bill. The attractiveness of the market is evidenced by the rapid pace of consolidation, the amount of investment money coming into the space and the success of the publicly traded HMEs.
At the heart of this crisis, the world became more resilient and learned the value of virtual care delivery. Virtual care delivery & in-home care is here to stay and will be the dominating force to drive digital transformation in the payer, health system, pharma, HME, home health and other home-based care providers’ businesses & operating models. Several such game changing market forces are currently in play that are likely to disrupt our industry in 2022 and beyond.