Managing Behavioral Healthcare Disruptors

As both our digital and economic landscapes shift, market disruption is inevitable—even in the behavioral healthcare industry. Experts have already begun to identify which behavioral healthcare disruptors will likely have the greatest impact over the next five years. This month, we examine the trends that may affect I/DD service providers.

CapGrow behavioral healthcare-disruptors blog

Changing Guidelines and State Interventions

It’s not uncommon for healthcare policies and programs to shift at the federal level. Every year presents a challenge different from the last, forcing providers to find a way to stay up-to-date on federal changes and adapt accordingly.

At the state level, decreases in federal funding often spur innovative solutions to ensure programs can survive. Medicaid is evolving through expansions in healthcare delivery, which enables states facing budget issues to utilize federal cost sharing to meet the health needs of its residents. Many of these programs are delivered at the community level and utilize value-based payment models.

→ This move toward value-based reimbursement requires I/DD service providers to focus on metrics, standardization and a customer-service orientation to remain successful.

Managed Care

Medicaid expansion has provided new and more community-centric approaches for providing healthcare services; however, the expansion has also led to heightened pressure to keep costs down. This shift in managed care and addition of waivers has boosted flexibility in services that offer more independence on a personal level to those who receive services in the I/DD sector.

Managed care models have had to adapt to better serve emerging target populations with critical health issues. This includes providing Medicaid direct services to those individuals with mental health and substance abuse issues at a community level. The I/DD and autism populations have also been affected by the adaptations of managed care, as providers look to implement LTSS such as community housing and employment for these individuals.

→ Providers face the challenge of moving from a volume-based mindset to a value-based one, wherein they can integrate care, track client satisfaction, and provide proof of evidence-based services.

Social Determinants

Although a person’s genetics evidently influence their health, experts have started to focus on social conditions as an even greater influencer on health outcomes. These “social determinants” constitute socioeconomic status, educational attainment, work and living environments, social connections, and access to food and healthcare. These external factors have also been identified as key drivers in preventing  morbidity or mortality, which is already changing the traditional healthcare paradigm.

Care is not just focused on acute treatment, but on preventative strategies, and providers are expected to take a wholistic and integrative approach to providing services that focus on long-term wellbeing. A more expansive (and proactive) approach expands the pool of those most likely to access services, and requires effective collaboration across a myriad of providers. Although a long-term approach to preventive care could yield a healthier population overall and thus lower costs, demand is likely to increase faster than costs decrease.

→ Providers will need to engage in strategic partnerships that allow them to meet the needs of an expanding client base, while balancing budgetary and staff constraints.

Personalized Care and Treatment

Consumers have begun to expect personalization in all areas of their lives, including their healthcare. Precision medicine has made it possible for individuals to access treatments that accommodate their needs, which can be both costly and difficult to provide on a large scale. Individuals – and their advocates – will likely continue to push for more healthcare services and programs that are self-guided. Many providers have already embraced self-driven services, but for the organizations that have not, there could be extra pressure to make the desired changes to their programs.

→ Designing implementation processes that ensure sustainability while preventing burnout may help balance consumer demand with employee needs.

eCommerce and New Technology

Top companies like Amazon, Apple and Google have started to make their way into the healthcare market. For example, these retailers, in addition to insurers, have begun to partner with pharmacies. This growth of ecommerce and the continuing transformation of new technology are predicted to have a dramatic effect on healthcare in the next few years. Many companies have begun to offer remote monitoring or smart home features, as well as behavioral supports and educational tools that can easily be accessed from home. Many other industries are already utilizing artificial intelligence (AI), and as it’s integrated into the healthcare marketplace, it is sure to rapidly change the current landscape.

With the introduction of healthcare wearables, apps, and companion tech, consumers have a plethora of options to choose from; the lines between information collection, analysis, and treatment administration have blurred. Healthcare data like this has become a valuable resource and powerful tool, throughout all niche healthcare industries.

→ Providers will be challenged to integrate new technologies into their processes, which could serve as an extension of their human workforce. They will also need to gather useful analytics and metrics that improve delivery of care by facilitating care coordination and integration across multiple sources.

Boosting Sustainability

While we’ve included strategies for dealing with each disruption described above, it may be helpful to think about concrete ways to boost sustainability amid the possibility of disruption. These changes could require greater flexibility to quickly adapt to unforeseen shifts in the market. Any kind of disruption calls for a vision based on long-term planning and strategic partnerships to make that vision a reality.

When it comes to planning for your future, we’re an ideal strategic partner. Our team of real estate experts free up staff time and energy so that your resources can be directed toward care. Our flexible leasing options and exemplary service are tailored to match your vision and enable you to allocate additional funds towards program development or payroll, for example. To learn more about how partnering with us can help you boost sustainability, contact us via email or visit our website.