Top 6 Insights for North Carolina Healthcare Providers To Know in 2023

If you wish you had a crystal ball to peer into healthcare’s future, we’ve got the next best thing. Leaders at five major healthcare systems in North Carolina have revealed the challenges and opportunities they are thinking about as they plan for the next three to five years. Their insights can help you with your own organization’s strategic planning.

 

Meet the Panel of 5 North Carolina Healthcare Experts

Speakers shared their insights at a May 9 webinar hosted by the Triangle, Triad, and Charlotte Business Journals:

• • Dr. Craig Albanese: CEO at Duke Health
  • Dr. Wesley Burks: CEO at UNC Health and Dean of UNC’s School of Medicine 
  • Dr. Mary Jo Cagle: President and CEO at Cone Health
  • Ken Haynes, EVP & President, Atrium Health, Charlotte
  • Jeffery Lindsay: EVP and CEO at Novant Health
  • Zac Ezzone (moderator): Staff Writer at Triangle Business Journal

 

Insight #1: Health Care Won’t Go Back To ‘Normal’

Even three years out from the beginning of the pandemic, “‘normal’ no longer exists for our colleagues or the patients we serve,” Dr. Burks said.

North Carolina health systems continue to grapple with COVID’s “persistent, longtail” financial effects, Dr. Albanese commented. Challenges include rising supply costs, patients’ inability to pay out-of-pocket costs, and payor contracts that are lagging years behind inflation. Many healthcare workers became burned out and left their fields during the pandemic, which has forced health systems to hire more expensive contract workers. More than half of the country’s hospitals finished 2022 with a negative operating margin, moderator Zac Ezzone pointed out. 

As healthcare organizations manage these pressures, they simultaneously must figure out how to serve patients seeking care that is more customized and convenient. The pandemic taught both health systems and patients that the care they need could sometimes be remote or closer to home. Many patients want these conveniences to continue, while some want to return to more old-fashioned ways of receiving care. 

Health systems must serve patients who have various, more particular needs and desires surrounding how they receive health care. 

 

Insight #2: Non-Healthcare Businesses Influence What Consumers Expect from Healthcare

Dr. Burks described what he called “the Netflix phenomenon.” Consumers can watch any show, anywhere, any time, and they want their healthcare providers to offer similar “on-demand” conveniences. People want to be able to schedule visits online instead of making phone calls. Many want to see providers via telehealth, and if they must visit in person, they don’t want to drive very far. And they don’t want to spend a lot of time in waiting rooms.

Even prior to COVID, patients wanted to receive health care closer to home, Haynes observed. Now they want care in the home. “Hospital at home” experiences started before COVID and accelerated during COVID, thanks in part to shorter post-surgery recovery periods and better ways to communicate with patients.

Consumers continue to push providers and payors to deliver care more efficiently and effectively. “I think it’s for the better,” Dr. Burks said. “We believe more and more people want to be cared for in an outpatient setting,” Dr. Cagle commented. To make this kind of care delivery work, health systems need to develop their home care and post-acute care offerings.

 

Insight #3: Healthcare Systems Will Put Digital Development Ahead of ‘Brick & Mortar’ Development

Health systems used to think about growth as “dots on a map,” Lindsay told webinar attendees. We followed the “Field of Dreams” model for health care–”If we built it, patients would come,” Dr. Cagle commented.

But now, North Carolina’s health systems are balancing new brick-and-mortar sites with new avenues for digital access. Virtual care won’t ever replace in-person care, of course. Rather, it will create what Dr. Cagle called “digital front doors” for patients–in primary care contexts, for example. In doing so, health systems must plan to serve North Carolina’s growing urban centers, as well as the state-long underserved rural areas. In many cases, digital development could improve access to care for rural patients. 

 

Insight #4: AI Could Help Doctors and Nurses Manage Communication Tasks

Healthcare technology has long lagged behind technology in other industries, a situation that has long frustrated both providers and patients. But as patients become used to electronic portals such as Epic’s My Chart, doctors and nurses have much, much more electronic correspondence to handle–a situation that contributes to employee burnout.

In the future, generative AI may help doctors and nurses answer patients’ digital questions more efficiently and clearly, a recent Wall Street Journal article reports. A preliminary study published in JAMA Internal Medicine last month showed that a “chatbot generated quality and empathetic responses to patient questions posed in an online forum.” More research is necessary to explore whether generative AI performs as well in clinical settings to reduce the administrative burdens that doctors and nurses face. North Carolina’s health leaders are closely monitoring AI’s potential to reduce administrative burdens for their workforces.

 

Insight #5: North Carolina Healthcare Providers Face New, Giant Competitors

In the past, major North Carolina health systems competed only with one another–what Dr. Cagle called “friendly elbowing.” Now, they face new competition from large international or national companies like Walmart and Amazon, which are muscling into North Carolina’s healthcare markets. Our country’s biggest employer of physicians is United Health Group’s Optum, one panelist reminded webinar attendees. Big companies will continue to try to lure talent in an already-tight healthcare labor market.

Our biggest investment is in recruiting and retaining our frontline healthcare workers, Dr. Albanese pointed out. That necessitates being “parsimonious” with capital spending, he said, and sometimes means reducing leadership spending, another panelist added.

To provide quality healthcare that isn’t overly commoditized, North Carolina’s health systems will likely partner with organizations they may have regarded as competitors in the past, panelists agreed. We no longer have to design, build, and own entire new systems ourselves, one panelist noted.

 

Insight #6: 600,000 North Carolinians Are Now More Able To Pay for Their Health Care

The opportunity for states to increase the number of citizens eligible for Medicaid came more than 13 years ago with the Affordable Care Act (ACA). Only 10 states have declined the federal funds that the ACA provides for Medicaid expansion, and North Carolina has been one of those states. But that changed this past March when the legislature passed the Medicaid expansion bill and Governor Roy Cooper signed it into law.

Medicaid expansion benefits working poor people who are not eligible for traditional Medicaid, but whose incomes are too low to benefit from the open health insurance marketplace that the ACA created years ago.

“We are delighted that Medicaid expansion has passed in our state,” Dr. Cagle commented. Many health systems have always served and will continue to serve patients without coverage who can’t pay for their care, particularly in emergency rooms regulated by EMTALA. But Medicaid expansion means fewer bills will go unpaid, and health systems won’t have to bear the financial burden of providing care they aren’t reimbursed for.

Even so, financing remains a perennial challenge for any healthcare organization, just as it has for years. “None of us created the healthcare financial system that we live with,” Dr. Burks commented, “we have to work within it as best as possible.”