There have been many defining factors throughout the past decade, especially in the healthcare industry. These changes, both good and bad, have defined this industry. From the opioid epidemic to progress made against cancer, these past ten years have brought new problems and new successes. According to Becker’s Hospital Review, these are the twelve milestones that have defined the 2010’s.
The Affordable Care Act
The Obama administration signed this act into law in March of 2010, bringing some of the biggest changes to the healthcare industry since Medicare. The ACA brought an expansion to Medicaid and the health insurance mandate, but it has also been a topic of heavy debate. While it has been weakened since Obama left office, and its future is unsure, the ACA has brought changes to healthcare that are likely to stay forever. The ability of children to remain on their parents’ insurance until age 26 and coverage for those with preexisting conditions will be a staple of healthcare.
The Opioid Epidemic
One of the largest public health issues of this decade was the opioid epidemic. Due to the over-prescription of these medications and a number of other problems, the abuse of opioids became a large issue across the country.
Despite the FDA and DEA’s efforts to curb this epidemic, whether that was through approving “abuse-deterrent” forms of opioids or performing drug busts, there were still 64,000 deaths from drug-overdoses in 2016. Three-fourths were due to opioids. The issue only grew in 2017, where it reached its peak with 74,000 drug-overdose deaths.
With these opioid-related deaths came crime, homelessness, and unemployment. These developments made it clear that there needs to be improved social services in addition to legislation and reform in the healthcare industry.
Fortunately, the number of overdose-related deaths fell for the first time in the decade in 2018. While progress has been made, fighting this epidemic is an issue that is going to continue into this new decade.
New Global and Public Health Threats
New threats have popped up over the course of the decade, whether it was diseases like Zika, or modern threats, like vaping and mass shootings.
Three outbreaks that defined the decade were Ebola, Zika, and measles. In 2014 the Ebola outbreak began, killing over 11,000 people in West Africa and two in the United States. This was followed by the Zika outbreak, which began in Brazil in 2015. Over 200,000 cases of this disease were reported in Brazil, with an additional 40,000 in the United States and its territories. Measles, which emerged after laying dormant for almost 20 years, affected 1,249 people in 2019. People in 31 states were affected, with people who did not receive their vaccinations contracting the disease.
Public health threats that were unrelated to diseases also became large issues during this decade: vaping and mass shootings. As physicians are the people who treat the results of mass shootings, they began a campaign to curb gun violence and end mass shootings. They were met with some resistance, especially from the NRA.
The end of this decade also brought many cases of illnesses connected to vaping. By the end of 2019, the CDC found that 47 people had died due to vaping-related illnesses, with another 2,290 affected. These deaths and illnesses have made vaping a heavily debated topic, which will continue into the new decade.
Healthcare spending reaches $3 trillion
2014 saw a huge expansion in healthcare spending, with an expansion in coverage and the growing cost of prescription drugs as causes.
As of now, this spending equates to over $11,000 per person, which is the highest amount of any country in the developed world. While America is number one for healthcare spending, the country ranks 27th for quality of healthcare. With this spending estimated to double by 2027, many people are recommending changes to the healthcare industry.
The Closing of Many Rural Hospitals
Throughout the 2010’s, 120 rural hospitals have closed. As about 60 million people live in rural areas and depend on these hospitals, these closures are an issue. Issues such as reliance on government payers, uncompensated care, a low number of patients, a shift from inpatient to outpatient care, and regulatory burdens are to blame.
Patients of these hospitals experience a lack of care when they close down, and studies have shown that the inpatient mortality rate grew by 5.9%. Patients also have to deal with transportation to further hospitals, a burden that many cannot handle.
Not only do patients go through hardships due to these closures, but the local economy does as well. Hospitals are large employers in rural areas, and their closures can drive people away from the town and hurt economic growth.
Theranos
Theranos was a biotechnology company that offered a large amount of lab tests through the use of only a few drops of blood using technology called Edison. It was started by Elizabeth Holmes in 2003. 12 years later the Wall Street Journal published an investigative story that exposed the company for using normal laboratory tests rather than its own technology. When it did use its own technology, it provided inaccurate results.
The company dissolved and Holmes and the COO face up to 20 years in prison. Although they can no longer harm anyone, many people were fooled by this company for over a decade. Not only were investors fooled, but patients were as well. They were the ones who trusted this company, and they were the ones who deserved better.
Employers Changing Health Insurance
Large companies have created their own healthcare programs to lower the cost of employee healthcare spending. Companies such as Walmart, Amazon, and Berkshire Hathaway have all done so.
The Pacific Business Group on Health created the Employees Centers of Excellence Network in 2013, which finds hospitals, doctors, and health systems based on their quality. Large companies can join this network, and employer use was at 88% in 2019.
One of the biggest changes to employer healthcare has been Amazon, JPMorgan, and Berkshire Hathaway creating Haven Healthcare, which is meant to cut costs for over one million employees. This program began testing in November of 2019.
Improvements in Cancer Treatment
Many advancements were made in cancer treatment in this decade. Survival rates are up for males and females for all types of cancer, and new breakthroughs have become available.
Immunotherapy has altered cancer treatment for the better, being named “breakthrough of the year” in 2013, and researchers earning a Nobel Prize for it in 2018.
New leukemia medications have also been approved by the FDA over the past decade after a lack of drugs for this cancer in the previous 25 years. CAR-T cell therapy is one of the most notable.
Genetic testing and mapping of the genome is something else that has allowed doctors to better understand and treat cancer. Awareness was risen about genetic testing as well, partly because of Angelina Jolie’s public testimony and double mastectomy.
While medications and technologies have improved throughout the decade, the price has also risen. This rise presents a challenge to healthcare professionals in the upcoming decade.
Deep-Rooted Industry Problems
Some issues in the healthcare industry have been exposed during this decade, such as extremely high prescription prices and surprise billing. Rather than legislative bodies and healthcare professionals working together to fix these issues, they have all pointed fingers at each other.
While legislation has widely been stalled, the Trump administration has finalized a rule that requires hospitals to show the prices for services that they agree upon with insurers. This administration has also created rules that encourage transparency in healthcare plans.
Prescription drug prices, on the other hand, remain high. Nobody wants to take the blame, and nobody seems to know what to do to fix it. This issue will follow us into 2020.
The Move to Digital Records
The move from paper to digital records through the use of EHRs defined the 2010’s. 95% of hospitals were using an EHR as of 2017, and 94% were using them to improve quality, patient experience and safety, and organization.
Patient portals have greatly enhanced the patient experience, as patients can make and cancel appointments, get doctors’ notes, and manage their own healthcare. They have also reduced the burden on hospitals and been used for research.
Healthcare Rankings
As people typically want to receive their healthcare from the best, it’s natural that they are interested in healthcare rankings. The U.S. News and World Report ranking is one that all hospitals want to be on top of.
The Leapfrog Group is another agency that helps people find the best healthcare, as they give a letter grade to hospitals across the nation based on their safety. ProPublica has also released a similar platform, called the Surgeon Scorecard.
While many of these agencies and ranking systems receive critique and need to update their methodologies, they are heavily relied on by patients and hospitals to rate performance. Patients use them to choose their care and hospitals use them to try to improve. They are not going away in 2020.
Hospitals Change their C-Suites
Hospitals have created increasingly diverse C-suites to reflect the changing healthcare industry. Old C-suites included positions like CEO, COO, and CFO. Now there are a multitude of different positions. They include:
- Chief Diversity Officer
- Chief Experience Officer
- Chief Innovation Officer
- Chief Medical Information Officer
- Chief Nursing Informatics Officer
- Chief Pharmacy Officer
- Chief Quality Officer
- Chief Revenue Officer
- Chief of Staff
- Chief Strategy Officer
- Chief Wellness Officer
Over this past decade, there have been many changes to the healthcare industry. Some are good, some are bad, but they have all defined the past ten years nonetheless. This new decade will bring its own milestones.
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