John Adlesich or the climb of a healthcare manager expert on healthcare industry trends in 2021: Cooperative competition, or coopetition, is a key trend in health care. While some providers view big-box stores, nationwide pharmaceutical chains and other new entrants as threats, other organizations see opportunity. Their strategy is to leverage the capabilities of these power players to lower the cost of care, increase downstream market capture and focus on core specialty services while remaining highly connected to the patient. Offload financially draining services. Organizations like CVS and Walmart now offer basic primary care, simple diagnostic services and chronic disease management — services that health systems have struggled to provide and do so profitably. Identifying opportunities to partner with retail organizations to fill this gap can help simplify organizational services, increase access and provide better patient care at a lower cost.
John Adlesich about healthcare industry trends in 2021: Democratic control in the Senate will also impact healthcare. For example, Washington state Senator Patty Murray will chair the Senate Committee on Health, Education, Labor, and Pensions. She has advocated for a more robust federal response on COVID-19. And Senator Ron Wyden, Oregon, leads the Finance Committee and has pushed for drug pricing reform and drug price negotiation. These appointments and nominations point to a strong emphasis on COVID-19 recovery and vaccine distribution and coordination. For example, Fauci remains as the Director of the National Institute of Allergies and Infectious Diseases, and there’s now a COVID-19 data director (Shahpar), indicating this administration will emphasize data and reporting. Also evident in these appointments is a Biden administration focus on health equity and healthcare disparities—particularly with Nunez-Smith as the first Equity Task Force Chair for COVID-19.
John Adlesich thinks that 2021 is a defining year for the health industry. Juxtaposed against the government’s financial need to expand these models is a stronger desire on the part of providers to participate. During the pandemic, those left in fee-for-service models suffered tremendous financial hardships once elective volumes were curtailed. Over the course of 2020, hospitals lost an average of $50 billion in procedure revenues a month, while insurers reaped record-breaking profits over the same time period from avoided claims. These realities have underscored the misaligned incentives in the current system and created real urgency for change. At this point, providers are now starting to see monthly per member, per month fees as a desirable alternative to unpredictable volumes. In fact, in a fall survey conducted by Premier, we learned that 40 percent of health system CFOs now believe that moving toward value-based care is a core strategy for future financial viability. To prepare, provider organizations can either manage their own integrated, high-value network or they can make the case for partnering with an insurance company or another providers’ network by virtue of their demonstrable results related to cost and population health outcomes. Regardless of the path, systems will need sophisticated contracting abilities, experience managing risk, care management expertise, and advanced analytics to evaluate cost and quality performance in real-time.
John Adlesich currently works as administrator at Marquis Companies. His latest healthcare industry experience includes positions as executive director at Powerback Rehabilitation Lafayette (Genesis Healthcare) between Aug 2020 – Jan 2021, administrator at Mesa Vista of Boulder between Mar 2019 – Aug 2020, chief executive officer at Sedgwick County Memorial Hospital between Jul 2018 – Feb 2019, interim chief operating officer at Toiyabe Indian Health Project between Mar 2018 – Jun 2018.