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2024 Predictions From Health Executives: Advancements in Genetic Testing, AI in Health Care, and Cybersecurity Challenges
In this commentary, 9 health care executives predict where the industry is headed in 2024, with an emphasis on advancements in genetic testing, AI in health care, and cybersecurity challenges.
The California bill passed and signed by Gov Gavin Newsom in October 2023 supports my predictions from last year about 2023 being an inflection point for genetic risk assessments. The bill specified that pharmacogenetic testing is a covered benefit under the Medi-Cal program, representing a critical step towards the widespread adoption of PGx testing as a standard of care. In addition, we have seen the wider expansion of point-of-care genetic solutions. Genetic testing and pharmacogenomics (PGx) are lining up to have a huge year in 2024. Consumer demand for genetic testing is on the rise, and it is expected to continue in 2024, particularly for cancer risk, dementia, and cardiovascular disease. For physicians and caregivers, 2024 should see increasing reliance on PGx in behavioral health, particularly as the crisis of adolescent anxiety and depression continues to rise.
—Joel Diamond, MD, chief medical officer of Aranscia
While the tight labor market seems more flexible, our clients continue to share their critical need for workflow automation to reduce the administrative burden on clinicians and support staff. They tell us their teams are plagued with increasing phone calls and the need for individual outreach to guide patients along their care journey. As health care has become more comfortable with generative AI–especially when it’s paired with conversational AI to ensure in-context dialogs–they are eager to adopt digital solutions that support patient self-service across a range of communication channels and equip staff with dashboards to monitor patient status along the care continuum. These tools remove many manual tasks from the worklist, freeing staff to spend their time and expertise with those patients who genuinely need their attention.
—Nate Treloar, co-founder and COO of Orbita
2023 was an emotional rollercoaster in the cyber health world. The impact of relentless breaches on patients, communities, and businesses was more severe and concerning than ever before. Fortunately, entities that can bring some much-needed support are paying attention. From the executive branch to agency and state governments, there is a movement that will impact on the posture of critical infrastructure health care in 2024.
We’ll likely see a greater emphasis on outsourcing security in various forms, allowing health entities to focus more on their core function to address the current state of trying to keep up with the constant change in the threat and policy landscape. Virtual talent in cloud, architecture, and engineering will thrive, and third-party risk will be a mountain everyone needs to climb. Identity and access will begin and act as the new perimeter, and the basics of hygienic cyber behavior will be promoted through standards and proposed legislation.
—Carter Groome, founder & CEO of First Health Advisory
As predicted, health equity was a central theme in 2023 amid Medicaid redetermination. Over the past year, we saw unnecessary lapses in care and disenrollments due to a lack of education about the benefits process for Medicaid members, especially in many disadvantaged populations who were already experiencing barriers to care. Through this process, it was clear that health plans using multi-channel and personalized messaging were more successful in reaching members, and many were able to collect information on social determinants of health to help improve outcomes. In 2024, it will be vital for health plans to continue to build trust with members, help them navigate the health care system amid Medicaid redetermination, and provide education to limit care gaps. Prioritizing year-round member engagement will be the key to success. From delivering benefit reminders to offering education on alternative care sites, health plans can make an impact by building trust with their members throughout the year.
—Leah Dewey, MPH, vice president, Clinical and Consumer Engagement Operations of Cotiviti, Inc.
In 2023, AI was highly anticipated to be a game changer for the health care industry, driving transformation across all aspects of the consumer experience. But, it was also clear that achieving a harmonious balance between technology and the human touch would be imperative to ensuring meaningful and successful health care interactions. We saw this materialize further, with generative AI (GAI) taking the lead in 2023. A more versatile and adaptable AI model, GAI is better suited for human-centric health care applications, greatly influencing digital health initiatives.
I’m excited about the opportunities these advancing technologies offer health plans to unlock value in new and innovative ways, from addressing disparities in research and care delivery to improving quality, accessibility, and affordability. As we enter 2024, consumers increasingly expect more personalized and convenient care. A digital-first approach will be instrumental in empowering payers to stay hyper-focused on elevating the end-to-end member experience. Tools like journey mapping, customer segmentation, and advanced analytics will be pivotal to creating a holistic understanding of members and facilitating deeper engagement. At the same time, personalization driven by existing member data will play a major role in crafting resonant messages and improving health outcomes. In essence, the emphasis will be on utilizing technology not as a replacement but as an enabler of more compassionate, effective, and equitable health care.
—Rajesh Subramaniam, CEO of ResultsCX
The industry buckled up for a big year in Cures Act data exchange at the outset of 2023. While some steady progress was made, sizable barriers also developed that kept us further from our goal of true interoperability. Amid all the positive regulations and rules around data sharing that have rolled out, the Trusted Exchange Framework Common Agreement (TEFCA) came in as well-intended but, unfortunately, at odds with modern concepts of APIs and computable data need to democratize computable health data. ONC proposed exemptions for the information-blocking practices inherent in TEFCA that the 21st Century Cures Act initially banned. We’ll see if these rollbacks are finalized.
Meanwhile, we optimistically await the CMS expansion of modern FHIR-based APIs extending throughout the health care ecosystem. These modern APIs will empower the digital, app-based economy we need. I remain hopeful that the cards are stacked to achieve consumer-grade interoperability in health care.
—Dr Don Rucker, MD, chief strategy officer of 1upHealth
As predicted, health care organizations faced continued labor and financial pressures throughout 2023. The industry became increasingly competitive, with nontraditional providers like drug stores and retailers expanding their health care services. In this environment, providers face the challenge of balancing investment in new capabilities with cost containment. The GAI tools that took the world by storm in 2023 will help them achieve those goals in the coming year.
Combining GAI tools with narrower AI applications and software bots will enable health care organizations to automate key functions intelligently and benefit from unprecedented efficiency. Staff will be more productive working at the top of their licenses and skills. Costs will decrease, and outcomes should improve as providers find ways to revamp revenue cycles, care management, clinical operations, and more with GAI solutions.
—Venkatgiri Vandali, chief sales transformation officer, head, Healthcare & Lifesciences of Firstsource
The race to be the premier choice for shoppable health care services is on, particularly with Amazon’s recent announcement of Prime’s new health care benefits through One Medical. But the problem of access remains the Gordian Knot for health systems: as the digital front door (eg, self-scheduling, triage, virtual visits) has become table stakes, we expect health systems to continue pursuing new digitally-enabled strategies designed to engage and attract the consumer further upstream—through real-time navigation, convenient offerings, and more choice.
As we look to 2024, we expect to see more health systems develop strategies to create an “n-of-1” experience for health care consumers, embracing context-driven personalization and orchestration throughout the entire health care journey. This includes digitally enabled ways to stay engaged between episodes of care, AI-driven interactions, seamless orchestration of care journeys with digital, proactive, and contextually relevant interactions, and more.
—Sonia Singh, chief insights officer of AVIA Health
Everything old is new again. Financial constraints have become the new normal as health systems embrace staffing challenges, strikes, and the necessity of doing more with less. Just as last year, the need for process automation is now a given; cautious use of AI will increase with greater awareness of potential large language model bias, hallucinations, toxicity, thought bubbles, and self-reinforcing outcomes. Mergers and acquisitions have been another major theme. Activity this past year was robust, not only in the tech sector but in health care overall, with a significant number of deals driven by financial insecurity between and by hospitals, payer organizations, and, yes, tech startups. Financial insecurity will become more of an issue in 2024, particularly as we head into the election cycle with uncertainty regarding fiscal policy. We will continue to see more workforce reductions and flat-out failures in the tech space, as evidenced by the insurtechs.
The current administration is releasing new programs and rules at a frenzied pace on the regulatory side. Most significant are the interoperability and transparency rules and TEFCA. After years of kicking the can down the road, all health care will be scrambling to become compliant. Additional federal legislation, while often redundant, is making traditional fee-for-service Medicare and Medicaid look and act more like managed care and more closely aligning the 2 programs (Title XVIII and Title XIX). ACA plans will likely see membership swell due to the end of the public health emergency. The percentage of the population covered by government-sponsored care shows no signs of slowing down as the country heads towards a two-tiered health care system: those in government-sponsored programs and those who can financially access the care they want.
While hospitals and systems are terminating their contracts with large Medicare Advantage payers, patients will remain in their MA Plans and ultimately call the systems’ bluff. These providers cannot ignore this market and maintain their infrastructure. After gains in efficiencies, improved revenue cycle management, and elimination of low-value care, their “losses” on Medicare Advantage contracts will, in many (but not all) cases, reflect lower margins. We will see many of these contracts renewed by the third quarter.
—David J. Sand, MD, MBA, chief medical officer of ZeOmega
