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On Feb 16 – 19 the Center for Health Care Management and Policy at the UCI Paul Merage School of Business held the 30^th annual Health Care Forecast Conference. The conference addressed the impact of the COVID-19 pandemic and its aftermath, exploring topics such as health care policy, health care delivery system, financial pressures, telehealth, clinical data exchange and provider burnout. Speakers offered their insight and presented their predictions for the coming year and beyond.

The event, which took place virtually over the span of four mornings, featured keynote speeches by Norman J. Ornstein, Ph.D, and Amy Compton-Phillips, M.D and presentations by executives from Kaiser Permanente, Cigna, CalOptima, TPG Global and SCAN Health Plan, among others.

Many presentations and Q&A sessions included call to actions—whether it was a call to address health inequities in our communities or a call to help alleviate and prevent provider burnout. Here are four lessons from this year’s conference:

1. Reform should prioritize health equity

Katie Heidorn, executive director of the Insure the Uninsured Project, referenced how the pandemic has disproportionately affected communities of color.

“The COVID-19 pandemic and recent civil unrest have really demonstrated that communities of color continue to face inequities,” she said. “And it’s really clear that we all have to do more, including us here today who have a role in state market reform.”

Heidorn provided an overview of state market reforms across the U.S. including Medicaid expansions, reinsurance programs, state premium subsidies, standard plan designs and a public option.

Heidorn recommended that policymakers prioritize health equity and social needs in healthcare when exploring market reforms.

She said: “We should ask ourselves—are our efforts meeting the needs of our population and reaching those who need the support the most?”

2. The pandemic worsened an already serious epidemic of clinician burnout

Dr. Christine Cassel, adjunct professor of medicine at UCSF and former planning dean at the Kaiser Permanente School of Medicine showed that by October 2019 between 20% and 50% of clinicians were already reporting signs of burnout.

Symptoms include emotional exhaustion, depersonalization and a low sense of personal efficacy—symptoms aggravated by the stress associated with the pandemic.

“The basic dynamic of burnout in any occupation is job demands exceeding job resources,” said Cassel. “In healthcare, this includes excessive workload, unmanageable work schedules and inadequate staffing.”

However, the main driver of clinician well-being is organizational culture and when “a clinician feels meaning and purpose in their work.”

Cassel advised building infrastructure for well-being with systems of accountability in place. She also recommends seeking an outsider point of view from human factors engineers and normalizing help and support: “There’s a role for communities and there’s a role for institutions, but there’s also a role for our own professions of getting real about our vulnerability and our fragility and finding ways to make it acceptable to seek help.”

3. Telehealth is here to stay

Dr. Romilla Batra, CMO at SCAN Health Plan shared that in Q2 of 2020, 50% of doctor visits were telehealth visits and that she expects this number to settle at about 25-35% moving forward. In the days before the pandemic “there was a myth that older people would not use telehealth,” which the pandemic has proved to be incorrect.

Dean A. Rosen, partner at Mehlman Castagnetti Rosen & Thomas, pointed out that there are restrictive policies on the federal level that could impair the growth of telehealth and shared concerns about the digital divide. 

“We’re going to have to address the broadband issue, which is not just an inner-city issue, it’s also rural disparity issue,” said Rosen.

Chris De Rosa, MBA ’00 and president at Cigna shared a similar message: “I think the past year has definitely taught us that we can’t rest on the status quo and we have to make it easier for access and deliver quality affordable, whole person care.”

4. A bipartisan solution is possible

Rosen argues that populism on both sides of the aisle may usher in change in the next 2-4 years.

“Both parties are undergoing a transformation, in part driven by a tech-enabled populism…that I think could allow the parties to come together and look at some solutions,” he said.

However, he predicts that the Biden administration will pursue a robust agenda on a partisan basis via executive orders and budget reconciliations. These agenda items include improving and expanding the ACA, streamlining Medicaid, reversing many Trump policies and expanding outreach and enrollment.

“This is a real opportunity for C-suites and a real opportunity for healthcare stakeholders to step up,” he said. “Government doesn’t have all the answers.”

You can watch the full 2021 Health Care Forecast Conference here.