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Timestamps:
Intro: 0-2:03
COVID-Like Emergency Room Visit Trends: 2:03-3:36
The New Normal and The Dual Track Workflow: 3:36-5:54
Elective Surgeries and Sustainability of Comeback: 5:55-9:04
Hospital Capacity on Reserve and CapEx: 9:04-15:32
Telehealth Uptake and Patient Satisfaction and TDOC: 15:32-22:04
Reassuring Patients: 22:04-23:17
Mix Shift for Insured Medical Consumers and Impact on Health Systems: 23:18-28:32
Price Transparency NFP v For-Profit and Role in Declining Population of Commercially Insured: 28:32-31:10
The Coming Deflationary Trends: 31:11-33:23
Impacts on Vendor Ecosystem, IT, AI and Efficiency (!) in Health Care: 33:24-37:08
Private Equity and Acquisition of Physicians Practices: 37:08-39:11
M&A Forecast: 39:11-46:03
What Does Health Care Look Like on Jan 1, 2023 Look Like? 46:03-53:00
Q&A: 53:01-56:25
Additionally, please see notes below from Josh Balch () from Hedgeye Sales Team:
Healthcare: David Jarrard on the Future of American Health Care in Post-COVID Era (7/15/20) NOTES
- Emily Evans, Sector head of the health policy team, speaks about the future of American healthcare with David Jarrard. David is the President and CEO if Jarrard Inc, the country’s leading health care strategic communication consultancy.
- The CLI data which shows the percentage of emergency department visits for COVID-19 and is used as a forecasting tool, is indicating that this second surge will abate soon. This surge was driven my migration patterns like people going to the beach (Myrtle beach). We could experience this again, possibility when kids go back to school in the fall.
- David believes that a new ‘normal’ was starting to begin which started after the first wave but also might have abated as US cases started to accelerate again. David thinks this “new normal” narrative that has been pushed the last two months might not actually be the new normal but rather the new normal being prepared and on guard at all times for new surges for the next couple of months or even years until there is a vaccine. David believes that this will be here for a while.
- COVID-19 is not going to pay the bills in the health care world. David said the data shows that people have started to go back to the doctor’s office. Right after the initial surge, we saw some pent-up demand from people who really needed to get procedures done. The question now is that after this surge, will the ongoing elective procedure be sustainable? Will the people who have not needed a procedure yet come back to the system?
- David’s company did a consumer survey during the first wave and is working on a second survey now as US cases re-accelerate. The survey indicated that the key factors for getting people back into the office was all around safety, with most people right now saying that they do not feel safe going into the doctor’s office. Women and moms were the most concerned along with the elderly people. Young males were the least concerned.
- Alabama is a bit of a mystery right now. Their case loads and CLI data was taking off but has recently taken a U-turn. This is the only time we have seen this occur so far. We will have to dig deeper into the cause of this since they are as close to single payer as it gets.
- During the first surge, many hospitals made dramatic changes to their infrastructure, but the COVID-19 patients did not come in the volumes that they were expecting. Hospitals will have to be very cautious on how they deal with this second surge and surges moving forward in terms of staff and reserve beds.
- David thinks more capex will be spent and let loose in 1Q21. He expects a lot of activity in 1Q and 2Q. Places will know more and have a real idea of how they should move forward after the next 6 months. David does not think companies should spend their money right now and that cash is king for the next 6 months. Alternative sites might be a place that companies decide to invest in.
- David thinks the future of telehealth will accelerate as he is seeing companies investing significant resources into this space. There is great interest in consumer satisfaction in telehealth. A portion of the healthcare space can be given via telehealth for a lower cost. In the survey that is company did, they found that 90% had a great experience when using telehealth.
- Half the population are either uninsured or covered by a government plan. Employer sponsored insurance has not grown in years at full employment. Medicaid expansion and demographics have shifted to government payers. Uninsured population has increased about 5 million. We were starting to head into a place where the system had been reliant on high margin, corporate employer-based plans but now this could create a reckoning just based on the data. This will put more pressure on employee-based premiums, and you will see less of them offered moving forward. Moving forward, David believes that doctors/companies will need to be very transparent on what procedures cost so that patients can determine if they can afford it.
- We expect price transparency to be included in the next stimulus bill. Based on the court decision and depending on what language is used in the next bill, providers will have to abide by price transparency starting on January 1, 2021.
- You will see margin compression due to larger amount of government plans or uninsured. Then you will start to have price transparency which will lead to price competition. This is set up for a deflationary environment in healthcare. COVID-19 has expedited the regulatory dynamic of this sector by 3-5 years.
- This deflationary healthcare environment will create investments opportunities for the vendor ecosystem in spaces like IT, A.I, and automation systems. Those will streamline systems and help predict and prepare for demand. This will create a more efficient system which will help manage/increase capacity while not having to increase beds. That is where the money will go, according to David. He also believes that experimenting in the vender world over a long-term horizon will shrink.
- David thinks that if we can break down the barriers and separate the roles of government and the care they provide and connect it will be existing and established health system, will accelerate the efficiency of giving real population healthcare. He does not see how we do not come out of this a more specific role for government in the health system.
About David Jarrard: Jarrard is a sought after thought leader. He is the principal author of “Healthcare Mergers, Acquisitions, and Partnerships: An Insider’s Guide to Communication,” written in partnership with Geisinger Health System. A regular speaker at national and state healthcare industry conferences, he is on the teaching faculty of the American Hospital Association’s professional group for hospital strategic planners and communicators. He serves on board of the PR Council (the public relations industry’s agency trade association), the editorial advisory board for Healthcare Insight Magazine and the board of professional advisors of the College of Media and Entertainment at Middle Tennessee State University.
Please let me know if you have any questions.
Emily Evans
Managing Director – Health Policy
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