Joe Public 2030

Five Potent Predictions Reshaping How Consumers Engage Healthcare

Chris Bevolo

• Publisher: Rutledge Hill
• Year: 2022
• Print ISBN: 9781400227075
• eBook ISBN: 9781400227082
• Topic: Business
• Subtopic: Pharmaceutical, Biotechnology & Healthcare Industry
• Index: Business

On the ten-year anniversary of the release of the original Joe Public Doesn’t Care About Your Hospital book, author Chris Bevolo and Revive have set their sights a decade in the future with Joe Public 2030: Five Potent Predictions Reshaping How Consumers Engage Healthcare. The book explores five key ways consumer health engagement may change over the coming decade, covering everything from AI and personal monitoring to consumerism, new competition, the politicization of healthcare, and growing health disparities. The book makes five bold predictions about that future, which range from exciting and promising to ominous and discouraging.

Based on insights developed by a team of researchers, strategists, and futurists at Revive, the five core predictions are supported by more than 250 resource citations and input from 22 industry experts who were interviewed for the book, including health system CEOs, venture capitalists, entrepreneurs, and physicians. The purpose of the book is to spark conversation about how the future of health and healthcare in the U.S. might emerge, and how individuals and organizations might want to prepare for – or even change - that future.

This is Bevolo’s seventh book, and the fourth (and final) installment in the Joe Public series. The book is scheduled for release in January 2022.

Chapter 1

Introduction

You will not agree with the contents of this book. At least not some of it. Or maybe even all of it. The team responsible for developing the predictions you will find here don’t agree with all the content in this book. The 20+ industry experts we talked with don’t agree with all the content in this book. Even I don’t agree with all the content in this book. But that’s ok. In fact, that’s somewhat the point. After all, we’re setting out to predict how consumers will engage with healthcare 10 years from now, which is both a vast area of focus and a long time away. We conducted an enormous amount of due diligence – studying reams of articles, research, and data. We conducted in-depth interviews with 21 experts from around the globe and from some of the most respected health brands in the world, such as Mayo Clinic, Geisinger, Intermountain Healthcare, Johns Hopkins Medicine, CVS Health, Optum, and Bain Capital. And we engaged a team of some of the smartest people I know to sort through it all and generate the five predictions found here. Which is why it’s critical to point out that these aren’t my ideas – they represent the ideas of our team of predictors. And I don’t convey that as a CYA, but rather to ensure credit is given where credit is due. While I contributed to the development of these ideas, I had the humble privilege of pulling them all together in the form you see here.

And yet, I can hear one of those experts loud and clear in my mind, when I ran one of our predictions by him for validation: “No way – that sounds like it comes from someone who doesn’t know anything about healthcare.” So, we expect some, shall we say, polite disagreement on what we’ve set out here. That’s not only ok, it’s healthy and desired. Our goal in publishing the five predictions you’ll find here is not to be right as much as it is to spark conversation. Because the truth is, in all five cases, the trends we’re predicting are already under way. In some cases, that may be a good thing; in others, clearly not a good thing. Yet by sparking conversation now, maybe there are those who read these predictions who will set out to either ensure they do happen as articulated, or who will fight like mad to prevent them. Either way, having the conversation now about how consumers and healthcare will change in 10 years will, at a minimum, better prepare all of us in the healthcare industry for what may come. And given some of the predictions, that is a very important goal indeed.

The idea for Joe Public 2030 comes from the publishing of the first book in the series, Joe Public Doesn’t Care About Your Hospital, 10 years ago in 2011. Since then, we have published two other books in the series, and when the idea of continuing the series came up, we wondered what else we could talk about? The first book, what I called a “manifesto for change,” rattled more than a few cages with our call for transformation in the hospital and health system space. It was also widely praised as a true driver of change in the industry, and I still have people today who reach out and let me know the impact it had on them personally, as well as on their organizations. The two subsequent books kept the theme of change front and center, with Joe Public II: Embracing the New Paradigm (2014) calling for hospitals and health systems to hurry up and dive headfirst into digital engagement, and Joe Public III: The End of Hospital Marketing, celebrating the progress the industry had made in engaging consumers in more effective ways. And so when the question of the topic of a fourth (and definitely final) book in the series came up, we decided to honor the decade since its inception by looking 10 years into the future.

Importantly, our focus changed midway through our process (which I’ve outlined in the following chapter). Like all the other books in the series, Joe Public 2030 was intended to focus on my primary area of experience and expertise, and that of the agency I work for, Revive, which is marketing, communications, and branding. But as our team explored the future, we kept landing on concepts and concerns that were far broader, and far higher-level, than the disciplines of marketing and communications. Our research and discussion kept coming back to opportunities and challenges for the healthcare industry as a whole. Most of us who participated in the book-development process have spent a lot of personal and professional time studying the business of healthcare and the way the healthcare system is changing over time, which better prepares us to help those looking to improve how they market and brand to consumers. So it probably shouldn’t have been a surprise when we kept returning to themes such as health disparities, political tribalism, or AI and digital twinning.

For those familiar with the previous Joe Public books, our target audience for this content is different than in the past. On a broad scale, Joe Public 2030 will provide value for anyone interested in the future of healthcare in the United States. More specifically, though, this book has value for those organizations that provide health or healthcare services to consumers – hospitals, health systems, physicians and physician practices, newer provider companies in the areas of urgent care and primary care, virtual care providers, retail health companies, vertically-integrated health insurance companies, or others – as well as any companies, firms, agencies, and consultants who support the broader provider sector. Unlike past books in the Joe Public series, this content is not aimed at only those responsible for branding, marketing, communications, and the consumer experience at provider organizations (though the content found here will absolutely affect those disciplines moving into the next decade). Anyone in a leadership position at a provider organization, or any other of the organizations listed above, from CEO to CFO and COO to CNO to CIO and on down, should find the content here thought-provoking. We hope those thoughts turn into actionable strategies, too.

The five predictions

This book posits five predictions about the state of healthcare in the U.S. that are powerful, compelling, and somewhat “non-obvious” (more on that in the next chapter). As I explain in the next chapter, we went beyond the fundamental trends we’re all familiar with, such as the advancement of value-based care, or the weight of Baby Boomers on the health system in the U.S., or the explosion of virtual care as a result of the Covid-19 pandemic. We actually give a synopsis of 20 such foundational trends in Chapter Three for context. Instead, these more common trends became the building blocks for higher-level predictions. Even where a prediction seems somewhat singular in nature, such as Constricted Consumerism, the rationale for the prediction goes beyond just understanding consumerism itself to include how that trend intersects with others, such as the increase in vertical integration by health insurers, or the continued acceleration of industry consolidation. There is a lot of value in the 30,000-foot view as well as the street map.

It’s also important to note the intentionality behind the active, current-tense voice used in the subtitle of our book, “Five Potent Predictions Reshaping How Consumers Engage with Healthcare.” Not “that will shape” or that “could shape,” but “reshaping,” as in, “already shaping.” That’s because in each case our predictions have already started to take root. They are founded in where we are now, and where we have been. These are not wild-hair guesses that have no grounding in reality, but instead are visions based on what is already occurring in the healthcare space. In each case, we build on what we see around us and take it to a potential future conclusion or dynamic. So while one could dismiss where our predictions end up, it’s impossible to dismiss their existence, to one degree or another, in today’s reality. People of a certain generation remember the cool artwork that consisted of a dense pattern of dots, and when viewed the right way showed a hidden picture inside the pattern. Our challenge here was to paint that concentration of dots, then to look for the subtly hidden and critically important picture that emerged as a result.

Here’s a highlight of each of our five predictions:

Prediction – The Copernican Consumer

Consumers will become the center of their own health universe more than ever before, enabled by sensors, AI, and other technology, as well as services geared toward empowering them, leading to profound implications for both consumers and healthcare organizations. Potential results could include a dramatic reduction in the need for primary care clinicians, an entirely new sector devoted to personal health management, true precision medicine combined with health management, and more.

Prediction – Constricted Consumerism

While consumers will become increasingly responsible for their own health and use of healthcare services, they will actually become less and less empowered in the choices they have for care, especially in higher-acuity, higher-cost situations. While many in the industry will continue to sing the praises of choice, the reality is most consumers will have far fewer choices moving forward, often in ways they might never ever consider or see.

Prediction – The Funnel Wars

Today we tend to consider hospitals and health systems as birds of the same feather in terms of business model, with variances based on size, scope of services, for-profit/non-profit, and other factors. Moving forward, we could see the splitting of the health system model, with some systems moving even further to the larger, more comprehensive “health” organizations, others retracting into solely acute-care destinations – the “giant ICU on a hill” – and others somewhere in the middle. These models may emerge based on core geographic/market differences such as presence of competitors, plan consolidation/ power, regulation, and dozens of other market forces. Yet the primary area where this transformation would play out is with health, wellness, and the lower-acuity care points – what we’re calling The Funnel Wars.

Prediction – The Rise of Health Sects

Challenges to and skepticism of the mainstream medical field and science itself have exploded in the past two years because of the pandemic and political tribalism in the U.S. Anti-vaxxers, non-maskers, and Covid deniers are just the start of an expansion of this distrust of experts, which taken to its potential end could result in multiple “health sects” – primary “schools” of medical thought that coalesce around political/world-views. Imagine “Mainstreamers,” who follow the establishment healthcare point of view, “Progressives” who follow minimal medical intervention combined with complementary and alternative medical solutions, and “Contrarians” who deny mainstream medical thought and create their own set of “alternative facts” on everything from vaccines to childbirth to end-of-life care, and everything in between. These sects will not only follow the medical thinking that best fits their worldview, they may in fact create their own reality through alternative research, diagnosis and treatment approaches, and models for the delivery of care itself.

Prediction – Disparity Dystopia

The Covid-19 pandemic shone an ugly light on the disparities that have plagued the U.S. healthcare system for decades. Unfortunately, that health gap is more likely than not to expand, as the “haves” gain access to increasingly more expensive medical treatments, health services, and personalized care, while the “have nots” face growing shortages of basic health resources, from clean water and air to physicians and clinicians, rural healthcare, and more. This shift will be compounded by the mental health crisis, which disproportionately affects systemically disadvantaged populations and groups outside traditional healthcare access channels (teens, for example). All while those entities that might address these disparities increasingly struggle financially – health systems, health plans, state and federal governments – and others lack the incentives to focus on the growing issue.

Some of these predictions will sound familiar – in fact, many of the experts we talked to shared similar views of the future. Others may feel less familiar or brand new. Our purpose wasn’t to strive to find and explore only net-new thinking and predictions of the future or break entirely new ground, but rather to follow our process to see which predictions we uncovered stood out the most to us, and which might drive the greatest level of conversation.

Looking backward to look forward

So how do you come up with big, bold, and somewhat validated predictions about the future? I’ve laid out our specific approach in the following chapter, but when we started this process, it was difficult to get our arms around trying to predict the future 10 years out. Are we talking about house calls via drone, or urgent care clinics on Mars? A decade seems so far out it can be hard to apply practical thinking to what might take place. So it can help to start by looking back over the prior ten years to understand the level of change we’ve experienced in healthcare. A look back a decade helps to provide the right perspective on the level of changes we might expect in the coming 10 years, if not which trends and changes had the most effect. Of course, it matters which 10-year period is reviewed. Trying to understand economics in the U.S. by looking back a decade in 1940 would provide a very different point of view than looking back in, say, 1990. And that variance is important here, because the 10 years starting in 2011 saw a level of change in healthcare that would be hard to match in any other 10-year period. Though, interestingly, not everyone we talked to agrees that the level of change we experienced matched what we thought we might experience back in 2011. Sometimes the delta between expectations and reality is just as interesting as the actual pace of change.

For example, the first Joe Public book was published in 2011, which happened to coincide nearly perfectly with the passing of the ACA in 2010. The ACA was so new that by the time the book was published the following year, the law had yet to be fully formalized through actual regulations and actions, leaving its potential impact somewhat of a mystery. We addressed the potential changes the ACA might bring through what was essentially a “punt” in the book, writing:

What about healthcare reform? As of this writing, the true shape of reform was still being debated, as organizations across the U.S. tried to untangle the complicated guidelines of the Affordable Care Act to understand how best to adapt to the potentially significant changes. But from what I’ve read and from those I’ve talked with, healthcare reform will likely continue the trends noted above, if not accelerate them. And at the very least, reform does not change the fundamental concept that provider organizations will need to continue to compete for business. And as long as there is a need for competition, there will be a need for us to conduct effective marketing.¹

So in other words, the changes we were focusing on in the first Joe Public book were unlikely to be rendered moot or unnecessary by the ACA (changes such as proactively building true br...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Ebook Instructions
• Contents
• Acknowledgments
• About the Author
• Chapter 1: Introduction
• Chapter 2: Our Process, Caveats, and Whatnot
• Chapter 3: Twenty Questions
• Chapter 4: Prediction - The Copernican Consumer
• Chapter 5: Prediction - Constricted Consumerism
• Chapter 6: Prediction - The Funnel Wars
• Chapter 7: Prediction 4 - The Rise of Health Sects
• Chapter 8: Prediction - Disparity Dystopia
• Chapter 9: Conclusion
• Appendix
• Endnotes