A look back at my predictions for 2024 is revealing.
Every year I dust off my crystal ball and try to predict what lies ahead for the healthcare industry. With an eye towards assessing the state of the industry and adjusting my crystal ball, I decided to review my predictions for what we can expect in 2024. What I’ve found is that I’m sometimes wrong, sometimes right, and always amazed at the rate of change in what is arguably one of America’s most dynamic industries.
So without further ado, let’s see which of my bold predictions hit the mark and which were as off target as a broken stethoscope.
2024 Prediction: Presidential candidates will be largely silent on health care.
At the end of 2023, I had little reason to believe that health care could become the focus of the next presidential campaign. Unfortunately, I was right. The subject, which affects all Americans, was hardly discussed, much less addressed in any substantial way.
Going forward, I think health care will become a topic of politics, but we will likely see discussions built around what I call the “RFK Jr. Effect.” Extreme ideas about wellness, disease causation, and medication will be commonplace. Skepticism about the work of health professionals will increase. Until, of course, people develop a real need for health care. Then they will be grateful for the science-based healers who form the backbone of our health care industry and, perhaps, wonder why we don’t discuss it more when we elect our leaders.
2024 forecast: Mega-mergers are making a comeback.
Looking back at my original forecast, I’d say I was a bit disappointed in predicting an increase in “mega-mergers”. As expected, in 2024 Cigna actually unloaded its Medicare business, selling it for $3.7 billion to the Health Service Corporation. Other than that, I would describe what we saw in 2024 as a healthy number of mergers, although deal volume was slightly down from 2023.
However, I am not completely backing away from this prediction. In 2024, hospital mergers increased, Summa Health in Ohio went to Health Assurance Transformation for $485 million, Adventist acquired Sierra Vista and Twin Cities Community for $550 million, and Risant snapped up Cone Health, to name a few notable acquisitions . These may not be mega, but they are mergers and continue to represent increased consolidation in the healthcare industry.
2024 Forecast: Medicare Advantage growth will slow.
In 2024, MA enrollment increased by approx the same rate as it did in 2023. My sense that criticism of the program would lead people to abandon it simply hasn’t materialized. I suspect this is because beneficiaries have found that MA plans offer rich benefits and limit out-of-pocket costs, things you just can’t get from traditional Medicare. (Disclosure: I run SCAN Health Plan, a California-based Medicare Advantage Plan with >297,000 members.)
Going forward, critics of MA are likely to find their arguments less convincing than ever. Last week, the Biden administration proposed an increase in payments to MA plans in 2026. Also, Dr. Mehmet Oz, the prospective new administrator of the Centers for Medicare and Medicaid Services (CMS), has been a staunch supporter of Medicare Advantage. Look for the program to continue to grow over the next four years and beyond.
2024 Prediction: Startups will disappear. But they will be replaced with new ones.
True to my prediction, venture funding for the digital health sector fallen in 2024. This does not mean that one should write off digital health. Its fundamental problem has long been a failure to connect meaningfully with the analog health care system. But no one should doubt that new startups with realistic valuations and a plan to integrate seamlessly into the traditional healthcare system will emerge and succeed. This is even more possible as artificial intelligence enters the scene. It promises to solve some of the industry’s most vexing and difficult problems, and it could begin to impact patient care—albeit in small ways at first—sooner than we expect.
2024 Prediction: DEI will face backlash.
Unfortunately, I hit the nail on the head with this one. According to recent data, the demand for chief diversity officers faded in 2024, which many attribute to the reaction of conservative state legislators. Support for DEI initiatives is not likely to come from the federal government either. A few days after the creation of the Department of Government Efficiency (DOGE) was announced, Vivek Ramaswamy posted on X, “An efficient government has no room for DEI bloat. Time to check it out.”
However, equity boosters should not despair. Regardless of whether companies choose to hire diversity officers, many healthcare organizations continue to see health equity as a worthwhile goal, and we should expect these efforts to bear fruit regardless of any headwinds they may face at the government level.
2024 Forecast: Clinician morale will continue to suffer.
I am happy to say that the number of doctors who say they are burned out marked down in 2024. However, the number remains stubbornly high—and may have fallen as a result of the exodus from the profession that we saw after the COVID pandemic.
The fact is that to fully face the problem, we need a revolution in the management and leadership of most healthcare organizations. But many organizations are getting by with business as usual, so they delay making fundamental and necessary changes to their strategies and operations, even as their frontline staff continue to suffer.
2024 Forecast: Ozempic, Mounjaro and other GLP-1s will grow in popularity.
There is no doubt about it: the popularity of these drugs is increasing. Their presence has literally changed the way the medical profession thinks about obesity as a health problem. Additionally, these drugs are being prescribed for a host of new conditions. Last April, the FDA ADOPTED Wegovy for people with cardiovascular disease. In an age of misinformation, where an entire segment of American society has decredentialed the medical profession, we should expect to see trust and use of these medications continue to grow.
Forecast 2024: Better diagnosis and therapy. More questions about how to pay for them.
New diagnostic tools and medications seem to come online every day. We hear about them and celebrate their life-saving perspectives. Less discussion is devoted to the cost of these advances. I believed that applying the Medicare Inflation Reduction Act provisions to drug negotiation would lead to more intense conversations about cost. I can’t honestly say that this has come true. No one should despair just yet: diseases that were once considered death sentences are turning into chronic diseases, a fact we should always celebrate, even as many of us look for new ways to fund these life-saving treatments.
Forecast 2024: Turnover at the top
In 2024, longtime Mount Sinai Medical Center CEO Ken Davis will make way for ER chief Brendan Carr. Humana’s Bruce Broussard will be succeeded by industry veteran James Rechtin. Amid the headwinds of the growing industry—regulatory pressures, declining reimbursement rates, and continued inflation—we will see many long-tenured health care executives step down from their roles. New approaches will be needed to lead organizations through a changing environment, and many long-tenured leaders will not be around to make the tough decisions needed to work with the impending changes. Such turnover will create significant opportunities for organizations to connect in new directions—but they will also create instability in what will ultimately be a year of transition across the healthcare sector. Look for many household names to have new business cards in 2025.
2024 Prediction: At Least One ‘Big Tech Company’ Will Fold (or Restart) Its Healthcare Efforts
Big tech is always poking around the edges of healthcare. For good reason. At nearly 20% of GDP, healthcare represents a potential growth vector. 2023 was the year of Amazon. It launched Amazon Clinic, completed the acquisition of One Medical, and completed the shutdown of Amazon Care.
Meanwhile, other big tech companies continue to define their own meaningful health care strategies. Look for at least one big-name tech company to announce a major change in its strategy and/or personnel. Some critics (rightfully so) label big tech for failing to contain misinformation and creating even greater distrust in the healthcare industry. Look for select players in big tech—led by the likes of Google’s Karen DeSalvo and YouTube’s Michael Howell and Garth Graham—to continue advancing solutions that improve the accuracy of health information.
***
I would say that overall, my forecasting skills were not far off. For a guy more practiced in the healing arts than the dark arts, I’m feeling pretty good about my past.
What about 2025? I will tell you in a year. Meanwhile, where did I put those tarot cards?
