Only 18% of providers and 24% of payers say they have a “full consumer-centric strategy” in place. Moreover, 14% of providers say they have “no consumer-centric strategy,” whereas 100% of payers report having a strategy or one in development. Consumerization efforts overall are mostly in the early stages, with 34% of providers and 43% of payers calling their strategy “nascent,” and just 36% of providers and 33% of payers characterizing their efforts as “intermediate.” Payers and providers also disagree on who is best positioned to provide cost and quality data to consumers, both believing they are the best choice.

Payers and providers are divided on what will make healthcare interoperability happen. More than twice as many providers (23%) than payers (11%) see consumer demand as driving interoperability, and nearly 40% of the C-suite believe interoperability will materialize when consumers insist on it. Payers, however, are nearly twice as likely (36%) than providers (20%) to cite regulatory changes as fueling interoperability, while 18% of providers think physician-driven initiatives are a key driver compared to just 2% of payers.


Payers and providers are aligned on the benefits of AI and ML investments. Respondents say smart technologies are having a positive impact on operations by improving health system efficiency (payers 38%, providers 56%) and reducing costs (payers 28%, providers 42%). AI and machine learning are also improving consumer engagement, with 36% of payers and 39% of providers reporting a payoff.

Regardless of who wins the White House in 2020, payers and providers don’t expect disruptive change to the U.S. healthcare system. The majority of C-suite respondents (39%) believe there will be no significant changes to the U.S. healthcare system following the 2020 elections, and a majority (28%) of all respondents agree. The highest percentage of providers (31%) predict a continued unwinding of the Affordable Care Act (ACA), while 26% of payers expect the ACA to be strengthened. Just 17% of respondents expect to see a public option take hold, and only 3% predict America will move toward a single-payer, “Medicare for all” system post-election.

“The 2020 Industry Pulse is the most powerful and complete insight into differing Industry perspectives that we have had in 10 years,” said Ferris Taylor, executive director of the HealthCare Executive Group, a 32-year old non-profit association of healthcare leaders. “It should facilitate a much greater discussion and collaboration across all segments of healthcare.”

Business Affairs Homepage