Medical Care
2025: Healthcare Delivery at a Critical Crossroads
2024-12-10
Staff shortages and financial challenges have become critical issues in healthcare delivery. As we move towards 2025, there is increasing pressure from various stakeholders for greater accountability and transparency. In our recently published Numerof & Associates 2025 Healthcare Delivery Outlook, we outline the current situation and potential solutions.

Redefining Healthcare in 2025 - From Crisis to Opportunity

Staff Shortages and Their Impact

In recent years, staffing shortages have become a widespread problem across the healthcare industry. From nurses to physicians and hospital staff, the shortage has led to large-scale labor disputes and providers seeking alternative employment. One report shows that compared to 27 other industries, healthcare ranks last in terms of employee satisfaction with pay. Healthcare employees also score lower than those in other industries in terms of intent-to-stay, engagement, and experience compared to their expectations. This shortage is not only affecting individual providers but also organizations. Small independent physician practices are overwhelmed by regulatory and reporting burdens, lacking the necessary infrastructure and technology. Even large health systems face strong headwinds, with wage and general inflation increasing operating costs and weakening balance sheets. Industry consolidation continues as health systems try to integrate recently acquired providers into their networks and care delivery models.

The Need for a New Approach

2025 represents a pivotal year for healthcare delivery. Dissatisfaction across all levels of the system has created an opportunity to rethink outdated models. By adopting a new, holistic approach that ties payment to outcomes that matter to patients, healthcare organizations can create value for patients while controlling costs. As stated in "Bringing Value to Healthcare", we need to change the underlying business model. This includes prioritizing transparency in cost and quality, connecting payment with relevant outcomes, and requiring accountability across the continuum. Patient-consumers should be able to easily access relevant data to make informed decisions when shopping for providers and health plans.

The Role of Government

In 2025, the federal government will take a closer look at the bureaucracy and reporting requirements that drive up costs without adding value to consumers. The incoming administration understands that the current regulatory environment is distorting the market and increasing the cost of care. A core pillar of the Trump Republican Platform for the U.S. economy is to "slash regulations that stifle jobs, freedom, innovation and make everything more expensive." At the same time, government-mandated transparency will accelerate the development of tools for comparison shopping for non-emergent care. President Trump pushed for price transparency requirements for hospitals during his first term, which were upheld by the Supreme Court in 2020 despite resistance from healthcare providers. In the recent vice-presidential debate, Trump's future Vice President J.D. Vance also emphasized the importance of this issue.

Provider Responses

Providers must respond to the changing landscape by fundamentally rethinking their business models. Traditional cost-cutting measures will not be enough; success will require redesigning care delivery to focus on patient-centricity, efficiency, and measurable outcomes. Forward-thinking organizations will accelerate their participation in capitated models and pursue direct contracting with employers to stabilize revenue. They will continue to emphasize total cost of care to strengthen integration across the care continuum, expand access through urgent care and home health solutions, and address health equity through community partnerships.

The Turning Point in 2025

Healthcare delivery is at a turning point in 2025. Growing dissatisfaction across all levels of the system has created the opportunity for productive change. Innovative, system-level thinking is needed from both the private and public sectors. The path to better outcomes at lower cost of care and a more sustainable, patient-centered model requires a willingness to rethink decades-old care delivery and payment models. Some promising developments suggest that the time has come to embrace this shift, as both government and private sector efforts begin to align towards greater accountability and transparency in care delivery.
"A Case Study on Ajax Health: Revolutionizing Med Tech"
2024-12-10
Healthcare innovation is a complex and challenging field. Each year, about 600,000 startups are launched in the US, yet only a fraction succeed. In the medical technology field, survival is even harder due to regulatory hurdles, clinical trials, capital intensity, and reimbursement issues. However, the Ajax Health model is helping to level the playing field for med tech startups and could hold promise for startups of all kinds.

Why Ajax Health Matters

Healthcare is often dominated by large oligopolies, making it difficult for startups to break in and innovate. Duke Rohlen's Ajax Health model offers a brilliant solution. By buying companies with technology deficiencies and developing them, Ajax Health has transformed stagnant companies and created significant growth. For example, when Duke bought Cordis from Cardinal Health, it was a broken company with no growth. But by bringing in innovation and a growth driver engine, Cordis blossomed.

Overcoming Challenges

Innovating in healthcare is not easy. It requires a deep understanding of medicine, motivation of physicians and other healthcare professionals, and navigating through heavy regulations. Ajax Health addresses these challenges by enabling scientists and engineers to focus on innovation while getting rid of operational details. Duke Rohlen's charisma and leadership have also been crucial in transforming the mentality of organizations and optimizing them for growth.

The Growth Driver Engine

At Cordis, Duke Rohlen created a separate innovation engine called Cordis-X. This engine focuses on developing technologies that can transform the company. It includes both transformative technologies like drug-coated balloons and iterative technologies. By having a portfolio of growth drivers, Cordis can achieve significant growth and transform the profile of the company.

Blending Cultures

Blending cultures between a fast-paced culture like Cordis-X and a slower-paced culture at Cordis was a tough challenge. However, by leading and finding like-minded people, Duke Rohlen was able to overhaul the mentality of the chassis and optimize it for growth. This shows the importance of cultural transformation in driving innovation.

Applying the Model Beyond Healthcare

Regina Herzlinger believes that the Ajax Health model could have applications beyond healthcare. For example, in the defense industry and the entertainment industry, which are often laggards in innovation, a similar model could help break through bureaucratic barriers and unleash creativity. Duke Rohlen is already applying the Cordis model to other med tech companies that need innovation but don't want to sell their companies.

Looking to the Future

Duke Rohlen is focused on evolving the Cordis model and applying it to more companies. He is also inspired by younger people with a passion for healthcare and wants to provide role-modelship and mentorship. Regina Herzlinger sees this as a golden era for technology in medicine, with opportunities to make healthcare more efficient, better, cheaper, and more accessible.In conclusion, the Ajax Health model is a game changer in healthcare innovation. It shows that with the right leadership, focus on growth drivers, and cultural transformation, startups can succeed in a challenging industry. And with the potential for application in other industries, it could have a lasting impact on innovation.
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Investing in Children's Mental Healthcare for a Healthier Future
2024-12-10
Currently, a significant portion of children face mental health challenges, with 1 in 5 experiencing such conditions. Moreover, over 50% of these young patients lack access to proper care. These figures have ignited a wave of investment activity, as seen with Khadijah Robinson, a General Partner at Fictive Ventures, and her support for entrepreneurs like Hafeezah Muhammad, the CEO of Backpack Healthcare. Backpack Healthcare is an AI-driven platform dedicated to providing mental health services for children, aiming to transform the industry.

Key Insights on Youth Mental Health Care

The current investment landscape in youth mental health care is highly significant. Startup investments have seen a remarkable increase, rising from 15% of digital behavioral health dollars in 2018 to 34% in 2023. This growth is driven by Wall Street's growing appetite for behavioral health solutions, transforming childhood mental wellness into a highly sought-after market.Private equity companies also play a crucial role. 60% of PE deals since 2018 have targeted behavioral health organizations, controlling a significant portion of mental health and substance use agencies. However, critics caution that the profit motive may overshadow patient care, especially in youth services.Backpack Healthcare stands out by focusing on mental healthcare for Medicaid-eligible children. As Muhammad mentioned during the Funding Cultural Currency conversation with CultureBanx, it was challenging to secure early funding as they had to prove the profitability of investing in such a niche. The ethnic breakdown of children on Medicaid in the US is 32% white, 42% Hispanic, 40% Black, and 25% Asian.Digital solutions are revolutionizing youth mental health care. They break down barriers and stretch limited resources to reach more children. For example, Backpack Healthcare is leveraging technology to provide accessible mental health services.

Impact of Tech on Youth Mental Health

The latest technological advancements have brought significant benefits to youth mental health. Digital platforms have made it easier for children to access care and connect with resources. Online therapy, in particular, is gaining popularity among young people. 26% of 14-22-year-olds already use online therapy, and Black and Latino youth are leading the way in terms of downloads. Text therapy is especially popular among the 18-24 age group.Investors like Fictive Ventures are recognizing the need for targeted start-up solutions. With a 'friends & family' approach, they back innovative ideas that can make a real difference. Robinson emphasized their goal of bringing concepts like Backpack Healthcare to market with a group of Black limited partners to create wealth within communities.

Future Prospects and Breakthroughs

Youth mental health care is at a critical juncture, with game-changing solutions on the horizon. Digital platforms, classroom programs, and neighborhood care models are breaking down traditional barriers. According to the CDC, every $1 invested in mental health interventions generates more than $23.60 in health and economic benefits. This shows the potential for significant returns on investment while addressing a critical social need.As we look ahead, it is clear that the convergence of money and mission in youth mental health care will continue to drive innovation and positive change. These investments are not just about financial returns but also about making a difference in the lives of children and their families.
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