Article

What Will Non-Acute Care Look Like in 2029?

September 3, 2021
patient waving to doctor on laptop using telehealth
After 16 months of rapid change, disruption and pivoting to deliver non-acute care, facilities are wondering what their future looks like. According to a new “Impact of Change Forecast” by Sg2 a strong recovery is in store for the rest of 2021 and beyond.
 
The forecast predicts that as COVID-19 abates, patient volumes for most services will recover quickly and healthcare services will shift from hospitals to other facilities. “We’re going to see a strong recovery over the next six months in terms of healthcare utilization, with overall outpatient demand surpassing 2019 volumes,” says Madeleine McDowell, MD, FAAP, principal and medical director for Sg2.

Not everything will return to pre-pandemic levels. Some changes will remain post-pandemic, including a sustained shift to virtual care. In addition, rising acuity and chronic diseases, trends that were occurring prior to the pandemic, will place increased demands on the healthcare workforce and across the system of care, McDowell predicts.
 
Because low-acuity visits are expected to shift from emergency departments to urgent care clinics, physician offices and other locations, by 2029, hospital emergency departments are forecast to see 4.8 million fewer patient visits annually than in 2019, representing about a 5% decline. 

LASTING IMPACT OF COVID-19 INCLUDES MAKING VIRTUAL VISITS ROUTINE

The pandemic will leave a lasting impact, creating an ongoing demand for specialist care required to support chronic COVID-impacted conditions, such as neurology and pulmonology, the forecast concludes.
 
The pandemic sparked a new interest in virtual care, or telehealth, and made it more commonplace. The forecast predicts this trend is here to stay. It says one in three healthcare visits will occur virtually by 2029, with the move to virtual care taking place across services such as behavioral health, medical specialties, women’s health and cancer.
 
Not surprisingly, the shift to virtual care means a decline for in-person visits for evaluation and care management (E&M) services. By 2024, E&M is predicted to see a 19% increase in visits shifting to virtual, and that percentage jumps to 29% by 2029.

A MOVE FROM HOSPITALS TO AMBULATORY SURGERY CENTERS

Hospital outpatient departments (HOPD) and ambulatory surgery centers (ASCs) will continue to experience rapid patient growth, according to the forecast. That will add up to a patient volume that’s 15 million people higher in 2029 than in 2019. “This shift will help drive down the cost of surgical procedures,” the forecast states.
 
The forecast expects ASCs to experience:

  • 14% growth in five years, from 32 million patients in 2019 to 36.5 million in 2024.
  • 25% growth in 10 years, up to 40.1 million patients.
PHYSICIANS EXPECTED TO SEE MORE PATIENTS, AND MORE VIRTUALLY

Physician clinics will see significant declines for in-person visits, a 19% decrease, as patients turn to virtual care. Patients who are seen in the office will be more likely to need ancillary services. “Non-visit services” in physician clinics, such as office-based diagnostics, laboratory testing and imaging, are projected to grow 18% by 2029, according to the forecast.
 
Overall, physician offices and clinics will see double-digit growth by 2029, much of which will be driven by procedures formerly done in hospitals like cataract surgery and endovascular procedures.
The forecast predicts physician offices and clinics will see:

  • 9% growth in five years, from 19.2 million patients in 2019 to 21 million in 2024.
  • 18% growth in 10 years, up to 22.7 million patients.
MAJOR GROWTH IN HOSPITAL-AT-HOME CARE, DECREASE FOR SKILLED NURSING FACILITIES 

Six in 10 Americans live with at least one chronic disease, like heart disease, cancer or diabetes, according to the Centers for Disease Control and Prevention (CDC). Where they and other patients receive treatment is poised to change.
 
“There will be a shift of admissions to the home toward the end of the decade with home-based services increasing by 15% to an estimated volume of 474.9 million,” according to the Sg2 forecast.
 
Non-acute facilities that invest in chronic disease management services can seize opportunities to grow. “Health systems are making major investments in their ability to provide care to patients from the comfort of their own home with many programs currently in pilot stage,” the forecast states.
 
Part of the growth in hospital-at-home will be driven by reimagining senior care. Patients will move out of skilled nursing facilities, which will see a 5% reduction in patient volume by 2029, despite an aging population, according to the survey.
 
The forecast points to more patients moving to home care:

  • 9% growth in five years, from 413.8 million patients in 2019 to 450.6 million in 2024.
  • 15% growth in 10 years, up to 474.9 million.

Meanwhile, skilled nursing facilities will see a decrease:

  • 11% decline in five years, from 3.2 million patients in 2019 to 2.8 million in 2024.
  • 5% decline in 10 years, down to 3 million.
KEEPING UP WITH RAPIDLY CHANGING HEALTHCARE 
As non-acute healthcare providers know well, how care is delivered is changing rapidly. Many changes were prompted by the pandemic, while others are the result of a shift to value-based care.
 
Facilities that are positioned to identify and act on emerging trends can improve their service offerings and profitability. This includes having an understanding of how and where patients want to receive care.
 
“Policy changes, virtual and digital innovations, and the shift to lower cost settings will all contribute to a restructuring of the current system of care,” McDowell says. “Understanding clinical demand, and where it is shifting, is essential for providers to properly plan for future resource, workforce, facility and program development demands. Health care providers will also need to evolve and pivot to compete with new market disruptors, such as telemedicine providers, hospital at home models and AI-enabled services.”
 

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