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Health Care Commentary: In 2018, the key word in health care is 'change'

Commentary: In 2018, the key word in health care is ‘change’

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I’ve heard health care described in many ways.

Words like dynamic, complicated and essential are among the most common, but there’s a new word I’m hearing more and more when it comes to talking about the economic, regulatory and local health care arenas. And that word is “changing.”

And as far as I can tell, health care in 2018 will have change. Likely lots of it.


The coming year will see a continued increase in the number of health care choices you will have. It shouldn’t shock you that Dallas-Fort Worth is growing, but what may surprise you is that health care players are stepping up and adapting to meet that growth. Whether you are an individual or an employer seeking health care services, your choices will grow.

If you are seeking care for yourself, you will find a greater number of urgent care centers, imaging centers, emergency rooms, hospitals, physician offices, rehab centers and many other care venues throughout North Texas.

You will continue to experience the digitization of health care, with multiple companies offering you the ability to schedule your appointments online, to have text chats with nurses and doctors and even to have video-based medical appointments remotely, on either your phones or computers.

If you’re an individual looking for insurance, you may find your employer offering not just one choice but several that provide different deductible levels, different copays and different coverage levels. If you are an older individual and/or a retiree, you will see advertisements for multiple coverage plans that supplement or complement your Medicare coverage.

If you’re an employer, you will have opportunities to purchase health care services from multiple providers and insurance plans, each of which will offer benefits customized to your company’s needs.

For anyone who has felt stymied by too few health care choices, 2018 is your year!


Why are all of these choices emerging? Look no further than in the mirror.

As the retail consumer industry has come to understand, individuals have different wants and needs that drive their buying behavior. In the end, consumers want value, which has components of convenience, quality and affordability. We know health care often is used out of need rather than out of want. But we can still work to make sure that when consumers need health care, they can experience it in a way that is convenient and affordable and keeps quality in mind.

When it comes to behaviors that drive consumers, some people will go out of their way to meet with a specific health care expert who has a certain personality or who treats them in their preferred way. Other people are set on logistical convenience. They want the health care services to be provided when, where and how they prefer. For some, they want services close to home while others want them close to their work. Some want physicians and health care providers on their smartphone.

But for these folks, it all boils down to convenience.

Some people who seek health care will only go to the “best” places — the doctors, hospitals or care venues where the providers are the most experienced or have the most impressive credentials. These consumers do their research and will drive farther for the physician or health care location they deem as the best.

There are others who are more interested in purchasing health care at the lowest cost. They like the low price of the “no frills” health care experience and they don’t give as much credence to the convenience or the experience or the credentials of the facility or health care provider.

Both the challenge and the opportunity is that all of these people exist. To make it more complex, there are many more who want some combination of these attributes. For this reason, health care choices will continue to expand as health care companies seek to meet the growing demands of the individual and try to meet those needs in a customized way.


Not only are the services provided being customized for the individual, but the very science upon which medicine is built is now being “personalized.” The theory for this approach came out of the mapping of the human genome. While much of the thought about personalized medicine is still years away from fruition, there are basic applications that are here today.

For example, any person today can take a simple test to determine if he or she has the genetic markers for various types of cancer. If there is a higher risk for a particular type of cancer, protocols can be put in place that would lead to much earlier detection, and, in some cases, protocols can be put into place that can lead to prevention. This approach is “personalized” because the care pathway chosen is customized for the actual risks of the individual.

I have a family member who recently was diagnosed with breast cancer. Her doctor told us that in the past, every individual with her stage and grade of cancer would have been given chemotherapy. They knew they were likely over-treating patients using this approach, but without better knowledge it was safer to err on the side of clinical conservatism.

Not so anymore. They ran a test on my family member’s cancer and it showed that there was no statistical difference in terms of projected outcomes if she did or did not receive chemotherapy. Because of this test, she avoided the difficulties and complications that would have come with chemotherapy, and her projected outcomes were the same.

These types of approaches to the science of medicine will continue to advance and enable individuals to receive the specific science they need, attuned to their specific conditions.


All of this customization in health care likely will not be brought to you by just one player who acts alone. You will most likely see many more partnerships forming where the best of both partners can be brought together for your benefit. This approach will likely result in more innovation as complementary features and benefits are combined.

Health systems and insurance companies, insurance companies and pharmacy companies, academic medical centers and community hospitals, post-acute providers and acute providers, physicians and technology companies are all partnerships that have already happened in our area. And there will surely be more to come. The goal is to provide more value to North Texas families, individuals and businesses that are expecting a higher quality service, with better outcomes, for an affordable price.

The tremendous population growth in the Dallas-Fort Worth area will accelerate and amplify all of these effects. Not only will the number of people dictate this partnering approach, but the fact that much of this growth will come from people who were transplanted here from other areas of the country will further drive the need for new ways of doing things. These new people will bring with them their own wants and needs, many of which were shaped by their home environment.

Some of what they want may exist in Dallas-Fort Worth, but much of it may have to be created or transplanted. We can expect 2018 to be a year of health care customization — a year for you!

Aaron Bujnowski is senior vice president and chief strategy officer for Texas Health Resources, one of the largest faith-based, nonprofit health systems in the United States. He has worked at the company since 2010. He formerly was a member of the health care practice at the Boston Consulting Group.


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