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Healthcare Services Predictions for 2021

An excerpt of the full report is included below. Download the PDF for our full 2021 Annual Predictions Report with more macro trend predictions as well as our forecast for over 20+ clinical specialties.

Macro Trend: More COVID-19

SCALE Forecast

Supporting Arguments

  • Weakened healthcare company balance sheets across the board
  • More patient disruption in 2021 as virus continues to flare up
  • More operational disruption as “what is safe” continues to involve new standards of care
  • Making sense of 2020? We will have time in 2021 to revisit lessons learned and changes that need to be made henceforth
  • Anticipate lingering confusion as to the effectiveness of the vaccine against mutations
  • Pent up demand – The US Census Bureau “Pulse Survey” (weekly survey of 1 million people) still pegs the number of people “delaying care” at around 35% across the country. In 2021, there should be a lot more patients looking to move forward on a wide variety of electives as well as a higher number of urgent procedures due to preventative care and/or delays.
  • Healthcare tied to national security – what new regulations, reporting requirements and precautionarily protocols will be implemented? What will be the resulting cost and administrative burden of any such measures?

Clinical Specialty: Gastroenterology

SCALE Contributor

Roy Bejarano
Co-Founder & CEO

SCALE Forecast

  • Intensifying competition among larger national platforms continues to keep all GI asset valuations high
  • Continued margin pressure from bundling and / or reduced rates for anesthesia services
    • Rich field of opportunities for growth at the practice level
  • 2021 is expected to be the most active year in GI PE `transactions to-date, with the formation of both new PE-backed platforms and the expansion of existing consolidators into new markets
  • U.S. Preventive Services Task Force proposed lowering the colorectal cancer screening age from 50 to 45 in response to growing early-onset Colo-rectal cancer rates on Oct. 27, 2020. This dramatically increases the screening population available to practices in 2021.

SCALE Company Watchlist

  • Gastro Health
  • Physicians Endoscopy
  • U.S Digestive
  • Pinnacle GI
  • GI Alliance

Clinical Specialty: Health Systems

SCALE Contributor

Mark Newton
Hospital Management

Charles Trunz
Hospital Relations and Urgent Care

SCALE Forecast

  • Additional multi-state mergers to create more SCALE efficiencies
  • More procedure leakage to outpatient sites of service
  • Further frictions with employed provider networks seeking faster rate of change
  • ACO performance eclipsed by national coordinated networks – JVs attractive
  • The new administration will try to Implement new changes around healthcare cost and price transparency. They may not be able to implement “Medicare for all”, but they will impact all hospitals and practices around what is charged for each type of service
  • Despite pressures to evolve, hospitals will continue to be meaningfully insulated from market pressures
    due to:
    • Recognition as a component of national security during COVID
    • Continued heavy reliance on hospitals as a backstop for high acuity care as well as care for low income and underserved populations

SCALE Company Watchlist

  • CommonSpirit
  • Intermountain Healthcare

Download the PDF for more macro trend predictions and our forecast for over 20 clinical specialties.

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