As the year 2024 approaches, the healthcare industry is bracing itself for significant changes and advancements. In a recent industry webinar titled "Healthcare in 2024: State of the Industry," ImagineSoftware welcomed Patrick Velliky, Vice President of Government Affairs at Envision Healthcare, to share valuable insights and interpretations on how healthcare policies and political landscapes are set to shape the future of this vital sector.

With a wealth of experience in healthcare, government issues, and views from Capitol Hill, Velliky is uniquely positioned to provide expert analysis on the upcoming transformations in healthcare legislation. His expertise and perspective shed light on the potential implications for both providers and patients alike.

Politics and Healthcare: An Intertwined Reality

According to a new heath tracking poll, at least eight in ten voters say it is “very important” for the 2024 presidential candidates to talk about inflation (86%) or affordability of health care (80%). These are closely followed by the future of Medicare and Medicaid (75%) and access to mental health care (70%).

In an era marked by extreme political polarization and an ever-intensifying media spotlight, the words of Velliky resonate profoundly. He observes, "Policy-making is often overshadowed", an assertion that underscores the intricate dance between politics and healthcare. As we move forward in anticipation of the 2024 landscape, we must grapple with the reality that the future of healthcare does not exist in isolation. It is inextricably linked to the political climate, shaped by the forces of public opinion, party ideology, and legislative power. This relationship serves as a critical examination point for scholars, policy-makers, and citizens alike who seek to understand and navigate the complexities of modern healthcare reform.

Senate Elections and Their Importance

Velliky points out the 2024 Senate races will be an important marker to delve deeper into the implications of the electoral landscape. With Republicans needing to protect 11 out of their 49 seats compared to 23 out of 51 Democrat seats, the power balance that we currently see may potentially shift. The Democrats find themselves in a rather precarious position, with nearly half of their seats up for contestation. The implications are vast and far-reaching, particularly for healthcare law and policy. Should the Republicans gain a majority, we may witness significant changes in healthcare legislation, possibly reversing efforts made by Democrats. This potential trajectory is worth close observation as the elections approach.

Speculation on Presidential Election

Velliky offered a candid analysis of the present political climate in relation to the forthcoming presidential race. He noted, "With President Biden's current disapproval rating outpacing his approval rating, this is a precarious position for any incumbent leader entering into an election year." This situation alludes to the uncertainty surrounding the political landscape in the upcoming year. The dynamic of public opinion could potentially lead to significant policy modifications, especially in the healthcare sector, depending on the results of the election. These possible shifts underscore the vital role that public sentiment plays in shaping the direction of policy-making and the broader implications for societal well-being.

The Hurdles Ahead for Medicare

Velliky's recent commentary on the state of the Medicare physician fee schedule brings to light a disturbing trend that calls for immediate attention. As he astutely observed, "Physician reimbursement rates have depreciated by 26% since 2001." This stark statement reveals a reduction in real terms of 26%, or as high as 40%, in the amount physicians receive as reimbursement over the past two decades. This downward spiral in physician compensation poses a critical threat to the sustainability of healthcare services, emphasizing an urgent need for robust and sustainable healthcare funding solutions. If left unaddressed, this trend could potentially undermine the quality of healthcare and accessibility for Medicare beneficiaries. According to the U.S. Census Bureau, all baby boomers (born 1946 to 1964) will be at least age 65 by the year 2030. As the Healthcare Financial Management Association (HFMA) stated in a recent article, “in economic terms, this means the largest base of taxable income in human history will soon evaporate from service. As increasingly costly governmental healthcare programs absorb diminishing tax dollars, policymakers will turn to the largest U.S. economic sector — healthcare — to close the divide.” Therefore, policymakers and stakeholders in the healthcare industry must collaborate to address this pressing issue.

Implementation Issues with the No Surprises Act 

Velliky raised several concerns regarding the actual execution of the No Surprises Act, expressing disappointment that the implementation has strayed from the vision of its original authors and illustrating the ongoing, complex challenge of finding equilibrium between safeguarding patient rights and ensuring the stability of healthcare providers. He suggests that the Act's true potential is currently hampered by its implementation, which fails to deliver on its initial promise: to build a system that simultaneously protects patients from unexpected medical bills and ensures the financial viability of healthcare providers. This issue points to a broader and continually evolving conversation around healthcare policy and reform.

Policy Priorities Amidst Election Fever

In the context of election cycles and their corresponding health policy promises, Velliky offers a word of caution, suggesting that such promises should be taken "with a grain of salt as election frenzy kicks in." This sentiment underscores the intricate and challenging nature of initiating substantial healthcare reform amid political upheaval and uncertainty. It is a well-documented phenomenon that election periods often see a flurry of ambitious policy proposals, many of which pertain to healthcare reform. However, the feasibility and eventual realization of these proposals are often impeded by a myriad of factors, including shifting political alignments, legislative complexities, and the ever-changing public health landscape. Thus, while election-time promises may hold potential, they should be examined critically, taking into account the broader political and legislative context.

Need for Proactive Advocacy in Healthcare 

Velliky highlights a critical concern regarding accumulating healthcare policy issues. He warns, "Facing an ever-growing backlog of tasks that require initiation, both CMS and the arbitrating entities stand at a precipice of daunting challenges should this accumulation persist." His observations bring to light the importance of adopting a proactive stance in the creation of streamlined and efficient healthcare policies. This proactive involvement is not merely a matter of good practice but a necessity to stave off potential adverse consequences. These consequences could manifest as organizational inefficiencies and may even compromise the quality of healthcare delivery if these systemic issues are not promptly addressed. As HFMA notes, “Hospital and health system leaders should not stand idly by and watch policy evolve. Almost as never before, they need to become outspoken advocates in Washington for their organizations and the industry overall.” 


As we traverse through these dynamic times, it is vital to stay informed and proactive about the changes happening in the healthcare industry. Velliky's insights serve as a valuable resource for understanding and preparing for the future of healthcare. From technological advancements to policy shifts, a wide range of coming challenges will undoubtedly impact the way healthcare is delivered and received. It is crucial for both healthcare professionals and policy makers to be well-informed and actively involved in shaping the future of healthcare. Stay tuned for more updates and developments approaching 2024 and beyond, as together, we can navigate through these changes and create a stronger, more efficient healthcare system for all. 

Key Takeaways

The healthcare landscape is rapidly evolving and staying up-to-date with informed information is more important than ever. Active participation and insights can directly influence healthcare policy and practice and steer dynamic changes the industry faces. In addition to staying informed, it's essential to continue developing essential skills to navigate the ever-changing healthcare sector. Look for ongoing seminars and workshops from ImagineSoftware in 2024 that offer opportunities to learn from industry professionals, explore innovative approaches, and adapt to new practices.



Ben Buchanan

Ben is a veteran of the healthcare industry with over 12 years’ experience in account management and product management roles. He is responsible for the oversight and implementation of the Imagine Product line. He holds a Bachelor’s degrees in Marketing from the University of North Carolina at Asheville, and a Master’s of Business Administration from Queens University of Charlotte.