There’s no doubt about it – 2020 shook healthcare to its core. Surprisingly though, with its back against the wall, the industry rose up with agility, rapid learning, adaptiveness and even a fair amount of  “what have we got to lose” experimentation. All that is the polar opposite of American healthcare’s usual DNA. So as we usher in a new administration and trucks filled with COVID vaccine vials fan out across the country, 2021 now has the potential to be the most transformative year for healthcare in decades.

Changes Upon Us

Chief among the changes brought forth by 2020 is that telehealth has reared its head as a quality care option during a pandemic. And now research by Amwell, the telehealth company where I am CEO, finds evidence that its staying power will go far beyond this global crisis. From the earliest days of lockdown, more patients than ever turned to virtual care for both urgent needs and normal annual check-ups. It’s true that healthcare has historically lagged other industries on the digital front, despite the fact that virtual care has been widely available since long before COVID-19. The adoption we saw this year could only have happened at the rate it did with the forcing function of COVID-19.


It’s true that younger consumers are generally eager to try new tools. But up until now, the lower reimbursement rates for virtual care have meant that many providers have not been eager to provide services online. The temporary financial enablers enacted through temporary emergency authorizations by the government and insurers this year gave providers something closer to parity with in-person visits. That was a major tailwind to utilization. However, providers need and deserve clarity around reimbursement before they will truly adopt telehealth in force. Until this is given, reimbursement will remain one of the largest barriers to physician adoption. My firm belief is that patients and providers alike enjoy the convenience and connectedness afforded by virtual care—and that there’s no turning back at this point. Public and private payors must work together in 2021 to ensure we continue on a trajectory forward, with telehealth no longer being seen as a nice to have, but a fundamental part of the quality care delivery toolkit.

The accelerated transition to virtual care we’ve witnessed this year also aided a switch from thinking of digital as simply an urgent care alternative for episodic needs to a well-considered option for longitudinal care with a patient’s own provider. Hybrid care – meaning a combination of virtual and in-person care interactions – is upon us. It is proving to be the best path forward for healthcare organizations and patients. When done right, hybrid care models fully envelop patients in care, which is especially meaningful for those with deeper healthcare needs. These models have already begun to emerge. But in the year ahead we will see a cadre of monitoring devices powered by machine learning and natural language processing automate some care interactions. That will enable the ability to escalate care to asynchronous telehealth, or further to physical care as appropriate. Hybrid care models allow for this seamless stitching together of interactions regardless of the setting. That’s why this model has the biggest promise for all patients.

Changes Ahead

The past year has also called on organizations, industries, and government to rethink racial disparities and to ask what duty we have to combat these systemic issues. The impact on the Black community throughout the COVID-19 pandemic is just the latest sign that our industry can and should do better to address the social determinants of health. From improving the patient-provider relationship to innovation in AI, healthcare has a significant role to play in rethinking how a lack of inclusion and misunderstanding of diversity may be impacting patient outcomes. How can technology democratize care? Virtual Primary Care can help by enabling greater access and equity to those who do not hold a coveted relationship with a clinician. We all know the impact of lack of access, procrastination, or neglect in healthcare, and opening up primary care via technology to overcome these barriers can move the needle in profound ways.


To that end, 2021 will be the year we have a serious conversation about state licensure and credentialing issues. Healthcare services are not spread equally across this country. It’s time for us to rethink how technology can pull us together as a country and how we can allow healthcare to be equally available to everyone, regardless of geographical location. Today there are strict limits in many cases for how health care can be delivered across state lines. Upending those limits so we can better serve our most vulnerable communities must be a priority in 2021. 

Our industry has for a long time attempted to control costs and create efficiencies with mergers and acquisitions. Conventional thinking in healthcare has often led to a need to buy. You can see evidence in the dozens of hospital mergers in the last decade as well as blockbuster deals like CVS Health & Aetna or Bristol Myers & Celgene. In 2021 we will see more of this. However, a new trend is also emerging in which thoughtful, strategic partnerships, both within healthcare and with adjacent industry players, are helping scale innovation and take the place of more traditional transactions. As competition stiffens and new players increasingly enter the field, especially in digital health, companies must realize that going it alone is not always the best strategy. In fact, those who succeed will be the ones who are most acutely aware of who else is doing it well and are able to find a way to work with them.  This is not to say that M&A as we know it is “over.” There will undoubtedly be more industry consolidation (do we really need 275 telehealth companies?).  But healthcare is increasingly open to new ways to learn, grow, and innovate.

This has been a year that spurred change out of necessity. I believe that the conviction of 2020 – don’t leave patients stranded, treat COVID-19 despite the risks in doing so, and ultimately find a way to bring in a vaccine – will have long-term impacts. 2020 has demonstrated that American healthcare–that antiquated, conservative, risk-averse behemoth–can actually move quickly.  Next year will be the one when healthcare changes its stripes and develops an appetite for reimagining itself. We will all be better off because of it.   

Roy Schoenberg is the President & CEO, Amwell. Watch his recent talk at Techonomy Virtual – Roy Schoenberg on the Explosion in Telehealth.