2024 Predictions: Looking Back and Looking Forward

The Year Ahead & Musings on Motherhood

Personal Reflection 2023:

I spent roughly half of 2023 actively observing the world in which I professionally operate from the confines of my den while I took care of a newborn. Unaccustomed to the slower pace, I spent ample time chatting with friends and colleagues as they shared dispatches from the ‘working world’ in exchange for pictures of my daughter. I am thankful to all of you — you kept me company and often were my tether to earth as I went through my ‘meta-mom-orphosis.’

This time allowed me to adjust to this new and very different part of my identity and I ultimately feel even more like myself. This feeling of being ‘more of myself’ has come from being intentional about how I spend my time and being more direct about the work that has resonance to me. My daughter and my challenging postpartum experience ground me in the importance of making both large strides and small, consistent strides in women’s health; of driving improved research upstream, and improved access downstream.

Early motherhood has a way of hollowing you out, digging deep into your core, bringing you to the brink — or ‘to the stars to get your baby’ as my doula would say. You teeter between two worlds for awhile like Janus, the Roman god of beginnings and endings, with two faces looking at the before and after. You hold both within your body and your mind…and so does your baby with their womb movements that they continue in their early weeks. You share this transition even if you can’t quite remember it well later. This in-between time — this hollowing out and humbling period — can grant familiarity with ambiguity and deeply expand your capacity for joy and connection…the ability to smile down at earth while simultaneously savoring the brilliance of the stars.

2024 Predictions:

And with that ramble, now for some 2024 divinations which really are not groundbreaking! My musings are my own.

(1) Election year is here and reproductive freedom is at the forefront. Half of the world’s democracies will have an election in 2024, making it the biggest election year in history. In 2023, the U.S. had significant momentum around reproductive rights including abortion access wins in Ohio, Kentucky, Virginia, Michigan, Pennsylvania; an executive order from President Biden on “Strengthening Access to Affordable, High-Quality Contraception and Family Planning Services,” and a RFI regarding the application of the preventive services requirements under section 2713 of the Public Health Service Act to include OTC preventive services. VP Kamala Harris kicked off her reproductive freedoms tours by mobilizing students and universities across the U.S. She’ll continue her tour in 2024 and I expect there will be a number of public awareness campaigns to promote contraceptive and abortion access. These efforts will be critical to combat the ‘infodemic’ or misinformation surrounding contraception and specifically abortion. If anyone reading is working on efforts to quantify the impact of misinformation, please let me know.

(2) Platforms continue to win; consolidation continues to happen. Distribution is a winning advantage in healthcare. I made this prediction in 2021 about 2022 and so it continues. We will see more in 2024 as companies struggle to fundraise and continue to realize the challenges associated with sustainable patient acquisition and the cost basis required to work with large healthcare incumbents. Efficient patient acquisition and distribution will predominantly drive consolidator interest.

(3) IPO market slowly reignites: we continue to dream BIG about the next big exit in women’s health. Chrissy Farr opined about just this in a recent article here. The business case for investing in women’s health needs to be made in the public markets. We have very limited comps and precedent transactions to use when mapping out valuation ranges and exit potential. Value chases value…more solid exits will command more funding.

(4) Good year for public awareness, research, and commercial traction for GLP1s. What comes next is more precise. Ozempic has entered meme culture. Multiple great papers/trial results on the impact of GLP1s on Diabetes and MACE — as well as the limitations of GLP1s’ impact on cardiovascular health if used and discontinued. Tirzepatide or Zepbound was approved for Obesity. In 2023, we saw employer programming focused on controlling and managing access to GLP1s based on weight restrictions and/or commitment to participate in step therapy or complementary programming. Milliman put out a report on payer approaches that referenced medical cost/waste associated with early discontinuation. In 2024, I expect we may see the early innings of predictive diagnostic approaches to GLP1 patient responsiveness. With the potential to reduce medical waste and improved adherence, payers will likely be the most interested party in these approaches.

(5) Functional medicine and food-as-medicine approaches get tailwinds from projected 15% increase in specialty drug spend in 2024. Related to the above! With the proliferation of costly drugs for a variety of condition areas — GLP1s, biologics, biosims — I expect that more high-touch engagement models that focus on lifestyle change may get piloted to assess effectiveness. These programs will have varying degrees of success but it is critical that they have the product and patient experience talent internally to design these programs for new patient populations.

(6) Evidence generation and cash are king. Cost conservative approaches to research and actuarial analyses get traction. Evidence generation drives validation which ultimately drives reimbursement. As more companies adopt performance-based and value-based models, the need to do research to improve your own care model will increase to appropriately manage risk. Organizations that can help you conduct research and actuarial analyses in a cost-effective manner will have a full pipeline from digital health companies.

(7) Continued focus on Medicaid for impact in women’s health. Medicaid enrollment is set to decline in 2024 due to the unwinding of the continuous enrollment requirement but state-level spending will increase. 20% of women of reproductive age are covered by Medicaid and roughly 40% of births are covered by Medicaid. I am hopeful that the White House Women’s Health Research initiative has a specific focus on the ‘implementation’ aspect of research. How do we ensure that innovations are distributed equitably and in the populations of greatest need? Telehealth can play a role given its ability to address access, affordability, and stigma issues in care delivery. A start might look like states evaluating current barriers that prevent clinicians from rendering telehealth services according to Medicaid reimbursement policy. You can play a role in bringing innovation to Medicaid — check out this volunteer form for Healthtech for Medicaid here.

Skillsets Poised for Growth in 2024 and Beyond:

• MPH/MBAs / HEOR experts / RWE experts
• Post acquisition/merger biz ops
• Strategic finance
• B2B2C marketing
• Public x private partnerships
• GTM: performance and value based payment schemas, strong payor rolodex