(October 2024) – Hospital and health system boards should regularly engage in education about the trends and shifts occurring in both national and local environments. While not an inclusive list, the trends outlined below are highlighted in the AHA Environmental Scan.

Public Trust: Trust in Hospitals and Doctors Is Positive. Although the pandemic resulted in significant erosions of public trust in the health care system, there are indications that trust may be strong with individual hospitals and providers. More than eight out of ten voters surveyed report they trust their preferred hospital either a "great deal" or a "fair amount" for information about critical health issues. In addition, more than three-quarters of individuals surveyed say they trust their doctor or clinician. Reported trust is much lower for digital health apps, websites and social media groups.

Uninsured Rates Are Low, but Some May Lose Coverage or be Underinsured. The uninsured rate improved from 9.2 percent in 2019 to 8 percent in 2022. In August 2023, the U.S. Department of Health and Human Services reported that the national uninsured rate reached an all-time low of 7.7 percent. While the low rates are good news, some reports indicate that nearly a quarter of those covered are underinsured and continue to face affordability challenges that impact access to care. In addition, Medicaid enrollment may be experiencing a shift. Legislation passed during the pandemic prevented state Medicaid programs from disenrolling people, but that ended in March 2023. Late in 2023, more than nine million Medicaid enrollees had been disenrolled, many for procedural reasons. Children accounted for 40 percent of all disenrollments.

Artificial Intelligence Has the Potential to Reduce Costs and Streamline Care. Artificial intelligence is already being used in varying degrees by health care organizations. Many are using AI for chatbots and personal assistants to streamline patient documentation and charting and to predict readmissions or individual risks for certain medical conditions. There are concerns about how AI can best be used to its full potential without introducing new risks and potential for errors. Still, one study predicts that wider adoption of AI could lead to savings of 5-10 percent in U.S. health care spending without sacrificing quality or access. Other studies predict AI could lessen workforce shortages.

Mental Health Concerns Are Growing Among Young People. Mental health cases in children's hospital emergency departments were 20 percent higher in 2022 than in 2019. Young adults are more likely than older adults to experience anxiety or depression, with half of all young adults (ages 18-24) reporting anxiety or depression symptoms in 2023. Social media can negatively impact mental health, and LGBTQI+ youth are at higher risk. In addition, firearms are the leading cause of death for children in the U.S. and are the most used weapon in interpersonal violence against women.

Heart Disease Is Still the Leading Cause of Death. The leading cause of death in 2022 was heart disease, followed by cancer, unintentional injury and COVID-19. COVID-19-related deaths declined by nearly 50 percent compared to the previous year. At the same time, deaths by suicide reached a record high in 2022.

Climate Change Is Impacting Health. In 2023, there were 24 weather-related disasters in the U.S., with damage of at least $1 billion. In addition, one in three Americans lives in unhealthy levels of air pollution, and the summer of 2023 was the hottest summer on record. Some hospitals are making changes to impact climate change by moving toward plant-based meals, updating HVAC systems, implementing building automation and controls, and updating electrical systems to be more efficient.

Health Care Trends: Questions to Consider

• Does our board receive regular education about current trends and how they impact our organization and community?
• How would we describe our community's trust in health care?
• Are rates of uninsured and underinsured shifting in our community? How is it impacting our organization?
• Is our organization already using AI?
• What steps can we as a board take now to understand AI better and start using it in small ways?
• What are our local community's mental health challenges, and how are we helping meet those needs?
• How do our mission and vision inspire our organization to respond to ongoing public health challenges and climate change?

Special thanks to The Walker Company and governWell™ for use of: What Boards Need to Know from the AHA Environmental Scan. Additional trustee resources are available in Kansas governWell and the Trustee Section of the KHA website.