Healthcare.Trends.Insurance.jpg“The Only Thing That Is Constant Is Change -” Heraclitus

It appears 2016 is already shaping up to be quite busy in the field of Health Care.  With the election season upon us, several of these topics are sure to take center stage in the coming months.  Many of these trends are interrelated and transformations in one area can have far reaching - hopefully positive - implications to others.

What are the trends escalating in today's health care discussions? 

Increase in Costs

It likely comes as no surprise that health care costs are projected to increase again in 2016.  While the increase is not as drastic compared to years past, many consumers will still feel the impact to their wallets due to higher premiums and out of pocket costs, like deductibles and copayments. A recent survey conducted by the Kaiser Family Foundation and the New York Times found that 1 in 5 working-age Americans with health insurance have trouble paying medical bills. 

For many consumers, a sizable chunk of their health care dollars goes to prescription drugs. How could we forget about the stories in 2015 which uncovered price gouging by some pharmaceutical companies? While these practices are not wide-spread, prescription drug costs are anticipated to increase across the country in the short term, in large part because of the high cost to manufacture and the increased usage of specialty and biotechnology drugs. Consumers will likely start to demand cost transparency and prescription drug reform in an effort to contain further increases.

Consumer Driven Health Plans

As Open Enrollment approaches, more consumers are expected to enroll in High Deductible Health Plans (HDHP), also known as Consumer Driven Health Plans. These plans offer lower premiums and higher deductibles compared to traditional insurance plans. Many consumers find HDHP’s an attractive option if they do not anticipate seeking medical care during the plan year as they are able to save money by paying only when services are rendered.  

However, because these plans require consumers to pay more out of their own pocket when they do access care, individuals enrolled in these plans are forced to be even savvier about their health care choices. Individuals must weigh out the financial benefit of seeing their primary care physician instead of a specialist or visiting an Urgent Care Center instead of an Emergency Room. There are potential drawbacks to these plans, including the decision by some consumers to forego care, even when necessary, in an effort to save even more money.  Consumers who are considering coverage through an HPDP must do their homework so that they are able to make educated decisions that are physically and financially right for them.

Mergers, Mergers, Mergers

The announcements of potential mergers of large health care companies like Anthem and Cigna is expected to increase into 2016. Some smaller groups, such as primary care practices and hospital groups may explore consolidation in an effort to reduce costs and improve care provided to consumers.  The collaboration of companies, large and small, are seen as a way to help mitigate the rise in health care costs and spending, while also creating larger health systems and greater brand awareness.

Fitness & Health Monitoring Technology

Fitness trackers, smart watches, reality glasses, oh my!  Nearly 70 million people in the U.S., that’s about one in five people, now own a wearable technology device. Consumers have shown an interest in knowing more about their own metrics (number of steps, amount of exercise, quality of sleep, etc.) and possibly a twinge of healthy competition with others.  

This accessibility has led to an increased awareness - and loads of data - about our health and well-being.  How clients choose to share this information with their providers remains to be seen. Doing so may help providers gain a better understanding of their client’s overall health, not just what is reported during a 10 minute office visit.

Given the amount of data that is available, it is not surprising that companies have a compelling interest in this information, as well. In the near term, companies will try to leverage information gleaned from this technology to gain a better understanding of how to more effectively communicate with consumers using these fashionable devices.  In the long term, companies may attempt to access this data to help inform policy changes and incorporate medical care into our daily lives.

Healthcare.Trends.2016.jpgConvenient Care

Another way consumers have embraced technology is by accessing the care of a medical professional from the comfort of their own home, school or office. Referred to as Telemedicine, consumers are showing an increased interest in being able to receive care remotely for minor health issues while also experiencing a reduction in their out of pocket costs. Not only are many health plans are covering these virtual consultations with doctors, there are several brands such as Doctor on Demand and TelaDoc, which allow consumers to speak with a doctor using their Tablet or cell phone.

For those less tech savvy or wanting a little more face-to-face care, the options are virtually endless. The number of Urgent Care and Walk-In Clinics will continue to rise across the country. There has been an increase in the number of Health Systems partnering with Urgent Cares companies and retail pharmacies building Walk-In Clinics as both have started to realize that consumers want to access care when it is convenient for them (read: no appointment necessary) and in a more cost effective environment. Regardless of the method, consumers have shown that they value greater accessibility as long as they do not have to sacrifice quality.

Better Cybersecurity

One area where companies and consumers are aligned is the need for greater patient privacy. Recent data breeches, like the ones Anthem experienced last year, will continue to be top-of-mind in 2016. Consumers are going to demand that companies be more prepared to deal with their personal health information and companies will scramble to enact tougher safety measures to ensure that consumers’ trust does not wain.  

Healthcare.Insurance.Trends.jpgAnalytics for Decisions 

Companies will continue to take a deeper look at the analytics of health care in the next year. Luckily, there is no want for information.  From individual claims and clinical data to providers’ admission and discharge statistics and everything in between, companies are clamoring to operationalize the large amount of data in an effort to transform health care. 

Companies are going to continue to focus on how consumers are making health care decisions as well as the financial and physical impact of those who do - and do not - receive care. While it will likely be many years before companies are able to accurately predict consumers’ health care decisions, the findings from their analysis will be instrumental in guiding and improving clinical outcomes, operational performance and patient care.

Going Forward

There is no doubt that health care will continue to evolve over the course of the 2016 and beyond, especially with the political season heating up. Hopefully, a look at 'Health Care Trends in 2017' will focus on decreased costs, increased coverage and improved access to care.