Healthcare predictions: What’s in Store for This Year and Beyond?

Guest blog content provided to Q4iNetwork consultants by freshbenies freshbenies-Logo-CMYK 2018

Love it or hate it, healthcare changes over time— as do the consequences for employers, employees, providers, and patients.

Each year, freshbenies attends dozens of conferences, speaks with thousands of benefits consultants, and reads hundreds of thousands of words about this industry. After all, we’re in this thing together.

Based on what we’ve learned, here are ten predictions for the coming year.

1. Costs will rise. Again.

This seems so obvious to those of us within the industry. So why even list it? Let alone as number one? Because it can’t be ignored, and it continues to rise. Last year, the annual healthcare costs for a family of four were over $28,000. Bottom line: families will continue to carry higher portions of healthcare increases, and it shouldn’t be overlooked or forgotten.

2. Low unemployment will drive creativity.

While rate increases are a constant, the biggest shift this year is to a 3.7% unemployment rate. Fear of loss is always a better motivator than the desire for gain. A tight labor market will drive employers to try innovative solutions more readily. This includes creative benefit plan designs, perk programs and programs for non-benefitted employees.

3. Innovative benefit plans will gain momentum. 

The pendulum will begin to swing toward less traditional plans, including:

  • Value-Based Insurance Design (VBID)
  • Reference-based pricing models
  • Association health plans
  • Captive medical plans 
  • Direct Primary Care (DPC) 
  • High-performance centers of excellence

When suggested in the recent past, many companies have declined to install these ideas amid complaints of complexity, employee confusion or skepticism of savings. But given the low unemployment rate and the fact that consultants are getting better at explaining these solutions and pulling them together – these types of benefit plans will increase. 

4. Perks will pop.

Perks will continue to gain interest and traction. Services like gym memberships, healthcare navigation experts, telehealth, consumerism savings networks, pet care, identity theft protection, flexible hours, remote work, student loan repayment, car wash services, free snack programs, etc. are often the things people list when they brag about their workplace culture. They’ve become differentiators even among the big expense of health insurance. An employer can lose an employee to another company from the draw of perks that scratch an itch employees didn’t even know they had.

5. “Caring” support for workers will grow.

Every employer says they care about their people. But how do they actively show it? Smart employers are getting significant PR power by touting two specific sets of services…

  • Behavioral Health – The US Department of Health & Human Services estimates that 96.5M Americans live in areas with shortages of mental health providers. Effective tools that offer video visits with counselors and psychiatrists or even text-based guidance with specialists provide employees with new methods of care.
  • Caregiver Support – It’s estimated that 1 in 5 employees care for an adult family member or friend. This significantly affects an employee’s work life by adding stress and taking 15 to 20 hours of their time each week. New solutions are capturing employer interests, such as services that pair employees with a licensed coach whose expertise best matches their specific caregiving situation, as well as secure portals for documentation and collaboration. These benefits bring much-needed help, increase productivity and build tremendous loyalty. 

6. Engagement will drive more decisions. 

Continued rate increases coupled with poorly-implemented cost containment tools will draw employers to focus on achieving employee engagement. Stats revealing low utilization will bring cancelation of past programs. A shift will take place from checking the box of offering a service to moving the needle on ROI via higher utilization. 

Employers will be driving employees to programs that:

  • reduce in-patient, urgent care or emergency room visits
  • include Remote Patient Monitoring (RPM), Centers of Excellence, and wearables
  • help employees effectively navigate the healthcare system, from selecting top-tier physicians, and providing price transparency to medical bill review and negotiation

7. AI growth will not be artificial.

Artificial Intelligence and machine learning in the healthcare app space will surpass $1.7 billion this year, while health data analytics will reach $68 billion. The strongest advancements will be with machine learning in diagnostic imaging, drug research, and risk analytics. On the benefits side, we’ll see AI functions being touted throughout websites and apps.

8. Little help will come from DC (Republicans)

With a divided Congress, we can’t expect significant changes in federal health laws over the next couple years. Rather, most changes to the “flavor” of ACA will come from the thousands of issues inside the law that were at the discretion of the various departments like Health & Human Services. 

Hopefully, we’ll see bipartisan agreement with updates to Health Savings Account (HSA) laws. What’s controversial about that, right? Right. Be hopeful, but don’t hold your breath.

9. Lots of single-payer talk will come from DC (Democrats)

Remember when Republicans had one consistent chant of “repeal and replace?” Turns out it was a great slogan, but there was no actual plan to implement it. That’s exactly what “single-payer” is among Democrats this year. 

Lawmakers have many different ideas about what these two words mean, but that won’t slow them down. Single-payer was one of the top subjects during the 2018 mid-term elections and it will gain traction throughout 2019, right into the 2020 election. But it’s unlikely that a workable plan will be developed.

10. True employee benefit consultants will be in demand.

Brokers who aren’t consistently improving their knowledge will fall by the wayside. Consolidation will continue and true consultants will be in demand more than ever before. 

What does this look like? True employee benefits consultants will stop talking about how many decades they’ve been in business and start talking about how they can deliver results to the businesses they help.

They will separate themselves from the broker crowd by coming up with new ideas and new solutions that deliver better healthcare while keeping costs in check.

And when it comes down to it, isn’t that the future we all want to see?

 

Photo credit Andriy Popov