'Messy' future ahead for health care market

Major shifts in the health care market, including the increasing adoption of private exchanges, continue to disrupt the health care landscape as we've known it. Those benefit managers and advisers who embrace the change ahead and adapt to it will be the ones that are successful.

During two opening keynote addresses at Employee Benefit News’ Private Healthcare Exchanges Conference in Chicago on Wednesday, show-goers got a glimpse of the expected changes to the industry. The warning signs are all there that change is coming, said David Smith, partner and director of payer services at consultancy Leavitt Partners. They include:

• Congressional Budget Office long form outlook which finds things are “quite dire”;
• A changing distribution model, with most states defaulting to federally facilitated exchanges, and the growth of private exchanges;
• A changing payment/delivery system, with a migration away from fee-for-service and the possibility employers may leave the health care game; and
• A change in the social contract, with millennials who access the working world differently than their older counterparts.

These warning signs are leading to a new health ecosystem which will at first be “rather imperfect and messy,” Smith said. “New markets figure themselves out after a series of self-corrections.”
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Separately, Ann Mond Johnson, chairman, board of managers at ConnectedHealth, said now is the time to be more optimistic than ever as consumers change the way they look at health care. They want convenience, seamless personalization, transparency and choice. As an example, she compared those attributes to commonly used applications on mobile phones, which she said are used more than 100 times a day.

Those desires by consumers have led to a health care “infliction point,” she said. New “mobile people” want services to manage their health, and on-phone apps are a way to do it proactively; social media sheds more transparency on purchasing decisions and is making the entire process more interactive.

In the end, she said, there is "a lot of collision between health and retail,” as 75% of consumers want to use digital services and 70% look up symptoms online.

But the key is making systems that work. “If you want someone to do something, don’t make them do it,” she said. “You want them to buy insurance, so don’t over-engineer the solution.”