A changing landscape: What’s in store for healthcare in 2019

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This year has been particularly eventful for the healthcare industry. Mega-mergers such as the CVS-Aetna and Cigna-Express Scripts deals both received regulatory approval, and the Amazon, JPMorgan Chase and Berkshire-Hathaway venture shook up the market. At the same time, heated debates in Washington and increased scrutiny on healthcare organizations have brought to light the need for greater healthcare transparency. This issue has become a tremendous challenge to consumers seeking out and receiving the medical care and prescription drugs they need—one that, when coupled with low healthcare literacy, has led to excess expenses and both unnecessary and avoided care.

As 2019 approaches, the healthcare system is facing, if not a turning point, a call-to-action for progress. As the industry works to meet this demand, there are a few key trends on the healthcare horizon.

Employers elevate their role. Given the slow movement seen by insurers and providers in 2018, 2019 will likely see more employers — either alone or banding with others — exerting their influence on the healthcare industry. From partnerships like the Amazon, Berkshire Hathaway, JPMorgan venture to more localized, industry-based arrangements, employers may be looking to negotiate deals directly with providers and carriers to get better deals for employees.

Data-driven healthcare decisions. More healthcare data is being collected now than ever before, with 76% of healthcare organizations investing in big data and analytics within the next two years. In 2019, savvy employers will use this information to identify high-cost providers and services to more accurately weigh their options. These data-driven insights will enable employers to better target communications to their plan participants and negotiate better deals with providers — ideally lowering costs for the companies and their employees.

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An examination room is seen at the Oscar Center in the Brooklyn borough of New York, U.S., on Wednesday, Dec. 7, 2016. The Oscar Center runs in partnership with Mount Sinai Health Systems providing primary care services and health and wellness programs. Photographer: Kholood Eid/Bloomberg

Enter the chief medical officer. In an effort to control healthcare costs in-house, employers are opening a new seat within their C-suite. Chief Medical Officers will serve as expert resources dedicated to controlling costs and improving overall employee health.

Increasing focus on behavioral health. According to the World Health Organization, depression is now the leading cause of poor health and disability worldwide. And, as the Office of Disease Prevention and Health Promotion reports, depression and anxiety can affect people’s ability to participate in health-promoting behaviors. In turn, problems with physical health, such as chronic diseases, can have a serious impact on mental health and decrease a person’s ability to participate in treatment and recovery. Employers are beginning to realize the costs of behavioral health conditions and are beginning to focus real attention on developing education and outreach programs.

New approaches to cost-sharing. Employers seem to be realizing they have hit the limit of what the market will bear in terms of upfront cost-shifting to employees (e.g., higher premiums, deductibles and copays) or high deductible plans as the only option. We’ll likely see more creative approaches to cost containment and reduction, such as no longer covering out-of-network expenses (other than in true medical emergencies) and offering more narrow-network options.

Generation-customized healthcare. As more millennial and Generation Z employees join the workforce, the healthcare industry is seeing an increased demand for customizable benefits. With so many different generations in today’s workforce, one size certainly does not fit all — a trend that shows no signs of slowing. To address this demand, the industry will likely see the role of brokers increase as they identify plan design alternatives and bring more voluntary benefits options to the table.

Personalized benefits communications. As benefits become more personalized, so will the way employers communicate them to employees. Every generation — and every individual — has preferences as to how, when and why they receive information, and has differing healthcare priorities. Employers (and, more specifically, HR) must learn to leverage these preferences and priorities to get their messages across, while still achieving corporate goals. Content may become more gender-, age-, condition- and utilization-focused. And, as more tech-savvy generations become a larger percentage of the workforce—and older generations become more comfortable with technological advances—the industry will see a rise in interactive communications materials.

Smarter healthcare consumers/shoppers. The demand for more information about health costs and how to shop for healthcare will only continue to intensify. As U.S. consumers continue to realize that healthcare is a commodity with pricing that varies by store and location, they will seek the ability to access prices and quality reviews — just as they do for everything else they purchase (cars, books, TVs, even food). While providers and insurers will need to supply more transparency for cost comparison, it will be up to employers to help employees shop smarter in the near-term.

Next year will be an impactful year for the healthcare industry. As healthcare issues continue to enter the forefront of national conversations, it will be increasingly in the hands of organizations and consumers to determine how those issues are met. In an increasingly complex healthcare market, employers and employees must educate themselves on all options available to them to ensure they are adequately covered, while not paying out the nose for that coverage.

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