Healthcare is in flux. From affordable benefits like Direct Primary Care (DPC) to the rollout of Employer Mandates, American businesses nationwide are viewing an entirely new healthcare landscape. The following list summarizes some of the benefits trends expected to affect employers and employees in 2016:
- More Health Plans Will Include DPC
Direct Primary Care will continue to grow in popularity with doctors and employers. DPC practices cover all routine primary care for a low monthly cost, leaving insurance’s role for ACA compliance and catastrophes. In 2015, record numbers of primary care practices began offering DPC services, and employers have begun to take note. As comfort and familiarity grows with DPC and its cost-saving strategy for companies, employers nationwide will turn to DPC to control healthcare costs. The nation’s first DPC “carrier”, MedLion, will continue to expand in 2016.
- Telemedicine Use Will Increase
Telemedicine helps keep employees on the job, and improves access to basic healthcare when off the job. As more insurance companies begin to cover telemedicine consultations and more telemedicine companies emerge to meet demand, employers will also turn to the new trend of “virtual” onsite clinics, where new telemedicine technology will not only be used to consult with employees, but also examine them remotely. For example, MedWand DOCs (Digital Onsite Clinics), a new telemedicine examination platform, will be available to employers nationwide in 2016.
- Insurance Premiums Will Continue to Rise
While this prediction typically holds true every year, many employers will face higher premiums due to adverse selection and low participation from continued implementation of the Affordable Care Act’s Employer Mandates. Also, as the larger insurance companies merge, laws of economics suggest that costs will increase due to diminished competition. Savvy employers will begin looking at higher deductible plans, self-insurance with increasing stop-loss plans, and new models like DPC.
- Brokers Will Focus on Service and Strategy
Competitive health insurance brokers will slowly let go of the traditional “menu” approach for health plan recommendations and switch to custom strategies utilizing the latest in healthcare options, such as Direct Primary Care. In addition, visionary brokerages will adopt a higher level of service to their clients. Not doing so will allow online brokerage options and exchanges to consume their books of business.
- Patients Will Become Smarter Consumers
With deductibles not showing signs of coming down, employees will be expected to control their own out-of-pocket costs. As employees realize prices on procedures and visits can vary zip code to zip code, healthcare consumerism will continue to rise. As awareness builds, competition in the market will increase, driving down costs and increasing quality of services. Startup ZendyHealth, for example, allows consumers to "choose their own price" for medical services.
- Employees Will Have More Tools to Monitor Health
As healthcare consumerism increases, tools to assist employees control healthcare costs will also continue to develop. Using mobile apps, transparency tools, and new services, employees will actively play a greater role in managing health and healthcare costs for themselves. One such tool, Wiser Together, teaches employees how to make the best decisions for their individual health conditions.
- Insurance Physician Networks Will Shrink
Studies have recently demonstrated that large physician networks don’t necessarily result in higher quality of care. In addition, healthcare institutions will learn to focus on quality rather than quantity to improve outcomes for patients. This trend has already begun and will continue to accelerate in 2016.
- Employers Will Shift Costs to Employees
Before implementation of the Affordable Care Act’s Employer Mandates, not all companies provided benefits. Now all companies with greater than 50 FTE employees have to provide health benefits with minimum requirements, otherwise face expensive fines. Companies with limited budgets will provide limited options, leaving pricier, option-heavy plans to employees. In addition, employers will continue looking for ways to shave healthcare costs, many times at the expense of the employee.
- Online Options Will Continue to Rise
Online brokerages like Zenefits, private exchanges, and electronic third party administrators (TPAs) will continue to grow in popularity and acceptance. New online companies will emerge to compete with the existing brokerage industry, driving up service and options for employers. Their popularity will force competing insurance brokers to focus on better service and ongoing client management.
- Employers Will Take a More Active Role in Controlling Healthcare Costs
Everyone is tired of high premiums. With the Employer Mandate in full force in 2016, business owners will become strategists when constructing their healthcare plans with their consultants, sometimes thinking outside the box for creative solutions. Using the aforementioned healthcare planning tools, employers will actively look for ways to stay in compliance with the ACA, avoid excessive healthcare costs, and provide value to employees.
We are witnessing a seismic change in America’s healthcare culture – a time ripe with innovation, disruption, and lots of changes for employers and employees. 2016 should prove to be another interesting year for healthcare.