Revisiting My 2019 Health Care Predictions

At the beginning of 2019, I made several predictions about which trends in the health care industry would come to fruition during the year. Let’s take a look back and see how well my predictions held up.

Prediction 1: The rising cost of health care will remain front and center in 2019.

Did it happen? Yes. Transparency mandates pushed even further, keeping the national discussions, and headlines, focused on the issue of health care costs and transparency. Alongside the national policy discussions, headlines were filled by journalists highlighting ridiculously high bills faced by consumers that fueled the heated discussions about health care costs in America. 

Prediction 2: New steps will be taken to address the issue of health care costs by addressing price transparency. Payers will partner with their providers to get insurance-based out-of-pocket cost information to patients at the point of care or point of referral. Costs won’t only be accessed by patients, but directly by providers helping their patients make the best decisions possible.

Did it happen? Partially. While meaningful payer-provider partnership didn’t materialize in 2019 to get out-of-pocket cost information to patients at the source of care, movement did take place to set the stage for the future. CMS’ new hospital price transparency rules came into effect, requiring health systems to make their standard fees available on-demand and online. This information alone is not partnership nor particularly meaningful to patients with insurance, however. The information shared by health systems currently is not tailored to what someone with insurance would actually pay for care based on their provider and their specific insurance benefits. Providers partnering with plans to get this personalized cost information to patients so they can use this information as a tool for care planning is the next step.

Prediction 3: Health plans will do more to encourage members to shop for care, including rewarding quality choices and the use of cost-effective alternatives, such as telehealth.

Did it happen? Yes. More health plans are putting incentive programs and shared savings programs into place to encourage members to shop around for services. These efforts are just part of an overall mix of engagement strategies to encourage better choices in healthy behavior and care selection.

Prediction 4: Digital strategy is no longer an afterthought.

Did it happen? Partially. There is an increasing focus on chat and concierge services and plans are working hard to figure out how to come across as more human, while also making digital a more valuable and integral part of members’ interactions.

Navigating health care continues to be too stressful for too many people. People are engaging with plans and providers due to illness and injury, but they aren’t experts and can’t answer all their problems with self-serve experiences. Sometimes people need guidance to address their health care needs and help from a real human. While we are seeing increasing focus on chat and concierge services within the health plan space, I’m not seeing this as a CORE theme for health plans quite yet, so there is still a ways to go in this area.

Prediction 5: Convenient care options will continue to expand.

Did it happen? Partially. Innovative and new care models continue to expand, but traction and adoption remain spotty. One bright spot is that virtual care for behavioral health adoption seems to be growing significantly and has the dual benefit of solving for network sufficiency challenges.

Prediction 6: Consumers will take an increasingly active role in their health care.

Did it happen? Not yet. While I predicted that people would move beyond thinking about health relative to their diet and tracking data to more actively manage their health and financial well-being, I think that broadly, this prediction coming true remains just over the horizon. People are getting more access to data than ever before and very soon we will see them taking advantage of it to manage their health care and health care finances.

Prediction 7: Patients will take an active role in the national conversation on health care costs and talk to their own providers about options. More and more people will find the voice to drive their health conversations, ask questions, and do their research.

Did it happen? Partially. Organizations like WEGO Health, Savvy Coop and even our own #WTFix initiative continue to get patients out in front of the health care industry to ask questions, drive discussions and focus on change. While we are making progress, patients having complete access and active roles in the health care cost conversation has still not fully materialized.

As I look ahead to 2020, I believe many of these topics and themes will continue to dominate discussions and headlines. Keep an eye out for my additional predications for the year ahead, coming soon.