Like any other industry, healthcare experts follow healthcare trends from year to year to make predictions about the future. Changes in government regulations, innovation and new inventions, changing social ideas, and more influence the healthcare industry and the experts’ predictions.
Get Ready to Pay More Out-of-Pocket
News of premium hikes for Affordable Care Act (ACA) subscribers dominated headlines when open enrollment rolled around in late 2016. Unfortunately, insurers across the board also plan to raise rates.
Expect to see increases anywhere between 5 and 25 percent on employer-provided insurance premiums, with deductibles also set to increase. In fact, healthcare costs in general are rising, with experts predicting an increase of at least 11 percent on prescription drug prices. Some insurers pass this cost to customers in the form of limited drug formularies and move to co-insurance instead of co-pays.
Comparison shopping, flexible spending accounts, and health savings accounts help alleviate some of these extra costs.
Value Versus Volume
The current healthcare model is volume-based, with healthcare providers prioritizing quantity over quality. This is because providers make money based on the number of patients they treat, tests they perform, and procedures they administer. This means there is no incentive to educate the patient or even provide quality care. It also leads to unnecessary tests, unnecessary follow-up appointments, and generally wasteful spending.
In recent years, the move toward quality care has grown. For example, Medicare and Medicaid both impose penalties, including financial consequences, against providers who fail to meet certain standards of care.
Telemedicine: Virtual Doctor Visits
Virtual doctor visits allow patients to consult with a physician without actually going to a doctor’s office. The solution works well for routine illnesses and is especially popular in areas with medical provider shortages or when doctors’ schedules don’t allow for same-day visits. Recently, mental health providers also joined the telemedicine trend.
Employers offer these virtual visits via onsite kiosks. The employee enters the kiosk, which includes equipment for checking the patient’s vitals, including temperature, blood pressure, and heart rate. The doctor receives the information electronically, during his or her consultation with the patient.
Some employers absorb the cost of these virtual visits. However, even when the patient pays out-of-pocket, the average cost is around $50, making it affordable even for those without health insurance.
Chronic Disease Increases Stress on the Healthcare System
The number of patients experiencing chronic health conditions continues to grow worldwide, with the World Health Organization (WHO) predicting a 57 percent increase by 2020, particularly in developing countries. This places significant stress on healthcare providers around the world, including here in the United States.
Providers have responded by increasing calls for patient involvement in healthcare, as well as recommendations for a holistic approach to total wellness, such as improved diet and exercise.
Rising Prescription Drug Prices
Increases in spending on prescription drugs, with a significant rise in specialty drugs, is likely to occur in 2017. The manufacturing of these specialty drugs is both more costly and more complex, and typically treats complex and relatively rare diseases, such as HIV. This limited market is part of what leads to the increased manufacturing cost.
In recent years, however, researchers and pharmaceutical companies developed specialty drugs to treat complex diseases that affect larger numbers of people. Right now, the result is higher medical costs, with specialty drugs accounting for 6 percent of all healthcare spending and 35 percent of prescription spending. However, over the next few years, experts predict that these drugs will help lower overall spending.