We’re only one month into 2024, but it’s already encouraging to be engaged in so many healthcare affordability conversations. Now it’s time to transform those words into actions. The following are a blend of trends, observations and wish-list items that can make 2024 a game-changing year.
Equity starts with affordability
Health equity and healthcare affordability are already hot topics. We believe the two conversations will converge as the industry recognizes addressing equity starts with tackling affordability and as employers embrace their power to do more. Costs – even just the fear of them – keep people from accessing care, despite having employer-sponsored coverage (a trend further exacerbated in lower-income Americans). Everyone deserves the fair and just opportunity to be as healthy as possible, without great sacrifice to their families or themselves.
The rise of SMBs at healthcare innovators
Based on conversations we’re having with both brokers and employers, we expect small- to medium-sized businesses (SMBs) to surface as the country’s most innovative purchasers of healthcare. Reeling from record-high renewals from traditional carriers, we believe they will lead the charge in adopting new solutions that address costs for their business and their employees.
This trend is exciting for multiple reasons:
- SMBs create and employ the most jobs (about 63%) in the US economy, resulting in a huge impact to the health of American workers.
- Healthcare is local, so SMBs can have direct impact on their communities and healthcare systems.
- SMBs are uniquely positioned to shift the direction of healthcare given their agility when it comes to meeting the bottom line of their businesses and the needs of their employees. In a recent poll, more than half of small-business owners said they adjusted plans and coverage to lower costs, and more than one-quarter changed carriers in the four years prior.
Advancing virtual primary care
While there’s no shortage of virtual healthcare options today, the game-changer will be practices that provide true advanced primary care versus urgent and one-off care encounters. True advanced primary care provides continuity of care, meeting the ongoing and acute care needs of the modern consumer by increasing access to thoughtful, cost-effective quality primary care wherever they need it. To drive better engagement, experience and outcomes with virtual primary care, the practice should be embedded into the health plan design for seamless in-network encounters.
Paying for change
If we want to change healthcare, we must change the way we pay for healthcare. The status quo fee-for-service model might treat symptoms, but it does little to promote long-term health and well-being. We believe employers purchasing healthcare for their employees will rethink the incentive structure behind healthcare, particularly how providers are paid.
We also encourage employers to demand more transparency with how carriers are paying providers and push to pay for value versus today’s reality of units of care consumed. Employers will look for solutions (in particular, health plans) that can facilitate transparency and alignment of incentives between employers and providers.
Improving mental health support
Mental and behavioral health has been a growing concern, particularly in the wake of COVID-19. Employers continue to rank this as a high priority but have more to do to increase accessibility and coordinate care across mental and physical health and beyond. One way is by making the primary care provider the quarterback in care, proactively screening employees and providing team-based support and referrals to in-network specialists to ensure members are guided across the care continuum.
Reflecting on the past year, we’re immensely thankful for our client, broker and provider partners who helped make affordable quality healthcare a reality for more of our country’s workforce. Going forward, these game-changing developments and aspirations can bring us all closer to the healthcare system we all deserve.
Want to be a part of the transformation? Reach out to us at https://centivo.com/get-in-touch