COVID-19 has forever altered how employers and employees access and deliver healthcare. Some of these changes were well underway in human resources prior to the onset of the pandemic. But with COVID, what had been a moderately-paced paddle through change became a jet-propelled industry disruption. COVID threw up a huge wake in the healthcare administration and benefits industry, and its impact is likely to be felt for a long time.
The CDC notes that 90% of our nation’s $3.5 trillion in annual healthcare expenditures are for people with chronic and mental health conditions. COVID added new urgency to dealing with the prevention and management of these symptoms. It stressed the system. Along the way, it illuminated problems and opportunities within the healthcare access and delivery space in factors ranging from how we use and reimburse new technology to how we creatively address rising cost pressures and unwieldy, fragmented care.
As we’ve observed these changes this year and think about the future, these are my seven fearless predictions for employers and employees.
1) The drive to more personalized and cost-effective healthcare will advance swiftly.
This will be supported by the presence of new technology and access to data to help predict patient needs and guide research and treatment. Combining virtual clinical models with patient-generated health data will drive us forward toward a value-based model of care that meets people where they are at in their health journey. In return, this will align with the “Triple Aim”: improving the patient experience, improving the health of populations, and reducing the cost of care.
2) Virtual care (including telemedicine) is here for the long haul.
By necessity, its use is more widespread than ever. Year over year, April telehealth use was up more than 8,000% according to FAIR Health. It’s convenient. It’s safe. It’s cheaper. And it’s a better experience in many regards. Providers will need to have an understanding on how to successfully bill for telehealth, remote patient monitoring and e-visits under one umbrella of virtual patient care.
3) Employee engagement is not just a laudable healthcare goal, but an imperative.
The pandemic has forced employers to think, daily – even hour-to-hour – about the health of their employees and to seek out the tools for better collaboration in managing care. There is greater push to spend reimbursement keeping the healthy, healthy, versus the fee-for-service model. We’re seeing large investments in healthcare access tech from payors and disease-specific (point) solutions.
4) The COVID exit will have its own bumps.
Deferred or avoided treatment has been a factor in hospital losses in 2020 and will be a factor in employee health at some point going forward. It is unknown exactly how avoided care will impact plan experience in the upcoming years, but we do anticipate it adding complexity and cost to potentially undiagnosed care.
5) Those hospital losses in 2020 could place upward pressure on prices for commercial (non-plan) prices.
Being efficient and proactive in employee health management will be crucial to offsetting these losses and maintaining care. Additionally, there will be continued efforts to drive members to the best quality, lowest cost providers by utilizing pricing transparency technology or narrow network options.
6) COVID has underscored the importance of health and well-being to macro-economies and individual business.
An outcome – employers will be more receptive than ever to finding ways to engage employees in the proactive management of their health. It can improve lives and save money. But the onus is on employers to find ways to increase engagement and personalize healthcare. Spending must be strategic and thoughtful or engagement will lag and healthcare costs will rise.
7) This COVID experience won’t leave us with a ‘new normal’ in healthcare and benefits.
I think and hope the eventual outcome will be a continuous evolution to a more resilient system that can create an employee population that is healthier mentally, physically and financially. Interoperability — the way systems work together — will be the key to the future of virtual care where data flows seamlessly between the electronic medical record, claims and remote patient monitoring to maximize patient outcomes and the consumer experience.
In the altered landscape of healthcare benefits administration and care, there are things from which we can learn and grow. The herculean efforts of healthcare professionals and so much of the support structure surrounding them has been inspiring and leads the way to a better future. And I want for us all to recognize the opportunities to explore new approaches creating healthier employee populations and structures and plans where employers can thrive and weather future upheavals, if and when they come.