by Dave Notari, CEO, Innovation Health
For business owners, December marks a critical moment
for assessing both the successes and shortcomings of the past year. With regard
to our health insurance, this month is also a time for reviewing the needs of
our employees and our business. As the health care industry continues to evolve,
it is important for business owners to know where it is headed, and adjust
accordingly to meet their needs.
To make sure you and your business are best able to
prepare for the year ahead, here are my top four predictions for the New Year
Shift from volume of
care to value of care
Over the past few decades doctors had been compensated
based on the number of services they provided to people, rather than the
outcomes those services produced. Recently, we have seen a shift in this
approach. Increasingly, employees and companies are paying doctors for the
quality of the care provided – i.e., keeping patients healthier and helping
them to better manage their care. In 2016 we can expect to see this overall “quantity”
trend continue to die out across the country. This is good news for your employees’
health and your business.
2016 you will have access to more health plans focusing on cost-effective care.
Since these are specifically designed to keep your employees healthier and out
of the emergency room, they could save your business quite a bit on unnecessary
copays and premium payments. As we move into the New Year, be sure to talk to your
broker and be on the lookout for health plans focusing on value-based care.
Alignment of health
plans and providers
For too long, health insurers and health providers
have been on different teams. Health plans are in the business of managing risk,
and they have looked to reduce the number of claims paid to providers in an
effort to improve their revenue. This approach put many hospitals and
physicians at odds with health plans; the approach simply wasn’t working. Fast
forward to today and businesses and employees now have access to health plans
that work to reduce risk by improving member health. This means that the health
plan, doctors and hospitals are all on the same team and working together to
achieve what is best for the individual.
Given the industry success this approach has seen,
moving forward there will be more health plans partnering with hospitals and
physician networks. As you select your coverage for 2016, be sure to look for
these collaborative plans in your area. They could improve employee health and
save your business money for years to come.
role of the consumer in health care
Since the implementation of the Affordable Care Act
(ACA) people have become more involved in their health care decisions,
demanding plans that are transparent, easy to access and understand, and are
affordable. In 2016 these expectations, and employee involvement in the health
plan selection process, will become the norm. This means that moving forward your
business will need to find plans that address those specific employee wants and
To make sure you’re paying for the care that is
most valuable to your workforce, look for plans with access to easy online
enrollment, clear language in the plan descriptions and on-the-go tools that
can help them look up the cost of a local MRI visit or the copay at a nearby physician’s
office. Moving forward, those plans will be most valuable to your employees.
Continued growth of private exchanges
Bottom line: people like to be able to customize the
things they buy. It is for this very reason that 6
million people selected health plans through private exchanges in 2015.
Looking ahead, I think we can expect this number to rise. Why? Because private
exchanges allow employees to choose the health plan that works best for them
and, as I mentioned earlier, that choice
is very important these days.
The great news
about private exchange growth is that it can be really good for businesses. Despite
the recent implementation delay of the Cadillac Tax, many employers are trying to find ways to
move away from rich benefit plans, while still offering employees the coverage
they want. Moving to a private exchange means employees can choose the care
they want at the price they want without employers being penalized. Because of
the “win-win” they offer you can expect to see more businesses taking advantage
of the private exchange option in the coming years.
The key to success in
any business lies in our ability to adapt. With each year comes new challenges
and opportunities to improve the care we provide our employees. By preparing
for these four trends you can ensure your business is prepared and your employees
have the care they need for a healthy and prosperous 2016.