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 and beyond.
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.
In 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.
Increased 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 needs.
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 that6 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.