As much as the healthcare industry has changed over the last few years, there’s still more disruption to come. Here are my predictions for 2016 – almost all of which are driven by the need to get costs under control:
- In an effort to avoid ever-increasing premiums, more businesses will experiment with various types of shared-funding arrangements, including group captives and self-funding.
- Narrow networks will become more acceptable as groups and individuals look to curtail premium costs. As a result, oversight of narrow networks will increase.
- Consumer angst over escalating costs will surge as many will start to question what they’re getting for their money. This will open the door even wider for disruption from innovative healthcare companies and unique partnerships. Newcomers will be prepared to promote cost savings and meet consumers’ expectations. (We’ve already seen some of this, like Oscar, for example, and ZOOM+PHI, but now providers and payers should expect the disruption to grow exponentially.) The angst may reach high enough levels to get legislators involved.
- Retail clinics will grow significantly both in terms of the number of locations and the breadth of services offered.
- Telemedicine will have a break-out year as consumers, payers and providers all begin to enjoy its convenience and cost savings.
- Consolidation will continue among hospital systems with hospital closures and conversions being part of the mix. 2016 will also see its share of mergers by health insurers.
- In response to pressure from public and private payers that are pushing for “value based payment” models, more health systems will get into the insurance business.