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2021 Health Care Trend Outlook

With the world turned upside down in 2020, the health care industry that existed prior to the pandemic has changed dramatically.

Although there are those in the provider community that may be wary of change, the general consensus is that better communication, cost and care transparency, and more efficient care models can ultimately help improve our health care delivery system (better outcomes) while creating a cost care conscious fee system that may be able to reduce the cost of care.

Here are just a few trends that are emerging in 2021 as opportunities to create cost and care proficiencies:

Transparent Pricing

For health plans, hospitals, and health systems in 2021 there are, and will be, even more new mandates around greater price transparency for drugs, provider and hospital costs that will require more exposure of actual costs to the end consumer/patient. This will empower health care users to make more qualified decisions not only by quality information available, but with cost impact as well. The ability for a consumer to be given a personalized cost estimate, financing terms, and an option to schedule the visit during a digital interaction can make the health care experience far more direct and convenient. That can translate into better financial outcomes for the provider and a better service experience for the patient. The new rules are creating mandates and opportunities for greater data-sharing in the industry. This can lead to Health plans finding better opportunities for collaboration by investing in specific initiatives and capacity for improving certain drivers of health (also referred to as social determinants) or around care management for people who have chronic conditions and comorbidities (patient with multiple underlying conditions).

Hospital-level care at home

The idea of providing hospital-level care in the patient’s home has gained traction among providers and payers over the past year as COVID-19 demonstrated how quickly a hospital can reach capacity in certain areas. The concept of identifying people who are candidates for admission to the hospital and then ‘admitting’ them to their home where they receive the same level of quality acute care is not necessarily new, but this could be seen as an opportunity to deploy on a more widespread basis. Of course, severity of condition and care plan would be deemed critical elements to home care admission.

‘Interoperability’

The new buzzword is interoperability, in broad terms meaning the ability of different information and communications, technology systems and software to communicate and exchange data accurately, effectively, and consistently and to be able use all of the information that has been exchanged. New rules went into effect on January 1 for providers to begin this process. Health plans do not have to adopt the transparency rules until January 1, 2022. This will give them a full year to understand how data sharing could help health plans empower and guide members to enhance the quality of their health care experiences. The effect of these changes could mean greater opportunities for stakeholders to evaluate key data elements that would be made more accessible and analyze how this data can be used to improve overall care delivery.

These growing trends are exciting opportunities at evolving a health care system that is more efficient and cost effective. With an ultimate goal of reducing the cost of health care which over the years has created an enormous burden on many Americans.

The role of your benefits partner is to bring some predictability, manageability, and stability to a chaotic and uncertain arena. As the insurance market continues to shift and the environment becomes more competitive and challenging, understanding the benefits landscape and maximizing your benefit investment is critical. For more 2021 trends, download our whitepaper, "10 Employee Wellbeing and Engagement Trends Shaping the Workplace in 2021."

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