It's no secret that healthcare is constantly evolving.
At Amino Health, we’re seeing the power of bespoke health plans; a rise in carve-outs, direct contracts, hybrid reference-based pricing plans, and more are all innovative attempts to increase access to high-quality care and curb skyrocketing healthcare costs. We predict this trend will only gain more traction—and are developing our platform to ensure that we can continue to support this new creativity in healthcare.
What else is next? Read on for five key predictions from leaders at startups and established institutions to learn what they’re anticipating for 2023 and how they’re preparing for the road ahead.
Personalizing the approach to health benefits
As I’m looking at the capabilities we have in the healthcare and technology space, it’s exciting to see the opportunities to personalize how employees interact with their benefits. We can coordinate data on the back end to meet employee needs at each moment during their benefits experience.
At Businessolver, we’re looking at how we can integrate data from carriers, vendors, employers, and point solutions to create a more personalized approach. I think the days of “here are all your health plan options…good luck” are long gone, and we’re going to see employers needing to provide a more tailored approach to holistic employee support (providing members with more custom technology) and an enhanced experience based on everything we know about their needs and circumstances from the data.
Sherri Bockhorst, Head of Consumer Experience and Strategy, Businessolver
Evolving delivery models
In 2023, I anticipate seeing delivery models continuing to evolve, even for traditional managed care organizations (MCOs) who have historically tried to make their networks as inclusive as possible. They'll be increasingly offering network products built around high-quality, efficient providers, and leverage network alternatives to address access challenges.
I also predict we'll see a lot more member empathy on the payer side. Payers are already coming to Amino saying they need to start living up to their marketing and putting resources behind initiatives to make healthcare more member centric. We are, of course, really excited about that trend and well positioned to help those initiatives come to life.
Elizabeth Swaminathan, Head of Partnership Sales, Amino Health
Shifting to condition-specific care
Traditionally, individual practitioners have been the currency for networks and plan design as actuaries and benefit leaders think about the accessibility, cost, quality, and network status of specific providers or their practice groups.
At Amino, we’re seeing this shift. Increasingly, employers are buying access to condition-specific programs and clinics (for MSK, diabetes, even virtual primary care), whereas individual providers are represented as an interchangeable spoke to a person’s care team. In this model, there may only be a single national provider identifier (NPI) for the program (or care team), but no observable data at the provider level and an emphasis on provider uniformity.
Andrew Rosenthal, Chief Product Officer, Amino Health
Supporting patients outside the clinic
We should expect to see more technology and services that support hybrid models of care, combining in-clinic care with virtual services to better support patients outside of the clinic.
During COVID, it was hypothesized that there would be a paradigm shift to virtual healthcare. While digital health solutions and innovation continue to rise, many brick and mortar healthcare providers also realized record months in patient visits following COVID surges. People trust their providers in their community and in-clinic care is here to stay. It is clear there is tremendous value in both in-clinic and virtual care.
High cost, high risk patients are also more likely to visit providers in their community. Therefore, to have the greatest impact on curbing healthcare costs and improving patient outcomes, we must continue to innovate on services we are providing to patients that visit the clinic.
Michael Gruner, CEO & Co-Founder, Limber Health
Acknowledging the link between financial and personal health
We are seeing more and more employers needing a comprehensive “one-wallet” approach to benefits. In our volatile economy, employees need to make every dollar count and see where their benefits dollars are at work. With the rise of specialized point solutions, care navigation, and voluntary benefits, employers need to create that single source of benefits information and a streamlined place to both promote and help employees cover healthcare costs.
This approach using a single platform or hub creates a better coverage model and engagement for employees. Adding in a component of a consumer directed spending account also provides employees with that extra peace of mind that they will be able to cover those costs when they arise. I think we’ll really see more moves toward technology providing that centralized hub where members can enroll in and activate all their benefits—whether it’s their care navigation, mental health services, fertility assistance, or their FSA or HSA. Getting members to see and understand that they have control over their healthcare spend has to be the focus over the next few years. Providing them access to see that in totality is a key in shifting behavior.
Keith Soranno, Head of MyChoice® Accounts, Businessolver
Thinking beyond 2023
From moving beyond traditional delivery methods to understanding better ways to integrate data, these predictions shine a light on where healthcare is heading. By being ready for emerging trends, our industry friends and partners are empowering providers to maximize care quality and delivery as quickly as possible—and ultimately delivering a better healthcare experience for the members who interact with their platforms.