Health benefits are changing dramatically, but our experts are here to keep you ahead of the curve. Here are six trends that we see coming in 2022:
Subscription model for primary care doctors.
The traditional fee-for-service business model has proven problematic in healthcare for many reasons: It incentivizes billable treatments over improved outcomes; administrative costs are high for both doctors and patients; and patients sometimes get stuck with unexpected medical bills. In 2022, we anticipate more independent provider groups will move towards a direct primary care model in which they collect a monthly membership fee from patients in exchange for a predetermined list of services. Not only does this simplify administrative processes but, as Hint explains, it “motivates [patients] to become more engaged, while giving providers… the financial security they need to reinvent care delivery” and focus on better outcomes. That’s a win-win-win for doctors and patients alike.
Virtual care and telemedicine will be the norm, not the exception.
Before the pandemic, telemedicine was already on the rise, but in 2022 it will become one of the most important benefits of a health plan. Research from the Kaiser Family Foundation shows that, in 2021, firms of all sizes expanded the number of services covered through telemedicine. A report from Deloitte concurs, which found that one in two clinical leaders said the pandemic had led to significant shifts in their health system’s virtual health strategy: “Rather than sequential visits with separate specialists, virtual health makes it possible for patients to connect to a suite of caregivers who can work collaboratively to offer more comprehensive and coordinated care.”
Smarter healthcare shoppers.
Thanks to the Hospital Price Transparency rule and 2022’s No Surprises Act, gone are the days when you’d book a medical procedure and find out how much money you owed after the fact. “Finally, taking care of ourselves medically doesn’t have to mean losing control of our financial health. We now have the right to see real hospital prices before we receive care,” explains non-profit Power to the Patients. In 2022, this means an increased demand for tools that make it easier for members to shop for procedures at the best prices. “We knew people were fed up with not knowing what they were paying until after the fact, which is exactly why we made transparency in pricing a priority on our platform from the day we launched,” said Jeffrey Toewe, CEO of Medxoom. In 2021, Medxoom took this concept a step further with the industry’s first virtual payment card that lets members pay discounted cash rates or pre-negotiated prices for medical visits and procedures before or at the time of service. “This is a truly revolutionary experience for patients and providers that we believe is going to be the model going forward,” said Toewe. “No one wants endless paperwork, least of all when your focus is on getting care. Our pre-payment card functions the same as cash but patients don’t have to outlay the money themselves, can settle any balances due seamlessly and stress-free.”
Improved mental health services.
Research from Boston University’s School of Public Health shows that rates of depression among adults in the United States tripled in early 2020 due to the pandemic, and has worsened in 2021, with 1 in every 3 American adults experiencing some form of depression. Additionally, the U.S. Surgeon General Dr. Vivek H. Murthy warns that “young people are facing ‘devastating’ mental health effects as a result of the challenges experienced by their generation, including the coronavirus pandemic.” In response, employers have made changes to their mental health programs, a trend that will continue in 2022, with increased coverage for out-of-network mental health or substance abuse services, and expanded online counseling services for emotional or financial distress, relationship issues, or other stressful situations.
Less reliance on traditional BUCA PPOs.
As premiums continue to rise, employers with 100 or more covered lives will take steps toward self-funded plans with stop-loss coverage in order to save on costs. “It’s not a matter of when; it’s a question of how long it’ll take to move away from fully insured BUCA Plan,” said John Glascott, CMO of Medxoom, “Seismic business shifts from the existing status quo take time. It took 20+ years for Kodak to shift from film to digital photography or legacy television networks to embrace streaming video. The same goes for health benefits. It will take time but, sooner rather than later, employers will realize how much they are overpaying and shift to self-funded plans which typically lower employers’ costs, often significantly. “There is at least $1,000-per-employee worth of savings inside your plan…What could your company do with that money?” asked Steve Watson, SHRM-SCP, CEO of Trendbreakers.
Increased preventative care and risk reduction services.
“The COVID-19 pandemic has only further emphasized the importance of chronic disease prevention and care — especially because many chronic conditions increase the severity of COVID-19 outcomes,” according to the CDC. That’s one of the many reasons that 2022 will be the year that employers will make it easier for employees to access preventative care services like annual exams, flu shots, and mammograms, and risk reduction tactics like smoking cessation programs and education about diet and exercise. After all, the best way to prevent a surprise medical bill is to never get sick in the first place.