As dynamic changes continue to ripple through the health care marketplace, senior finance executives will want to keep an eye on the several emerging trends relevant to planning their health care strategies for 2020 and future years.

They won’t just want to monitor how the changes in health care will affect their cost trends in the future. They also should be looking at how to best position their organization’s health care strategy and benefits to stay ahead of and capitalize on these trends to bring better value for their employees and for the company’s health care spend.

The top-line medical cost trend is projected to be 6% in 2019, with a net increase of 5% after plan-design changes, contracting, and cost-management initiatives, according to a recent survey of large employers by the National Business Group on Health.

Brian Marcotte

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While those increases are consistent with what we’ve seen the past several years and are nowhere near as high as they were for a number of years before that, they are still running at twice wage growth and about three times the rate of general inflation.

Thus, health care costs continue to put economic pressure on employers and employees. As a result, employers are more actively engaging in health care delivery transformation, helping employees better understand and use their health benefits, and positioning their plans to capitalize on the additional disruptions in the health care marketplace.

Here are five trends we expect to see in 2019:

Employers Playing Activist Role

The pace of meaningful and sustained change in delivering better value for the health care dollars that U.S. employers spend is slower than needed.

However, more employers are driving transformation in health care delivery by either directly contracting with health systems and physician groups, partnering with their health plans, or working with other third parties to promote value-based care.

In 2019, nearly half (49%) of the employers we surveyed will be pursuing one or more of these strategies, which focus on improving access and convenience in addition to better quality and lower cost.

While most initiatives are centered in one or two major urban areas where companies have significant employee populations, we predict it will spread to more localities in the future.

Meeting the Needs of Today’s On-Demand Consumer

Employers are rethinking consumerism. Today’s consumer places a premium on simplicity, convenience, and personalization. But for most people, even those who are interested in their health, health care is much too complicated.

Navigators, concierge services, and employee advocacy services are expanding to help consumers take some of the complexity out of accessing care and to better anticipate and address their unique needs. Most of these services place a premium on a personal, one-on-one approach to assist employees with health care decisions and resolve issues.

For the first time, our survey shows a decline (by 9%) in the number of employers offering only consumer-directed health plans. We expect that percentage to grow in future years, reflecting a movement toward increased choice under tighter labor-market conditions. It may also reflect the realization that for many people, the ability to absorb still higher out-of-pocket costs is limited.

Fast-Approaching Tipping Point for Prescription Drugs

The push for more straightforward, simple, and streamlined supply chain pricing and contracting models is reaching a tipping point.

Next year may well bring a paradigm shift. More than 90% of employers responding to our survey said they would welcome an alternative to the rebate-driven approach to managing drug costs.

While the jury is still out, only 26% of respondents expect the recent mergers of health plans and pharmacy benefits managers will result in lower costs, higher quality, and a better consumer experience.

However, they are even less optimistic about health-system-and-provider consolidation.

Emotional Health Moves to the Forefront

From stress and anxiety to addiction, depression, and serious mental illness, the full continuum of emotional, behavioral, and mental health is front and center.

Indeed, the latest data from the Centers for Disease Control and Prevention show these factors are leading causes of declining longevity in the United States. To counter the shortage of behavioral health professionals, employers are addressing the access challenge through onsite and virtual counseling, network expansion where feasible, and the integration of employee assistance programs and mental health benefits.

Successful approaches that improve employee utilization remove stigma and consider brain health on par with other medical conditions.

Disruption Is the New Normal

Today’s health care players are not yesterday’s players, nor do we fully know who tomorrow’s leading players will be. Incumbents are evolving while new entrants will continue to make a splash and shake up the existing players.

In addition, we expect more combinations of existing players. Technology too will continue to disrupt and transform health care. Artificial intelligence, wearables, voice recognition, genomics, blockchain, bioprinting, and other advancements will play an increasingly larger role in disrupting health care delivery and access, and some are already making inroads rapidly.

Savvy employers will want to continue to monitor these trends throughout 2019 and look ahead to see what else is coming on the horizon.

Brian Marcotte is president and CEO of the National Business Group on Health, a coalition of approximately 420 large employers.

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