By Eliot Asyre and Tamara StClaire
The national healthcare conversation in 2015 focused primarily around topics such as patient engagement and population health – and we expect many more conversations around these topics in 2016. However, we predict several other topics – and challenges – may also come to the forefront this year, particularly in terms of pharmacy cost, the growth of well-being programs, influence of government-sponsored programs and patient monitoring. This is just a short list, but we believe these trends will affect business, employees and healthcare institutions for years to come.
Skyrocketing Pharmacy Costs
We’ll see a double-digit growth in pharmacy expense as new specialty drugs come to market. Pharmacy is not only becoming a more costly component of healthcare benefits, but it’s also the most visible to participants. When an individual is going through an annual enrollment period, they’re likely concerned about getting needed prescriptions on day one. Cost is a big deal, and specialty drugs are especially expensive. Employers don’t have a lot of options except for cost shifting or cost sharing. We see a trend toward employers sharing more of that cost with employees – somewhere in the range of 20-25 percent, making the cost of prescription drugs an issue for employers and employees. By 2020, we expect that employers will spend 50 percent or more on specialty prescriptions.
The Focus on Wellness Shifts to “Well-Being”
The way employers look at wellness is also expanding. As a result, the conversation is shifting to “well-being.” The term implies a more comprehensive approach. Well-being recognizes the importance of engaging employees more holistically across their health, wealth and career, and even into their social and spiritual lives, local communities, work environment and culture.
Increased Government Influence
Government-sponsored programs affecting the workforce will continue to evolve in the U.S. and abroad. Small and mid-sized employers in the U.S. may stop offering traditional health insurance benefits and offer increased compensation and encourage employees to purchase insurance on the Affordable Care Act’s public marketplaces. Employers may also begin to expand the list of perks they offer in lieu of health and retirement benefits, based on generational personality and expectations. More employers are restructuring their workforce with more jobs being part-time and not eligible for benefits. This presents a twofold problem for employees and their families: lower wage earnings as well a loss in employer-provided health benefits.
Medical devices will also rapidly permeate everyday life, allowing providers to monitor patients remotely and unobtrusively, and provide a greater opportunity for non-emergent interventions. Patients and physicians will have better systems to monitor conditions as well as responses to treatment regimes. The result: Opportunities to intervene more quickly to change treatment patterns and control deteriorating situations.
What trends have you seen in health and wellness this year? What are your predictions for the New Year?
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