1. Affordability. Health spending is projected to increase by 4.91 percent in 2016. Healthcare continues to assume a growing share of the country’s GDP. Rising health costs means higher prices leading to challenges in affordability for individuals, families, health plans, employers and government health care programs.
2. Value. Value-based care models and initiatives will continue to expand and mature in the coming year. More than 95 percent of U.S. providers have at least one value-based care contract with a commercial health plan, according to a recent survey by Deloitte.
3. The consumer. More than 24 percent of the 147 million individuals covered by employer-sponsored insurance were covered by a high-deductible health plan in 2015. The increase in cost-sharing responsibility will cause individuals to act more mindful when choosing healthcare products and services.
4. The government. The role of government as a purchaser, regulator and catalyst in the healthcare space is growing in scope and impact. In 2016, Medicare and Medicaid are expected to account for 49.9 percent of all U.S. health insurance expenditures. Additionally, the ACA exchange marketplace may experience more disruption in 2016, due to poor financial performance of many participating health plans.
5. Innovation. Breakthroughs in healthcare delivery, products, services and technologies will change and challenge many of the assumptions and characteristics of the industry, thereby affecting health plans. However, the nature of these changes cannot be predicted with certainty today.
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