Executives expect consumerism and health coverage affordability to be major trends in the new decade.
Looking ahead to 2020, healthcare leaders are optimistic about potential innovations and business strategies that could improve the patient experience and lower costs.
Despite uncertainty surrounding the future of the Affordable Care Act (ACA), executives believe there are ample opportunities to provide quality coverage to consumers.
Leaders also said that new technological advancements will improve administrative operations and offer innovative clinical solutions for patients.
Below are predictions about 2020 from several healthcare executives.
Scott Flanders, CEO of eHealth, told HealthLeaders that he expects the marketplaces created under the ACA to stabilize in 2020, but sees even greater potential in the Medicare Advantage market.
"For seniors, this is going to be a good year to shop and get into a highly desirable Medicare Advantage plan, which increasingly covers many things beyond a doctor or a specialist,” Flanders said. “The expanded services of Medicare Advantage offer considerable benefits to seniors."
Flanders said that consumerism is also continuing to impact how healthcare organizations operate as the burden of employer-sponsored coverage has increasingly shifted to the consumer.
With more costs absorbed by consumers, there is a greater expectation and demand for more value in return, Flanders said.
He also added that healthcare will be one of the most significant issues in the 2020 presidential election, especially if Sen. Elizabeth Warren is the Democratic nominee.
Warren is likely to run into resistance if she continues to support a 'Medicare for All' plan, Flanders said, but could potentially benefit from pursuing a "less radical or extreme" healthcare reform policy more like former Vice President Joe Biden.
Dr. Craig Samitt, CEO of Blue Cross Blue Shield of Minnesota (BCBS MN), remains focused on driving the "reinvention of healthcare" in Minnesota, specifically prioritizing the shift to value-based partnerships with providers.
In 2019, BCBS MN entered the care delivery business industry by partnering with North Memorial Health, a Minneapolis-based health system. The deal will give BCBS MN a 50% stake in North's ambulatory business.
Samitt said that many healthcare mergers have been centered around scale when the focus should be on "getting better" as well focusing on value-based care orientation. He told HealthLeaders that BCBS MN is seeking to establish a new set of partnerships with providers, turning them into "payviders" that focus on delivering a lower cost of care.
"The key thing to point out about [the partnership] is that the hospital is not getting into the health plan business and the health plan is not getting into the hospital business," Samitt said. "We are essentially co-creating what we believe the future of care delivery will look like."
Samitt said he expects a resurgence in the telehealth space as payers and providers in Minnesota continue to utilize technology-enabled and home-based care to assist consumers. He also said he has a keen interest in the use of AI beyond administrative tasks, focusing more on its potential clinical purposes that could deliver preventative care solutions.
"The current incentive system doesn't reward a broader use of talent. One of the things that we're trying to accomplish is to be more encouraging, and perhaps a bit more forceful, in shifting providers to value-based contractual arrangements,” Samitt said. “When we make that pivot, telehealth starts to become more attractive because our focus is how can we deliver equal quality or higher quality through lower cost venues?"
Looking ahead to the 2020 presidential election, Samitt said he's heard proposals centered around Medicare for All or ‘Medicare for More’ but hasn't seen a ‘Medicare Advantage for More’ proposal.
He said he supports a path to universal coverage that builds on the ACA and believes that Medicare Advantage for More would achieve those goals. Samitt said that Medicare Advantage provides a “competitive model” and “expands benefits” for beneficiaries while also allowing for clinical innovation outside of the traditional fee-for-service model.
Jaewon Ryu, MD, JD, CEO of Geisinger Health, said he's hopeful for the future of affordable healthcare access heading into 2020.
"We know that healthcare costs are climbing at an unsustainable pace. But with any crisis comes opportunity," Ryu said. "Whether it is the sustainability of the Medicare program or the increasing costs for employers and consumers, the affordability crisis in healthcare will help spark transformation and innovation over the next ten years. And that’s the part that I look forward to because Geisinger is wired to address these challenges by managing overall health."
Matt Hawkins, CEO of Waystar, said 2019 was "an incredible year" for healthcare and pointed to enthusiasm and excitement spurred by access to technology with the ability to store data securely at a low cost.
Heading into 2020, Hawkins said price transparency is top of mind for both consumers and provider organizations. He said there is a need for improvements so that patients have a clear understanding about the price of a particular service.
"I'm excited about the fact that we can model algorithms that can quickly estimate prices," Hawkins said. "I think that, coupled with a legislative mandate for more transparent pricing, is going to benefit patients in the long run. Providers who would like to understand the cost for healthcare services or pharmaceutical treatments upfront will then be able to model their behavior."
Hawkins said he expects a greater use of technology that can calculate the estimated provider reimbursement rate and what the estimated patient payment will be. He also added that he predicts "more novel use cases" as consumers seek to take control of the clinical and financial aspects of their healthcare data.
Editor's note: This story has been updated January 10 correcting the spelling of eHealth CEO Scott Flanders’ name.
Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.