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As we step into 2024, the healthcare industry is poised for transformation. From rising healthcare costs and premiums influenced by demographic changes to the emergence of new technologies, medications, and treatments, the healthcare industry is evolving. Here are the top five healthcare trends to watch in 2024 and beyond.  

  1. Healthcare Costs
    The first healthcare trend to watch is healthcare costs. Rising healthcare costs continue to challenge employers and employees nationwide. KFF is predicting a 6% average premium increase in 2024, outpacing the decade-long average of 3-4% increases.  Consultants from Mercer, Aon, and Willis Towers Watson predict employer healthcare costs will increase as much as 8.5% in 2024. This increase is fueled by medical inflation, growing demand for weight loss drugs, and greater access to gene therapies, plus the continued effects of deferred care during the pandemic.  

    The 2024 presidential election is also creating uncertainty about the future of healthcare costs. Depending on who wins the presidency, policies could change around drug pricing, healthcare price transparency, and the Employee Retirement Income Security Act (ERISA).  

    To prevent placing additional financial burdens on their employees, employers anticipate shouldering the brunt of increasing healthcare and premium costs. So, to manage healthcare costs, employers must design their benefit plans strategically. The Alliance equips employers with the data and guidance they need to create effective health benefit plans for their employees and their businesses. Reach out to us to learn how The Alliance can help you offer better benefits at a lower cost.  

  2. Direct Contracting
    Direct contracting is a healthcare trend that is gaining traction with large employers for specific healthcare services like imaging and outpatient procedures. This contracting strategy involves the direct purchase of healthcare services from a provider. This can result in lower costs for employers and their employees and covered family members. Learn more about direct contracting here. 

    The Alliance has been enabling employers of all sizes to benefit from direct contracting for over three decades. We unite our employer-members to create more buying power. As The Alliance grows, so too does our ability to negotiate fairer healthcare prices.  

  3. Healthcare Price Transparency   
    The Hospital Price Transparency rule, which went into effect in January 2021, expanded access to pricing data for medical services. Despite challenges, progress is being made toward real price transparency. This is important because in order to realize the power of the free market in healthcare, consumers need to have a clear understanding of prices before services are performed.  

    Once real price transparency is established, employees can identify lower-priced options for shoppable services. Employers can then incentivize the use of these preferred-value providers by plan participants through the use of strategic network and plan design, making it less costly – or even free – to receive care at these locations.  

    While compliance with price transparency regulations has lagged, change is on the horizon. The Centers for Medicare and Medicaid Services (CMS) recently finalized enhanced hospital price transparency requirements for 2024. With this update, hospital price transparency mandates will become stricter, reinforcing the regulations established in 2021. Now, hospitals must disclose charge information using a more prescriptive template. There will be a greater likelihood of public citation and stricter penalties for noncompliance.  

  4. Regulatory Changes Impacting Health Benefits 
    UPDATED CMS POLICIES 
    CMS issued its final rule on the 2024 Medicare Physician Fee Schedule. The telehealth flexibility made possible during the pandemic has been extended through the end of 2024, expanding access to care and treatment for acute and chronic physical and mental health conditions. The ruling also includes several coding and payment policies intended to increase health equity nationally.  

    MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT (MHPAEA) 
    Mental health services continue to be a high priority for employees, with 70% of employers planning to prioritize mental health access in 2024. The MHPAEA requires group health plans to provide equal coverage for mental health/substance abuse services and medical services. In 2024, proposed updates to the MHPAEA could advance and potentially impact employers in 2025. The Alliance hosted a webinar in November to explain the MHPAEA. You can read the most important insights or watch the session on-demand.  

    We’re hosting another session to go through the proposed regulations and how they could impact employers. Register for part two of our MHPAEA webinar series to get an in-depth analysis of the proposed regulations and practical insights and strategies pertaining to the legal requirements.  

  5. Technology Advances Changing Healthcare
    The application of Artificial Intelligence (AI) in healthcare is on the rise, promising improvements in efficiency, cost reduction, and enhanced care quality.  

    In the face of staffing shortages, AI automation can allow medical professionals to spend more time with patients. With medical professionals currently spending 25% of their work time on administrative tasks, reducing the administrative burden with AI could lead to more accurate diagnoses and effective treatments, improving patient outcomes. As administrative waste constitutes one-fourth of US healthcare spending, eliminating this waste can also help to lower healthcare costs. Automating administrative tasks could result in substantial cost savings for providers, patients, and employers – potentially up to $265 billion. This not only increases efficiency and accuracy but also addresses burnout among medical professionals, allowing them to focus on patient care. 

    AI’s ability to quickly analyze vast amounts of data enhances diagnostic accuracy, particularly in radiological image analysis. AI utilization can also boost patient engagement and promote compliance with pre- and post-procedure guidelines. AI’s capabilities make remote patient monitoring feasible, enabling timely interventions and providing customized care. 

    While challenges exist in the full integration of AI into clinical settings, its transformative impact on healthcare is inevitable. AI will not replace human medical professionals, but it will serve as a valuable tool to enhance performance, increase efficiency, and ultimately improve patient outcomes in the coming years. 

Looking Beyond 2024  

As employers navigate the complexities of offering health benefits in 2024, it is crucial to understand how these trends are shaping healthcare. It is important to stay informed and remain flexible to successfully adapt to the ever-evolving healthcare landscape. The coming year will pose challenges, but by working together, we have the power to shape the future of healthcare.  

Learn how you can get more from your health benefits when you self-fund with The Alliance.  

Tags:

High-Value Health Care Legislation Transparency

Categories:

Health Policy Members & Employers

Tags:

High-Value Health Care Legislation Transparency

Categories:

Health Policy Members & Employers
Cheryl DeMars

Cheryl DeMars
President & CEO, The Alliance

Cheryl DeMars joined The Alliance in 1992, assuming several roles before becoming CEO in December 2006. Cheryl works with the Board of Directors and senior leadership team to establish the strategic direction of the cooperative. Cheryl participates in a number of national and regional initiatives that align with The Alliance’s mission of controlling costs, improving quality and engaging individuals in their health. She serves on the Advisory Board of the Wisconsin Population Health Institute and the board of the Wisconsin Collaborative for Healthcare Quality. Prior to joining The Alliance, Cheryl was a program manager at Meriter Hospital in Madison. She earned a master’s degree in social work from the University of Wisconsin-Madison.

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