Out with the old, in with the new! 2021 health predictions.

January 4, 2021
Josie Rasberry

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2020 was…well, enough about 2020, right? So let’s look ahead to 2021!

We asked a few healthcare leaders what their predictions are for all things healthcare in the coming year. Factors like COVID, a new Presidential administration, and price transparency legislation are shaping the new year to be a big one. Bigger than 2020? Only time will tell. Our experts’ predictions are grouped by topic further below, but it’s a long read (well worth your time though) so here’s a TL;DR summary of each topic:

  • COVID-19: There will be big government investment into vaccine research and other tech to prevent the next pandemic. COVID will dwindle down in the U.S., but not in other countries. Changes in the workforce due to COVID will continue long after the pandemic is over.
  • Politics: Fighting inside the Democratic party over how to address healthcare reform is highly possible. Unfortunately, there will be continued consolidation among hospitals, insurers, and middlemen. Biden will likely focus on improving quality of care, and HHS will get strict on monopolistic hospitals.
  • Innovation: Telehealth grew by leaps and bounds in 2020, and will continue to do so in 2021. This usage will lead to growth in DPC/VPC, and could even lead to big evolutions in concierge medicine. It’s also possible there will be an increase in people focused on the point of care being anywhere the patient is. Further acceleration of products around specific health needs is likely, and telehealth for mental health services will continue to rise in popularity.
  • Healthcare Business Models: More people will make the change to cost-sharing companies like Sedera. We could see an uprising of small factions that move away from traditional employer-based insurance models, but then the companies offering these alternative methods will face higher government scrutiny. Membership-based medicine will also continue to take root and grow.
  • Price Transparency: Price transparency will take some time to lead to lower costs, but it will begin to shift consumer demands. Simply being able to compare prices and see the massive discrepancies in cash pay and negotiated rates will begin a movement that ultimately forces hospitals to compete on price in a way they never have before.

Keep reading below for the full predictions from our experts!

COVID-19

Dr. Nick van Terheyden with Incremental Healthcare: “We’re going to see a cataclysmic change that will be driven, in part, as a result of the pandemic. We will not let this crisis go to waste and we’ll force these issues, such as campaign finance reform, to be addressed. We will also see the end of COVID-19 as a major concern in this country, but not worldwide. I think it will take a little bit longer than that, but the lasting consequences will be felt for a long time to come.”

Jenny Aghamalian, Vice President, Public Affairs and Strategy at Sedera: “There will be changes in the workforce as a result of the pandemic. We’ve seen a lot of adaptations and changes in rules to allow for more innovation in the healthcare space to meet people’s needs.”

Matt Dale, CEO and Founder of Point Health: “Globalization of the economy, rapid expansion into untouched habitats, and ease of travel have ushered in the era of pandemics. We had SARS in 2002. H1N1 in 2009. Zika in 2015. As the human population grows, viruses will jump from animals to people more often and will be harder to contain. It’s estimated that COVID cost the global economy between 10 and 15 trillion. Covid was a wake-up call. We’re in an accelerating arms race against Mother Nature. We’re going to see massive government investment in vaccine research and other technologies to try and prevent the next big one.”

Politics

Clay Johnston, Dean of University of Texas Dell Medical School: “I’m concerned whether politics can actually move us forward. I don’t think that even in this kind of crisis that we’re going to see major changes in what the government does. That being said, I do think the government is slowly working towards pushing for high-value care in the programs that it currently supports, which is positive.”

Matt Dale, CEO and Founder of Point Health: “Expect infighting in the Democratic Party over healthcare reform. More radical members will push for universal healthcare. With the goal of uniting the country, not dividing it, Biden will try to find initiatives with wide bipartisan support: price transparency, investment in technology, and of course vaccine research.”

David Balat, Texas Public Policy Foundation Right on Healthcare Director: “In the political landscape today, I think that there’s going to be continued consolidation among hospitals, insurers, and middlemen, which is not the direction I’d like for it to go.”

Steven Cutbirth, Director of Marketing at Point Health: “There will be a shift to focus on quality from the Biden administration. While the Trump administration had a strong focus on bringing down healthcare prices, I see the Biden administration shifting to ensure all Americans have access to quality care. Both price and quality are incredibly important when it comes to healthcare, so I hope the Biden administration keeps a hard line on things like price transparency, healthcare consumerization, and value-based care while also pushing for payment based on outcomes, not FFS.”

“I also see HHS getting more aggressive in regulating hospitals and their monopolistic practices. Biden nominated California Attorney General Xavier Becerra as the next Health and Human Services Secretary. Those who have followed Becerra know he recently made headlines with his investigation into Sutter Health and their monopolistic practices in Northern California. I am hopeful he will take the same approach at HHS and put an end to the increasing consolidation in healthcare which leads to fewer options for patients, less competition, and higher prices.”

Innovation

Matt Dale, CEO and Founder of Point Health: “Healthcare technology will continue to change the marketplace. We’ve seen “last mile” services in other industries: Uber Eats taking food from the restaurant to your house, and Favor taking groceries to you from the store. For those that can afford it, a platform might emerge that brings doctors and nurses to you. It’s an evolution of concierge medicine that I wouldn’t be surprised to see widely adopted in 2021.”

Greg Matthews, Founder of HealthQuant: “I think the big change in 2021 that we’re going to see relates to telehealth. The way that we seek care is forever different as a result of the pandemic. To broaden that slightly, I think we’re going to start seeing a lot more people focused on the point of care being anywhere you are. For example, being able to do off-hours MRI scans that provide additional revenue to radiologists, but doesn’t add any additional costs to their system because the real estate is sitting there. We’re going to see a lot more efficient use of healthcare tools and creative use of healthcare tools to change the continuum of care.

Clay Johnston, Dean of University of Texas Dell Medical School: “We’re going to see a further acceleration of products around specific health needs. Right now, these products are generally sold to consumers but I think more and more they’re going to be sold to self-insured businesses and other combined entities. There’s a kazillion of these specific health need products and companies, but that marketplace is not mature at all. So I suspect that there will be some maturing of that marketplace as we see what really works or not.”

“I actually think what Point Health is doing is perfect because we need that play for the platform. We need a place where patients get aggregated to a level in which physicians can influence behaviors and have patients treat healthcare like a marketplace. Other companies like Amazon for health services will also help to accelerate all these innovations in specific health areas.”

Steven Cutbirth, Director of Marketing at Point Health: “Increased Teladoc usage will lead to growth in DPC/VPC. As patients get used to using services like Teledoc for health needs, they will 1. realize that having an ongoing personal relationship with a doctor is far superior to one-off calls with random doctors and 2. demand the same kind of access to their own doctors. This will lead to DPC/VPC taking off as people see the benefit of connecting directly with not just any doctor, but their own personal doctor who understands their unique needs.”

Jenny Aghamalian, Vice President, Public Affairs and Strategy at Sedera: “I think 2021 will usher in more innovation in the telehealth space, especially as it relates to virtual primary care. I also love that mental health services are being made available virtually. This is a critical time to make sure that people are connected with mental health professionals.”

Healthcare Business Models

David Balat, Texas Public Policy Foundation Right on Healthcare Director: “Employers are the key to driving change until we separate insurance from employment, so depending on what the employers do, we could have an uprising of small factions that move away from traditional employer-based insurance models. These factions are going to have solutions like cash-based care and cost-sharing ministries. The concern that I have is that with these increases in alternative methods, these folks that are trying to provide an affordable solution are going to get more government scrutiny.”

Matt Dale, CEO and Founder of Point Health: “It’s clear that insurance is broken. More people will make the change to cost-sharing companies like Sedera. Walmart is making a big splash in healthcare. As they expand the numbers of doctors and labs in stores, people will seek routine medical care on a cost-effective, walk-in basis. Other retailers might follow suit. There’s a McDonald’s in most Walmarts and most Targets have a Pizza Hut and/or a Starbucks. Just as restaurants did, expect to see doctors and labs embedding offices in big retailers.”

Jenny Aghamalian, Vice President, Public Affairs and Strategy at Sedera: “Membership-based medicine is really starting to take root. Whether it’s direct primary care, virtual primary care, or medical cost-sharing, I believe that belonging to a medical practice or a community that supports your holistic health — rather than the less than desirable fee-for-service status quo — will continue to take root and flourish.”

Price Transparency

Dr. Nick van Terheyden with Incremental Healthcare: “GoodRx is a standout for options solution. We’ll see the end of pharmaceutical runs across the border to get cheaper medications as we address the inexplicable differences in pricing that are driving things like Good Rx.”

Steven Cutbirth, Director of Marketing at Point Health: “Price transparency will take some time to lead to lower costs, but it will begin to shift consumer demands. I don’t expect to see price transparency lead to lower costs immediately but I do think consumers will begin to ask questions as they are now able to see cash-pay prices as well as negotiated rates. Simply being able to compare prices and see the massive discrepancies in cash pay and negotiated rates will begin a movement that ultimately forces hospitals to compete on price in a way they never have before. The biggest caveat here is that patients must be able to easily see the prices and compare them, which is what we are trying to ensure with our work at Point Health.”

Wrapping It Up

So, we’ll see the aftermath and continuation of COVID in 2021. We’ll see value-based care and alternative healthcare business models continue to take root. And we’ll see even more innovations in healthcare tech thanks to the acceleration it experienced in 2020. What are your predictions for 2021?

Download How to Leverage Ambulatory Surgical Centers for Lower Costs and Higher Satisfaction

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Is Your Health Plan a Tech Whiz or a Dinosaur?

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Download the Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Lowering Member Costs

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download Healthcare Consumerism 101: A Playbook for Health Plans

Learn the best strategies and tips for retaining your members while keeping costs low.

Download Your Guide to the Transparency in Coverage Rule

Discover how the the new rule will affect TPAs and health plans and how you can start your journey to compliance.

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Discover what health plan members had to say about the value of patient advocacy in our survey.

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