The marvel of a magician’s magic is not about what the audience sees; it’s about what they didn’t see.
Here’s one really interesting healthcare revolution that should have a very positive impact on the future of healthcare spend – one that has been largely overlooked by politicians, lobbyists and Washington lawyers.
Since the end of WWII, the US has had an employer-based health insurance system where benefits are tax free to employees. Last year, politicians added a new parallel universe system of mandated health insurance rules, along with 35 million additional covered lives that will co-exist alongside our employer-based system.
Even though The Affordable Care Act doesn’t begin until 2014, many employers are shifting to self-insured employer plan alternatives
What this means is, employers will be doing things that politicians have avoided because of the perceived political risks. Look for self-insured employers to move to high-deductible plans with employees responsible for the first $3,000 to $5,000 every year before their co-pay kicks in. To offset the impact of high-deductible plans, self-insured employers are offering incentives to reward their employees for better health behavior (like several hours per week time off to go to the fitness center if an employee goes on a weight loss program). And self-insured employers are willing to penalize an employee who has bad habits like smoking or alcohol abuse. This makes good business sense because healthy employees are more productive and their insured risk is less expensive.
The tipping point when more than 50% of employers are offering a self-insured plan will probably occur between 2016 and 2018.
The implications are that employees will be highly motivated to search for alternative and less expensive health services when they have to pay for many of their low acuity care costs out of pocket.
- Look for walk-in urgent care centers – there are already 9,000 of them, mostly owned by hospitals – to continue to expand. A large sample survey we did last summer indicated that 24% of the population had visited a walk-in urgent care center in the previous twelve months.
- Look for telehealth services offering virtual doctor visits for low acuity care like flu medicine prescriptions to become as popular as walk-in urgent care centers.
We are in the very early days of consumers taking charge of their own health. I predict it’s going to be a very positive derivative effect of an unpopular law, one that will help Americans adapt to a changing world. Stay tuned . . .