Four Health Insurance Trends to Watch for in 2016

January 19th, 2016 | Posted by Sarah Jones in Guest Blogs - (Comments Off)

This week on NVTC’s Blog, Innovation Health CEO Dave Notari identifies key health insurance trends to consider in 2016.


As the healthcare industry continues to evolve, it is important for business owners to know where it is headed, and adjust accordingly to meet their needs. To make sure you and your business are best able to prepare for the year ahead, here are my top four predictions for the New Year and beyond.

Shift from volume of care to value of care

Over the past few decades doctors had been compensated based on the number of services they provided to people, rather than the outcomes those services produced. Recently, we have seen a shift in this approach. Increasingly, employees and companies are paying doctors for the quality of the care provided – i.e., keeping patients healthier and helping them to better manage their care. In 2016 we can expect to see this overall “quantity” trend continue to die out across the country. This is good news for your employees’ health and your business.

In 2016 you will have access to more health plans focusing on cost-effective care. Since these are specifically designed to keep your employees healthier and out of the emergency room, they could save your business quite a bit on unnecessary copays and premium payments. As we move into the New Year, be sure to talk to your broker and be on the lookout for health plans focusing on value-based care.

Alignment of health plans and providers

For too long, health insurers and health providers have been on different teams. Health plans are in the business of managing risk, and they have looked to reduce the number of claims paid to providers in an effort to improve their revenue. This approach put many hospitals and physicians at odds with health plans; the approach simply wasn’t working. Fast forward to today and businesses and employees now have access to health plans that work to reduce risk by improving member health. This means that the health plan, doctors and hospitals are all on the same team and working together to achieve what is best for the individual.

Given the industry success this approach has seen, moving forward there will be more health plans partnering with hospitals and physician networks. As you select your coverage in the future, be sure to look for these collaborative plans in your area. They could improve employee health and save your business money for years to come.

Increased role of the consumer in healthcare

Since the implementation of the Affordable Care Act (ACA) people have become more involved in their healthcare decisions, demanding plans that are transparent, easy to access and understand, and are affordable. In 2016 these expectations, and employee involvement in the health plan selection process, will become the norm. This means that moving forward your business will need to find plans that address those specific employee wants and needs.

To make sure you’re paying for the care that is most valuable to your workforce, look for plans with access to easy online enrollment, clear language in the plan descriptions and on-the-go tools that can help them look up the cost of a local MRI visit or the copay at a nearby physician’s office. Moving forward, those plans will be most valuable to your employees.

Continued growth of private exchanges

Bottom line: people like to be able to customize the things they buy. It is for this very reason that 6 million people selected health plans through private exchanges in 2015. Looking ahead, I think we can expect this number to rise. Why? Because private exchanges allow employees to choose the health plan that works best for them and, as I mentioned  earlier, that choice is very important these days.

The great news about private exchange growth is that it can be really good for businesses. Despite the recent implementation delay of the Cadillac Tax, many employers are trying to find ways to move away from rich benefit plans, while still offering employees the coverage they want. Moving to a private exchange means employees can choose the care they want at the price they want without employers being penalized. Because of the “win-win” they offer you can expect to see more businesses taking advantage of the private exchange option in the coming years.

The key to success in any business lies in our ability to adapt. With each year comes new challenges and opportunities to improve the care we provide our employees. By preparing for these four trends you can ensure your business is prepared and your employees have the care they need for a healthy and prosperous 2016.

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This week on NVTC’s Blog, Business Development, Marketing & Sales Vice Chair Jenny Couch of member company Providge Consulting shares critical changes to the IT landscape that your healthcare organization needs to have on its radar.


These days, technology seems to advance too rapidly for most of us to keep up. It’s certainly moving too rapidly for organizations to keep up with every single one of the “hot” trends.

healthITIn the noisy field of today’s latest tech, it’s all too easy to get caught up in the buzzwords and lists of “This Year’s Hottest IT Trends”, and miss the truly critical changes to the IT landscape that your organization needs to have on its radar.

The healthcare industry is uniquely positioned to be impacted by a convergence of critical IT trends within the coming years. But with budgets decreasing, and resource pools shrinking, it’s more challenging than ever to prioritize IT needs within the healthcare space.

We’ve highlighted the top five technology trends healthcare organizations must have on their radar in 2016.

  1. Cloud computing. Whether it’s a pharmaceutical company needing to store large amounts of data from clinical trials, or a hospital with a newly implemented EHR system, healthcare organizations of all kinds are increasingly turning to cloud computing for a variety of uses. According to Healthcare Informatics, the global healthcare cloud computing market is expected to reach $9.5 billion by 2020. And 83 percent of healthcare organizations are already leveraging the cloud. Only 6 percent of organizations have no plans to take advantage of the cloud in the coming years. If you’re in that 6 percent, it’s time to reconsider your plans. Cloud computing can be used to decrease costs, improve access, and create a better user experience for any healthcare organization. But, it’s critical that your organization take a strategic approach to moving to the cloud. Learn more about how you can leverage the cloud to best support your organization here. 
  2. The Internet of Things. Take a look at that FitBit on your wrist. Think about the incredible amount of data that one tiny device is generating constantly. The number of steps you take, the calories you burn, your sleep pattern, the stairs you climbed. These devices get more accurate and more intricate with every passing day. We are not far off from a future when we’ll be able to monitor nearly every aspect of our health, and the health of our loved ones without setting foot in a doctor’s office. Healthcare organizations will have to find a way to address what will be tectonic shift in how care is delivered. Communication methods will need to be established to collect the data generated by wearable and mobile devices. Methods for collecting and analyzing the influx of data will need to be developed so patterns can be identified. The manner in which treatment is delivered will have to change as we move away from the traditional doctor’s office visits, and into a world where a diagnosis can be made through analyzing the information generated through a patient’s mobile device, car, appliances, wearables, etc. And while this future may not quite be a reality, it’s coming soon, and healthcare organizations need to start preparing today.
  3. Data Explosion. Big data. Data analytics. Whatever term you use, the unparalleled rise in the amount and accessibility of data over the past few years is certain to have a massive impact on the healthcare industry. The explosion in big data occurred so quickly that 41 percent of healthcare executives say their data volume has increased by 50 percent or more from just one year ago. 50 percent in just one year. This incredible increase in data will allow medical professionals to more quickly and more accurately diagnose patients, but as with the Internet of Things, it will require fundamental shifts in how data is managed and how care is administrated. Healthcare organizations will need to train, or hire a workforce with the right data analysis  and medical skill sets. Regulations, processes, and platforms will need to be developed or implemented. Healthcare organizations who ignore this trend do so at their own peril. For as Accenture notes in a report released earlier this year for those who take advantage of the wealth of opportunity within big data, “Greater operational excellence and improved clinical outcomes await those who grasp the upside potential.”
  4. Efficiency in IT. If you haven’t heard the phrase “Doing more with less”  in the past few months, it’s probably time to climb out from under that rock you’ve been living under. With healthcare spending wildly out of control in the United States, every healthcare organization from physician’s offices to the largest hospital chains are being asked to do more with less. IT is a particularly ripe area for cutting costs, and resources. In 2016, the emphasis on doing more with less in IT will continue. Expect to see IT departments pursue options such as moving to the cloud, outsourced managed services, and bring your own device to help decrease IT operating costs.
  5. Cybersecurity. In 2014, 42 percent of all serious data breaches occurred at healthcare organizations. Sadly, this trend is certain to continue its upward trajectory in the coming years. Healthcare organizations who have not adequately upgraded their systems, and developed a thorough cybersecurity strategy are especially vulnerable to attack. Now is time to evaluate your systems, processes, and resourcing. Make sure your organization is positioned to proactively protect against attacks where possible, and identify and respond rapidly to breaches when they do occur.

Planning your 2016 health IT projects and priorities? Looking for a partner that will truly understand the challenges you are facing and the need to ensure success? Get in touch with us today. Our experienced health IT experts know the obstacles you face, and are ready to partner with you to deliver your projects on time, and on budget in 2016 and beyond.


Jenny Couch

This post was written by Jenny Couch. Couch is a project management consultant, and Providge’s Business Development Manager. She loves efficiency, to-do lists, and delivering projects on-time and on-budget.

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