The health insurance sector has experienced numerous changes in the past few years due to the COVID-19 outbreak. One of these major changes is the significant decline in claims activity. Fortunately, insurers are becoming more innovative, embracing new technologies to streamline traditionally time-consuming processes — a trend that will only persist in 2023.
However, the forces reshaping the health insurance sector are not simply digital. They also include harsh market conditions, changing consumer needs, and new market entrants. Whether you’re looking to revamp your employees’ health insurance benefits or just want to keep tabs on current industry trends, here are the most notable healthcare trends to look out for in 2023.
1. Blockchain in Healthcare
Blockchain technology is a distributed database that enables safe, transparent, and impenetrable transactions. Blockchain technology could potentially alter the way the healthcare insurance sector operates. Inefficiencies and high costs are commonplace in the healthcare insurance industry. Blockchain technology may enable process simplification and cost reduction. Blockchain could be used, for example, to track payments and claims for medical care. As a result, there would be less need for middlemen, which would lead to lower costs.
2. Cost Transparency
The absence of cost transparency in the global health insurance market has drawn criticism in recent years. Patients are usually unaware of their healthcare expenses until after they have received the services. This has become a concern since it could induce patients to overpay for healthcare or fail to set aside money for it. Additionally, if patients are unsure of the costs associated with various healthcare treatments, it may be challenging for them to compare prices and make informed decisions on their choice of health insurance.
Health plan cost transparency helps consumers know the cost of a covered item or service before receiving care. Following the enforcement of the Transparency in Coverage rule by the Centers for Medicare & Medicaid Services (CMS), most group health plans and individual health insurance providers of group have begun posting costs for covered goods and services as of July 1, 2022. Third parties, like academics and app developers, can better utilize this pricing data to inform customers about the costs of their medical treatment.
Under the Transparency in Coverage rule, new standards take effect beginning January 1, 2023, through January 1, 2024. These new standards will give consumers more access to pricing data and enhance their ability to shop for health care that best suits their needs.
3. Telehealth
With the advancement of modern technologies, insurance companies are exploring innovative approaches to healthcare delivery. One such strategy is the use of virtual healthcare services. This entails giving care via telehealth or virtual visits online. Telehealth is the delivery of medical services and knowledge via electronic communication and information technology. With telehealth, health personnel can provide care to patients without physically interacting with them. It enables remote admissions as well as long-distance patient and clinician interaction. Telehealth can prove especially useful when access to healthcare is restricted due to rural conditions, a lack of mobility, or a pandemic.
During the pandemic, demand for these telehealth consultations surged. Millions of doctor visits and healthcare checkups were delayed or even canceled to stop the spread of COVID-19 early in the pandemic. Physical consultations were done through phone or video conference calls in many other instances instead of in-person meetings.
4. Wellness Programs
Wellness programs aim to promote and improve one's physical and mental well-being. They are typically provided through the workplace, though insurance companies may also make them available to members directly. Employer-sponsored wellness programs have increased in recent years, which has been good for the healthcare insurance sector. These initiatives aim to save on healthcare expenses while enhancing employee wellness. While no one wellness program works for everyone, the majority of businesses utilize a mix of education, screenings, and awards to motivate staff to make healthy decisions.
Insurance firms, in a bid to stand out from their rivals, offer premiums of high quality. One such quality premium is the Wellness premium. This premium is given to policyholders who take part in wellness initiatives. You may use the program to give your employees premium savings, cash rewards, gym memberships, and other incentives to participate. Programs that help people quit smoking, diabetes management programs, weight reduction programs, and preventative health screenings are a few examples of wellness programs.
5. Mental Health Resources
Managing mental health is important as it directly affects physical health. In the United States, one in five adults encounters a mental health issue at some point during the year, according to the National Alliance on Mental Illness (NAMI). Only around 25% of individuals who suffer from a mental disorder obtain treatment.
Despite this prevalence, the healthcare sector continues to drastically underfund and underserve people with mental health illnesses. The absence of mental health resources is detrimental to both the individuals who experience mental illness and to society as a whole.
Since the outbreak of the pandemic, more people have become aware of the connection between mental health, physical health, and job satisfaction. As a result, mental health is becoming a key issue for both businesses and employees.
6. Distributed Infrastructure via Cloud Technology
The business world is fast adopting cloud technologies. By moving infrastructure to the cloud, businesses can boost productivity while saving time and money. The healthcare insurance sector is not an exception. Cloud technology has completely changed the way healthcare businesses operate. The "cloud" is a metaphor for the Internet, and it describes how services and apps are delivered to users. Cloud technology allows users to access information from any device with an internet connection, irrespective of location. The healthcare insurance sector has employed cloud technology to enhance patient care.
Cloud computing in healthcare simplifies and secures the sharing of medical records, automates back-end tasks, and even enables the development and maintenance of telehealth apps. It makes the healthcare sector more cost-effective and efficient. Insurance companies can use artificial intelligence (AI) and machine learning (ML) technology in the cloud to automate a variety of workflows and business operations, including lead qualification, underwriting, claims processing, and policyholder services.
Conclusion
The health insurance sector is undoubtedly going through a significant transformation. The aforementioned technological developments will fundamentally alter the insurance sector, fostering opportunity and innovation. However, where there is a challenge, there is an opportunity. Hence, all the trends discussed above can be used to spur growth.
To ensure you offer the best health plan that not only incorporates these current trends but also considers your business goals and your employees’ needs, you need to enlist the services of an expert agent like Quantum Benefits. Quantum Benefits helps you align your healthcare strategy and benefit plan design with key short- and long-term business objectives.
We help you manage the financial aspects of health and group benefit plans, ensuring the most cost-effective solutions. Give us a call today at 203-946-0320 or fill out our contact form to speak with a representative.
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