[December 15, 2014]

Vitals 5 Health Care Predictions for 2015 (and Beyond)

With one year of the Affordable Care Act under the nation's belt, there's no doubt that major changes are still in store for the health care system and the people it serves.

Increased cost responsibility on consumers, smarter technology, and more choices are shaping health care for 2015 and beyond. Vitals CEO Mitch Rothschild outlines five key changes he predicts health care consumers will see in the coming year.

1. DIAGNOSIS OUTSIDE THE DOCTOR'S OFFICE. There are several reasons your next diagnosis will happen outside of a doctor's office. Retail clinics and urgent care centers are often more convenient. Over-the-counter home kits are moving beyond just pregnancy tests and glucose monitoring, able to diagnose conditions like Hepatitis C, HIV, and prostate cancer. And technology is forever moving closer to our bodies, allowing us to scan for everything from fevers to Parkinson's disease.

This trend means that we'll be seeing the doctor less often, but for more serious problems. It will also translate into better office visits. Wearable technology provides hard data that patients can discuss with their doctors, allowing for more accurate diagnosis and care.

Outlook for 2020:

• Diagnosis 2.0 Indeed, there is a huge appetite for self-diagnostics, which could reduce the cost and resources it takes to provide routine care. A wave of simple diagnostic tools and tests are coming to market and, within a few years, will become the norm.

2. PROVIDER PRICE WARS. More options for medical care and diagnosis, coupled with increased transparency, will rev the engine of the health care marketplace. Quality information on hospitals and doctors has been in the public domain through websites. Now, companies and health plans are starting to pair quality data with cost, allowing consumers to shop for care. This trio of competition, cost and choice will fuel price wars among health care providers.

Besides just retail clinics like CVS and Walgreens, hospitals and medical centers will also compete on price. Places like the Surgery Center of Oklahoma guarantee the price for procedures, inclusive of doctor fees, initial consults and uncomplicated follow-up care. As a result, they've attracted patients from across the country. Th cost is cheaper than local hospitals, and employers are willing to foot the bill - flights, travel and lodging included.

Expect to see more of it. Couponing, incentives and other retail-model discounts will become part of the shopping experience for patients. The beneficiaries will be patients and their pocketbooks. Better quality care at lower cost - courtesy of the free market.

Outlook for 2020:

• Centers of Excellence: On the heels of competition is consolidation and specialization. Hospitals will invest in specific diseases and disorders, while general surgeries and procedures will be outsourced to more efficient and price-competitive surgery centers. This will lead to better, more efficient care.

3. EMPHASIS ON (News - Alert) BEHAVIORAL DATA. Today, the savvy marketer probably knows more about you than your doctor. Physicians routinely ask about alcohol and cigarette use, but know little about your buying habits or how you select and use services.

The psychology and science of consumer behavior is used to create desirable products, loveable brands and marketing campaigns. Those same principles are coming to health care. In fact, a recent Institute of Medicine report recommended that social and behavioral measures be captured in patient's EMRs. Your credit score, magazine subscriptions, even your grocery list may start to reveal how doctors can better position wellness and motivate people to stick to healthy habits.

Closed loop systems owned by health plans give insurers the opportunity to take the lead. Personal data combined with incentives can target individuals to take proactive initiatives towards managing both their financial and physical wellbeing.

Outlook for 2020:

• Bigger Data. New tools and services will be needed to connect and analyze a wider range of data sources, and deliver deeper meaning as we move from historical tracking to predictive modeling.

4. CARE DESIGNED FOR ONE. Behavioral data. Trackable biometrics. The convergence of data and technology will help drive the personalized care movement. Generic medicine has long ignored differences between patients in favor of generalized outcomes.

With more personal data and information becoming available, doctors can go beyond the medical history form and inflexible guidelines and consider the unique genetics and behaviors of individuals.

Outlook for 2020:

• DNA-designed pharmaceuticals. As personalized health evolves next to genetic mapping, we will soon see bespoke medications and treatments designed specifically for your physiology.

5. COST INCREASES SPUR CONSUMER SHOPPING. Unfortunately, there's no end towards the move to high deductible health plans (HDHPs) as employers look to provide lower cost health benefits to employees. While these plans keep monthly premiums down, large deductibles mean employees will go out-of-pocket paying medical bills for most of the year.

The upside of increased costs will be a more deliberate consumption of health care in 2015. In other words, shopping, where thoughtful consumer purchasing becomes the norm. The result will lead us towards a less wasteful, more efficient health care system.

Outlook for 2020:

• More benefit trimming. Pharmaceutical benefits will be redesigned. Expensive specialty drugs will force employers to start controlling drug spending by pushing back on brand names and increasing cost sharing for medications.

About Vitals

Vitals is reinventing the way people shop and save on their medical care. We support effective decision-making through cost, quality and access data, as well as reward and incentive programs. Vitals leads the market with the first transparency and engagement platform that achieves measurable savings for consumers through a retail-like approach to purchasing health care services. Through health plans, hospitals and our leading consumer websites, Vitals helps more than 150 million people each year access better, more affordable care.

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