Health Care Megatrends that could be expensive in current year

In the previous year 2014 there were plenty of achievements in terms of health care. There were many health care success stories to celebrate which includes new health technologies, major medical advances and Affordable Care Act.

At the same time many of health care changes in last year yield potential risks for patients, employers and whole nation. As a result the health care industry would be facing a massive financial hangover.

Following are five health care megatrends from last year and consider their implications for this year or beyond.

Breakthrough therapies, High Prices

For the treatment of hepatitis C, a chronic liver infection, FDA approved several new drugs in 2014. Gilead, the biopharmaceutical company introduced two oral medications that eliminate the hepatitis C infection in around 90 percent of the patients and these drugs were signalled a major medical advancement in 2014 although with some major side effects.

We are very much clear about these new drug therapies which are far more superior to anything available before 2014; so one should expect to pay more for superior product.

And under today’s rules, biopharmaceutical companies like Gilead can exploit their monopolistic market position and present US patent laws in order to maximize profits.

Expanded Coverage, Limited Access

According to Gallop, by the end of 2014, the number of uninsured Americans fell to less than 13 percent and more than half of newly insured were covered through Medicaid, a joint federal and state program helping individuals having low income with medical costs.

The fed offered to reimburse stated the total cost of Medicaid for newly eligible enrolees in exchange for two year commitment.

Similarly, the Affordable Care Act increased Medicaid payments for primary care doctors in the year 2013 and 2014. Although many new insured Americans enjoyed reasonable access to primary care in 2014 but unfortunately rates revert to their previous levels in 2015.

As a consequence, millions of Americans who have coverage now may eventually find access to medical services limited.

More People Insured, More Expenses

Health care costs have risen more faster than both general inflation and GDP( Gross Domestic Product).

To eliminate unnecessary use of health care services, some insurers decided to increase employee copayments for office visits and emergency room trips. But health care expenses continued to rise and higher deductibles come into existence. These deductibles require people to pay out of pocket costs for health care services before their insurance covers the expenses.

Health care models evolving, costs remain largely unaffected

According to policy experts there are two factors leading to better clinical outcomes at lower prices:

1. Firstly joining more primary care physicians, doctors, specialists and hospitals into integrated health care delivery organizations.
2.  Secondly, shifting to financial model that consider value, not volume, of services provided.

Various forms of ACOs (Accountable Care Organizations) have developed up that help to deliver better outcomes at lower prices, combining the two key factors. In 2014 ACOs have achieved some quality improvements due to collaboration among experienced doctors and better sharing of patient information. But on the whole they need to reduce total health care costs.

New Technologies, Untapped potential

In 2014, technology was at the centre of the health care industry but till date the improvements many hoped for haven’t matched the hype. New technologies are being introduced in health care services but it’s tough for doctors, physicians to access.

We are not very much sure where health care will end up long term but we can expect 2015 to be crucial year for industry and the whole nation.

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