Healthcare’s Year Ahead: What’s Already Happening in 2024

Healthcare’s Year Ahead: What’s Already Happening in 2024

Here at Lark, we enjoy a “2024 Predictions” article just as much as everyone else. They’re great conversation starters, especially the ones that are very niche or a tad outlandish. But predictions are just that— an educated guess on what might happen. With 2024 in full swing, we wanted to share two important, yet potentially overlooked healthcare priorities that are already happening.

‍Self-Insured Employers Seeking Strategies to Manage Rising Medication Costs

The 2023 buzz and excitement around GLP-1 medications was met with the stark reality of the cost impacts for organizations paying for these impactful, but expensive drugs. “Obesity and excess weight cost U.S. businesses and employees an estimated $425.5 billion last year¹” and finding cost-effective solutions to curb these increases is becoming a regular topic in our conversations with employer leaders. In trying to balance cost and GLP-1 demand, three common areas employers are focusing on are prevention, medication adherence and alternative vendor billing models.

“An ounce of prevention is worth a pound of cure.”² This is a great quote to describe how employers can save on expensive, acute care costs with prevention programs. Employers do recognize that GLP-1s and other chronic condition medications can be incredibly beneficial for the right people. But open access to the drugs for any employee who’s seen an Ozempic commercial will make their costs skyrocket. Finding programs to ensure the right people have access to the drugs while providing alternatives for the rest of their workforce is top of mind.

Which brings us to the next effort: medication adherence. A recent study shows that “50% of prescriptions filled for chronic diseases … are not taken correctly, and as many as 40% of patients do not adhere to their treatment regimens.”² Employers want to make sure they’re making the most of their healthcare spend and are looking for solutions that can drive the best possible health outcomes for the individuals currently taking these medications. 

In terms of alternative billing models, employers need to ensure their budgets are making an impact and are asking for utilization-based contracts. Traditional human-led coaching programs are defined by the number of coaches, both in-person and telephonic, needed to support the size of a given workforce. Contractually, coaching vendors need to cover their staffing fees and utilization-based contracts can’t support this financial model. For example, in a utilization-based agreement, if employees only use the time of two out of ten coaches, the vendor would have to cover the other 8 coaches out of their own pocket. Virtual coaching platforms don’t have these restrictions. Plus, digital utilization is easy to track and report on. At the end of the day, employers are happy to pay for services their vendors can prove employees are using and want contracts that reflect as much. 

Beyond Tech

Digital health solutions can solve a lot of common healthcare problems. For example, Health Equity has been a priority for both health plans and employers over the last few years. Digital health solutions are proven to provide better access and the same quality care to entire member or employee populations, especially in Health Professional Shortage Areas (HPSAs).³ Additionally, virtual coaches don’t carry the same biases some people associate with traditional healthcare practices, helping overcome social determinants of health.

All that said, we’ve all had the experience in our daily lives where helpful technology maxes out and talking to an actual human is the solution we need to solve whatever problem we’re dealing with. Healthcare is no different. Everyone’s health situation is unique to them, and no matter how intelligent the tech is, there will be a situation where the human touch is needed to provide the best health outcomes. We call this approach “Beyond Tech.” 

What’s Next

Since all of these healthcare efforts are already in motion, here are two predictions of how employers and health plans will achieve them. The first solution is the need for vendors that can address multiple priorities. Both health plans and employers’ portfolios are inundated with specialty vendors hired to fulfill one need and consolidating these vendors is an easy step to reduce costs and administrative overhead. The vendors that are going to be the most demanded are the ones that can improve the prevention of chronic conditions, provide responsible medication strategies, and help employers and health plans meet health equity and engagement goals.

The second prediction is that virtual platforms complemented by humans are going to overtake human-led programs complemented by tech. We touched on this briefly with our “beyond tech” approach, but digital platforms have the capabilities to address many challenges. From overcoming care barriers and engaging hard-to-reach populations to engagement-based billing models to getting newly enrolled members’ health plan experience off on the right foot, tech offers the scale, reach and on-demand access that human-centric programs struggle with. But remember, the best platforms will still support those "I just need to talk to a person” situations whenever they’ll inevitably happen. 

¹https://www.benefitspro.com/2024/02/26/obesity-excess-weight-cost-businesses-employees-more-than-400-billion-in-2023/?kw=Obesity,%20excess%20weight%20cost%20businesses,%20employees%20more%20than%20400%20billion%20in%202023

²https://www.benefitspro.com/2023/12/13/the-prescription-for-tackling-soaring-employer-sponsored-health-care-costs/

³https://www.liebertpub.com/doi/abs/10.1089/pop.2022.0278