But once the dust settles and the final kinks are worked out, what will health care in America really look like?
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To glean some insight, we reached out to Brad Grossman, founder and C.E.O. of Grossman & Partners and the creator of "Zeitguide." This cutting-edge guide showcases the year's trends and provides predictions for the future, for topics from health care to science to movies to art.
Here, Grossman points to trends surrounding the Affordable Care Act to shed light on the future of health care—and how it will affect your wallet.
LearnVest: In the "Zeitguide," you use the term "me-centered health care." How is health care now being personalized?
Brad Grossman: As people have to shop for their own insurance, they will have to choose that [which is] most relevant to them.
Senator Bill Frist used a term the "grand medical inflection." Described in his own words, it's “consumer empowerment through portable devices—coupled with the parallel development of supercomputing.” For example, we are already seeing personalization, with individuals tracking their sleep and calorie expenditure with wearable devices like Fitbit, Up by Jawbone and Nike FuelBand.
There are also companies like HealthLoop that develop cloud-based technologies to help doctors automatically track patients between visits. Senator Frist may also be alluding to personal genetic data—emerging companies like 23andMe, which offers low-cost genetic analysis—which could help providers and patients make health decisions.
The guide discusses how the landscape is changing particularly for mental health care. What shifts will we see?
We have seen behavioral health become part of broader health care, especially since Patrick J. Kennedy’s Mental Health Parity Act, which required health insurers to provide equal coverage for mental and physical illnesses. But the White House also just recently pledged $100 million to increase access to care for people living with mental health and substance abuse disorders. Half of the amount will be made available through the ACA.
How will the ACA affect spending decisions?
Our "Zeitguide" friend Marshall Votta of Leverage Health Solutions taught us about a concept called "value over volume." Traditionally, providers have been incentivized to maximize the volume of patients they see—not the value or the quality of care they give to their patients.
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But mandatory insurance packages now have higher deductibles and copays. (And high deductibles are becoming prevalent in employer plans too; the average amount of an annual deductible for a single employee grew 88% from 2006 to 2012, according to the Kaiser Family Foundation.) Paying more before insurance kicks in should incentivize Americans to demand more value and efficiency for their money—like lab work done instantly at a pharmacy, an ECG monitor they plug into their mobile phone, or getting an MRI for $300 versus $2,000.
Overall, $1 trillion of the $3 trillion we spend on health care each year is wasted on unnecessary spending. Imagine a world in the future where everyone can buy individual health insurance best suited to his or her needs—whether the government or your company puts the check in your pocket. And as the culture changes, we will no longer waste money.
"Mandatory insurance packages now have higher deductibles and copays. Paying more before insurance kicks in should incentivize Americans to demand more value and efficiency for their money."
The "Zeitguide" mentions that start-ups have sprung up in the wake of the ACA. How will these new companies help consumers?
Perhaps the largest growths are in companies that are assisting consumers, providers and insurers to navigate the future of health care.
For example, start-ups like Gravie, Wellthie and Bloom Health are all companies that help employers and employees make sense of the exchanges. Evolent, Valence Health and Rise Health are in the business of helping providers advance value-based care delivery and innovative payment models. Healthloop has cloud-based technology that connects providers with patients and caregivers.
Another huge business opportunity: companies that are enabling direct-to-consumer health care, like Iora Health and White Glove Health, and concierge health services like MedLion, Paladina Health and One Medical.
But these start-ups aren't exploding onto the marketplace—what are the holdups?
Any start-up that creates systems that diagnose or treat patients in a new way will have to be evaluated by the FDA. This is not a new thing. It’s just that we are in a time in our culture where more start-ups are forming—the ACA is creating a space for entrepreneurial innovation. Digital technology devices are being created, and we are also now more aware of new companies and inventions through media and the internet.
Overall, how will the ACA lead individuals to live healthier?
If you have to spend that much money on a high deductible, you're going to have to live a healthier lifestyle so you don’t get sick. The big picture takeaway is that the ACA has disrupted the industry. Every stakeholder in the health-care industry will have to think of health in new ways.
To find out more about how our changing culture could affect your financial well-being, check out ZEITGUIDE 2014.