The US healthcare market is a vast and ever-changing space, and even the most dedicated professionals may worry about falling behind.
The Brooks Group’s Key Trends in the US Healthcare Market Primer pulls information from multiple sources (such as the JP Morgan Healthcare Conference, the latest CVS Health Trends Report, and the Pharmaceutical Research and Manufacturers of America) to offer an in-depth look at the latest trends in the American healthcare landscape. Read our highlights below to take a quick look at some of the most important developments in this field, including coverage expansions, alternative payment systems, and the impact of new technologies.
Section One: US Healthcare Economics
- US healthcare spending rose by 4.6% in 2019 to reach a total of $3.8 trillion or $11,582 per person. Hospital care and physician & clinical services make up $1.2 trillion and $772.1 billion of that total respectively.
- Commercial care is by far the largest segment of the healthcare market, accounting for 153M lives and approximately $1.33 trillion in total spending.
Section Two: Evolving Payment and Service Delivery Models
- The Biden administration has indicated that they are interested in implementing a Medicare drug pricing model similar to Germany’s Institute for Quality and Efficiency in Healthcare (IQWiG). Under this model, drug companies could freely set the price for their products for their first 12 months on the market but would face strict value-based limitations after this period.
- The Centers for Medicare and Medicaid Services (CMS) are also investigating several alternate methods of delivering and paying for care, including physician-focused payment models and value-based care. Now may be a good time to offer employees managed care training as a refresher on the current state of the US healthcare market.
Section Three: Healthcare Innovation and Investment
- Precision medicine, pharmacogenomics, and gene therapies have emerged as excellent but expensive treatment options for cancer, rheumatology, and other gene-based diseases. Now is the time for payers to plan how they intend to handle these expenses in the future and invest in strategic account management training for executives in these up-and-coming fields.
- Similarly, AI is poised to have a greater impact on healthcare in the coming years. Key stakeholders such as hospitals, research centers, and biotech market research companies are most interested in using this technology to streamline billing and administrative efforts and to aid in scientific research.
Section Four: Better Consumer Healthcare Experience
- 2021 saw a new focus on social determinants of health, or SDOH. Vulnerable and underserved populations, including racial and ethnic minority groups and those who live in rural areas, will receive $2.25 billion in targeted support from the CDC.
- To combat waning consumer trust, new CMS rules for 2021 require hospitals to electronically publish comprehensive and transparent pricing information on all items and services they provide.
Section Five: Health Policy and Government Impact
- 2021 has seen a new political focus on affordable healthcare, with increasing support for Medicare-for-all and strong outcry over drug prices from increased patient advocacy in the pharmaceutical industry.
- The Biden administration also plans to work on expanding access to specific types of care, including contraceptive care, mental health care, and care available through community health centers. This initiative will likely require extensive collaboration between payers and health organizations; healthcare executive leadership training courses may be useful in helping leaders develop the skills necessary for these interactions.
Update Your Knowledge of the US Healthcare Market
These key insights are just some of the many powerful influences reshaping US healthcare at this time. Download the full Brooks Group Primer report for more details on how the US healthcare landscape is changing in 2021 and beyond, and how your organization can prepare for these shifts.