Politics, Policy and Technology
2021 Trends That Will Change Health Care in 2022
Although I have less than two months in “The Chair” as CEO of eHealth, my many years of experience in the health care industry provides me with an instinct for how emerging trends in politics, business, and public opinion drive change in the way Americans choose and receive care.
There are too many moving parts to be certain how health care will change in 2022, but I believe that the overall trends are moving in a positive direction, and that our growing comfort with technology will accelerate the pace of improvements.
Americans Want Action on Health Care Reform
eHealth’s recent Health Insurance Trends report reveals several insights on what Americans — and specifically Medicare recipients — expect from the government and their health care providers. Across the political spectrum, 92% of Medicare recipients support expanding Medicare benefits to include dental, vision and hearing. Notably, a large majority of respondents, or 83% of beneficiaries surveyed, want the government to take action to lower drug prices.
Our survey was conducted in October and, as we know, Congress has since decided that — for now — a large expansion of Medicare is a bridge too far. However, the public’s need and expectation is clear. With the 2022 elections looming, we can be certain Medicare expansion will be front-and-center next fall.
America’s Growing Comfort with Online Services
The power of public opinion to create change is second only to how people “vote” when they enroll in coverage and receive care.
This month, the US Dept of Health and Human Services reported the number of patients utilizing telehealth services increased nearly 63-fold — from 840,000 visits in 2019 to close to 53 million in 2020. To be sure, the increase was driven by the pandemic, but the accessibility and quality of care received, plus the efficiencies realized by providers make a large roll back unlikely. Many who couldn’t find time for an appointment are now being treated.
The need for direct access — office and hospital visits — is not going to change. As I noted in a recent post on Forbes, today’s Tik-Tok user is tomorrow’s Medicare beneficiary, and the convenience and efficacy of digital enrollment and treatment is only going to grow.
Americans Support the Public/Private Partnership on Health Care
Throughout my career, I’ve worked closely with state and federal regulators, including The Centers for Medicare and Medicaid Services (CMS). Although our perspectives may vary from time to time,I’ve always found the CMS leadership and their teams to be deeply committed. In most cases, they recognize the importance of private sector participation and the innovation that brings to health care.
eHealth’s research report showed that a majority — including ~80% of Medicare beneficiaries — oppose a government takeover of health care. When it comes to innovation and technology, only 18% of respondents think the government does a better job than the private sector.
Overly burdensome regulation is detrimental to the free-market forces that stimulate innovation. Take that away and we’re not going to get the breakthroughs that beneficiaries appreciate today.
There is room for improvement in every single element of American healthcare — a job too big for government or business to tackle individually. Americans don’t want a political turf-battle, they want more choice and better care.
Incremental Improvement v. A Grand Bargain
With so much to do, where can we expect the public/private sector partnership to make progress in 2022? I’ll defer to Congress on the “grand bargain” of major reform. Instead, I’ll suggest three incremental improvements — low-hanging fruit that will improve efficiency, transparency, and access for consumers.
Better Partnership In Enrollment at the State Level
President Biden’s recent action to improve access to ACA subsidies for struggling Americans is commendable. However, many state exchanges still do not allow private, online entities like eHealth to assist in enrolling subsidy-eligible beneficiaries. Beginning with forward-thinking states like Kentucky and California, we hope to forge a 2022 partnership that demonstrates that support from the private sector can make a big difference in enrollments.
Improved Quality in Enrollments
This year, eHealth made big investments in improving the quality of our enrollments. We hired more full-time support, improved training, and accelerated our use of technology to improve our process and the customer experience. eHealth took the initiative to make these important improvements without a mandate from government. We’ll continue to identify opportunities to improve the customer experience and satisfaction to further demonstrate our commitment to setting the gold standard for private-sector brokerages.
Refine the CMS Complaint Tracking Module (CTM)
A recent directive from CMS holds insurance carriers accountable for marketing activities — many of which are not of their making. Reducing misleading practices is a shared responsibility, but the system for registering complaints is dated and fails to draw a distinction with respect to the severity of the infraction. In effect, misdemeanors and unfounded complaints carry the same weight as very serious alleged infractions. — A complaint that a broker spoke too quickly or had an accent counts the same as an outright marketing misrepresentation or fraud . The consequences are disruptive to business and, most important, service to beneficiaries.
We can do better. CMS should work with brokers and carriers to transform the current CTM “system” to a new 3-tiered system that distinguishes between fraud, mistakes, and specious claims.
The good news is that the bad news is wrong: America’s health care system is not beyond repair. While virtually every part warrants some level of improvement, many of the trends we saw in 2021 foretell progress in 2022. What we need now is trust — trust in the public/private partnership that drives integrity and innovation in our health care