Disruption is not a dirty word: Embracing change to unlock value  

Mercer’s 2024 Healthcare Innovation Symposium gathered employers, thought leaders and industry experts to look at the bigger picture and craft plans for tackling problems of not just the next three years but even the next five to 10. This year’s theme – Disruption is not a dirty word: Embracing change to unlock value – aimed to help attendees navigate the evolving healthcare landscape and explore how their organizations might embrace positive disruption in preparation for 2035. 

Over the course of the workshop, Mercer along with event sponsors Artemis, Centivo and Coupe Health shared predictions for what benefits will look like in 2035. In our culminating activity on Day 1, participants were asked to bet on which one would be most likely to come true.  

Six predictions for healthcare in 2035

1. Virtual primary care dominates. VPC becomes more standard than in-person primary care for the working-age population and, as a result, PCP spend accounts for 20% of plan cost. 
2. Healthcare consumers are empowered. Health literacy increases due to increased healthcare cost transparency and the availability of this data on a popular user-friendly platform.  
3. Generative AI guides care. AI supports doctors in making clinical decisions by providing recommended diagnoses and rationale. Meanwhile, AI in benefits creates a more automated, self-serve experience for members. 
4. Precision medicine is becoming routine. Genetic therapies and personalized medicine will improve healthcare outcomes and make personalized prevention the norm for many disease states and reduce costs as treatments become more accurate.  
5. Healthcare is affordable and sustainably priced. Low acuity care is no longer considered “healthcare,” but instead is treated as a consumer service provided by a mix of retail and online companies. 
6. Traditional carriers are losing market share. Non-traditional carriers emerge as primary servicers to the commercial (employer) space, capturing most of the market share. Carriers continue to service employers, but service degrades as they prioritize other service lines.  

Attendees were given $1,501 dollars to “spend” on their bets for the future. Given the recent news cycle, it may not be that surprising that Generative AI came out on top, and affordable healthcare was voted least likely to come to fruition. Do you agree?  

Opportunity for action

1. Understand your value-based care position. 2035 will be the first year that there are more people in the US over the age of 65 than under the age of 17. Older adults tend to consume more healthcare and are more likely to still be working. Combine this demographic shift with a looming provider shortage and employers need to have a strategy for accessing high-value care (low cost, high quality) for their members. 
2. Define health literacy for your organization. 49% of employees don’t understand their benefits and only 4% understand basic plan terminology. Asking employees to make smart healthcare decisions for their themselves and their families starts with health literacy. We must think critically about what information is needed when and by whom, and what technology can help us deliver it. 
3. Investigate AI constraints and use cases for your organization. Attendees unanimously felt that generative AI would influence the future of benefits. Internally, does your organization have a strategy for incorporating AI into your workflow? Perhaps more importantly, does HR have a seat at the table? Externally, ask your vendor and carrier partners how they are preparing for the future and protecting you and your members.  

Ultimately, disruption is not a risk to be managed, it’s an opportunity to be harnessed. Incremental change begets incremental results. To avoid unsustainable cost growth and achieve a positive healthcare future, we propose the following next steps: 

• We must get comfortable with disruption in all areas of healthcare and benefits delivery to truly drive transformative change. 
• Employers have a key role in driving change. The evolving landscape of plan risk, increasing costs and variable access to care demands our attention. 
• A simple and coordinated care model with payment transparency is the key to a positive member experience and to driving increases in appropriate care. To disrupt the status quo, traditional health plan models may not be the only (or the primary) partner needed to deliver on this future.