Access to affordable quality care has been a persistent problem, and it’s just getting worse.
Over time rising premiums have ended up hurting more than helping. They were supposed to encourage members to be more responsible with their health by putting “skin in the game” (reducing duplicative tests, ER visits, etc.) but instead, it has steered people out of getting treatment. Very few people can hit their deductible which means that people can’t afford to pay out of pocket for preventative and wellness visits.
The perfect storm: Pandemic + Inflation
We are now dealing with the fallout of the pandemic and inflation, which have left people struggling to pay for care. During COVID-19, people didn’t get regular care, screenings, or treatment for chronic conditions. Two years on, inflation and a possible recession mean a higher cost of living. According to a recent article in the New York Times, “Nearly four of 10 Americans said they had put off care in 2022 because of cost, the highest number since Gallup started asking people about delaying care more than 20 years ago.”
More layoffs are looming across the nation, leaving higher numbers of people uninsured. An estimated 15 million people will lose access to Medicaid this year.  Out-of-pocket costs keep going up so people skip seeing doctors and ration their meds so that they can pay their rent or electric bill.
Sicker People have Less Access to Medicine and Care
Despite medical advances and healthcare technology innovations, the rate at which people are developing multiple chronic conditions is growing at an alarming rate. Only 6.8% of people in the U.S. have optimal cardiometabolic health, which is determined by ideal body mass index and waist circumference ranges; normal blood pressure, blood sugar, and cholesterol without medication; and no evidence of prior cardiovascular disease, according to a study from 2018.
Drugs are scarce and expensive. According to the Peter G. Peterson Foundation, “In inflation-adjusted 2018 dollars, nationwide per capita spending on retail prescription drugs has increased more than sevenfold, from $140 in 1980 to $1,073 in 2018.” This has led to the unfortunate phenomenon of rationing of medications such as insulin.
There is also a massive shortage of healthcare professionals that is only going to get worse as baby boomers enter the senior stage of life. There are fewer providers to see and it takes longer to get appointments. The Association of American Medical Colleges reports that the U.S. could see an estimated shortage of between 37,800 and 124,000 physicians by 2034.
Digital Health Solutions: Meaningful Care for Every Economy
Health plans can help by offering solutions that give their members the power to take control of their health. When chronic conditions are managed effectively, health plans can reduce costs while improving outcomes, no matter what’s going on with the economy. Here’s what to look for to weather the storm.
Adopt One Solution for Multiple Conditions
Members with undiagnosed or poorly managed chronic conditions can drive up to 60% of claims expenses, so it’s important to have solutions in place that address common health needs like diabetes, high blood pressure, obesity, pain, anxiety, and depression. Chronic conditions are known to have a high rate of co-occurrence, especially cardiometabolic-related issues. The undeniable truth — which recent research supports — is that we can’t ask people to manage multiple and often inter-related conditions with multiple siloed solutions: Integrated solutions can drive better results.
Scrutinize Dependency on Coaches
In light of the recent layoffs and cutbacks in coaching at several prominent digital health companies, be mindful of the potential impacts downstream for your employees when selecting solutions that rely on human support to drive results. Additionally, not every member finds value in coaching or wants it consistently.
Look for Proven Clinical and Financial Results
Digital health solutions offer tremendous potential to drive better health outcomes and reduce the cost of care. Yet a lack of rigorous studies and robust clinical evidence are often missing, leaving health plans to wade through unsubstantiated claims. To get a complete picture of a given solution’s potential, look for studies based on the highest standards of research methodologies that offer thorough analysis.
Empower Your Members to Take Control
As the world has become more tech-savvy during COVID, it’s the optimal time to leverage technology to help members manage chronic conditions. Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.
For more information, please visit www.dariohealth.com.