Health Plans 2030

This Insight is the second in a new series, Health Plans 2030, that details Avalere’s thoughts on how the health insurance market will shift over the next six years and what plans should consider preparing for now (read the first installment here). To receive updates in this series directly in your inbox, complete the form below.

How will today’s clinical care delivery need to evolve in the future?

Evolutions in the demographic, technology, and environmental landscape continue at a rapid pace, and in 2030 the landscape will look different from today. Today’s solutions will not work to solve tomorrow’s challenges. The evolving policy landscape further creates a level of complexity that creates challenges for plans as they navigate federal and state laws. The rise and shifts in population and how today’s policies and future policy predictions will influence care requires strategic planning to adequately manage members. The US Census Bureau projects that, between 2020 and 2030, 30% more adults will be between the ages of 65 and 84, and 36% will be 85 years and older. Individuals under 18 and between 18 and 44 will also see single-digit increases: 2% and 5% respectively (Figure 1).

Figure 1. US Population by Age Group (2020 vs. projected 2030)

In 2030, technologies that are nascent today, such as wearables and remote monitoring will be more established and either show their value or disappear. Providers, health plan, and patients will more seamlessly incorporate the technologies that gain a foothold into their healthcare approaches in a way that customizes health for each unique individual. With that, today’s generalized clinical programs will be less effective. Health plans need to evolve operations, practices, and clinical models today to prepare for future shifts and better provide true person-centered, individualized care (Figure 2).

Figure 2. Forthcoming Shifts in Healthcare Operations, Practices, and Clinical Models

RWE: Real-World Evidence: USPSTF: US Preventive Services Task Force

As the demographics of the US population shift, and as technologies continue to evolve, plans must prepare to evolve their products, offerings, and benefits to meet the changing needs. With expertise in health plan strategy, product design, clinical care, and health technology, Avalere is well-positioned to be a thought partner to strategize around these issues and operationalize changes today that can position you favorably in the future. Connect with us to learn more.