Healthcare Companies Catch Up With Consumer Demand in 2016

January 12, 2016 Paul Smith

A look ahead to 2016In 2016, I believe that healthcare consumerism will cross the chasm and enter the early stage of pragmatism or the early majority of adoption. Why? Well, 2016 will be the year actions by the healthcare companies catch up with consumer demand.

Consumer-oriented thinking in healthcare is about shifting the balance of power from healthcare companies to the consumer. Armed with personal health data, ratings and rankings, and driven by finances, people are demanding a more personalized approach to their healthcare decisions.

While this doesn’t necessarily mean that people will apply the same approach of purchasing a car or a home to making healthcare decisions, it does mean that people are price shopping, comparing quality and reliability, and choosing the best option based on their individual or family needs.

This shift has been evolving for years, but 2016 will see three things that will further accelerate the “consumerization” of healthcare.

Health Insurance Goes Retail

Imagine walking into a storefront where you can shop for a surgical procedure, mammogram, or appointment with a primary care doctor based on price, availability, and quality. Welcome to the “healthcare super center,” an online marketplace that is a separate concept from the Health Insurance Marketplaces, or exchanges, created as a result of the Affordable Care Act.

Healthcare is becoming a retail business. The exchanges created by the ACA combined with other influences are making consumers responsible for choosing health plans and providers on their own, a monumental shift for both the consumer and the insurer.

The ACA subsidies are forecasted to drive growth of the direct or “retail” purchase of health insurance from ~6 million Americans in 2013 to ~75 million in 2020. Many forecasts project that about 45 million people who are now on employer-sponsored plans will move to retail plans purchased on exchanges. 

Making a significant step into this new world is Wal-Mart. In October of 2014, the company stated they intended to become “the Number One healthcare provider in the retail industry.” Through a partnership with, they intend to help shoppers understand and compare plans, eventually offering an off-the-shelf health insurance plan. There are also companies like ZocDoc, which is akin to an OpenTable for doctors’ appointments.

I believe this trend of health insurance going retail will absolutely continue for a set of consumers. The larger players like United Healthcare or Aetna will continue to provide services to corporate customers which won’t look very different from the past decade. On the other side of this is the retail market that will allow individuals and people traditionally not served by an employer to choose not only insurance, but shop for health services more like they do for other consumer type services. I believe we will see something like this from a Wal-Mart or CVS or a start-up company by the end of 2016.

DIY Health - Transition to Self-Service and Transparency

Taking the health super center a step further is the transition to self-service and transparency – or DIY health. Just like the travel, hospitality, car insurance, and entertainment industries, healthcare must embrace self-service and transparency if it’s going to be optimized in this new world.

Image altered for useAll consumers, from Millenials to Baby Boomers, welcome the era of personalized medicine via digital communications. We all are looking for messages and service options to be personally tailored. 

The real game changer will take place when the work that consumers put into finding the best insurance fit for their specific healthcare needs is done in a more automated way. This will be the next phase of self-service. Software that collects, assesses, and applies the specific preferences and needs will soon transform the search process. 

While the consumer/patient plays an increasing self-service role in health care, insurers, providers, doctors, etc. will need to take advantage of the data being produced via doctors’ visits, activity trackers, and personal medical devices to deliver the type of personalization necessary.

But how are we going to get here? 

Cognitive Computing Isn’t the Stuff of Movie Scripts Anymore

More companies will embrace cognitive computing in 2016 enabling the consumer or patient to make better decisions, faster.

With the adoption of activity trackers and other mobile apps combined with data from electronic heath records and medical devices, the next generation of healthcare will be born. Over the next two years, the projected volume of data will nearly double, with 88% of it unstructured. This is significant for doctors, providers, insurers, hospitals, researchers, etc. to surface new insights from all the personal health data being created daily and ultimately automate and improve patient care.

On the flip side of this is the consumer use of cognitive computing. Consumers/patients struggle to keep up with an overwhelming sea of information, but technologies like IBM’s Watson, can understand that information and bridge gaps in knowledge, helping patients to make better decisions, faster.

But Watson is only one part of the equation. Other technology like virtual assistants will be an important part of enabling people to gather information and improve decision making. Virtual assistants similar to the new Amazon Echo are becoming ubiquitous. While these assistants are really generalists serving up common information, they will become more personalized over time. Imagine the ability to interact with one of these assistants to help you find the right health insurance plan based on your age, location, and other specific qualifiers. This is the next phase of empowering patients, and we are going to see great advancements in 2016.

The continued trend of health insurance as a retail model and the maturation of self-service will be made possible by cognitive computing. This all continues the trend of shifting the balance of power from healthcare companies to patients. In 2016, we will see changes and advancements – a bigger leap forward – than we have in the previous five years.


Like what you read? Like, Tweet, share, and check these out, too: 

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About the Author

Paul Smith

As Chief Strategy & Revenue Officer, Paul is a sought-after industry speaker. He is responsible for driving company revenue, and for developing, communicating, executing, and sustaining strategic initiatives at CodeBaby. His impressive results include driving revenue growth more than 300% in 2 years at TeamShare, and 250% in 4 years at Ziff-Davis. His expertise includes training & consulting services technology, eBusiness consulting to Fortune 500, and analysis software for Law Enforcement.

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