United States healthcare and medical market: trends and opportunities

The United States spends a lot on health care as compared to other countries in the world and it’s expected to grow even more every year according to country data and statistics. The challenge here for health care providers and stakeholders lies in containing the costs and reducing them persistently.

On the other hand, through the 2010 Affordable Care Act (ACA), health care funding and insurance coverage have been transformed. Health insurance coverage became a mandate with one of the reasons centered on slowing rise in health care costs. But despite this, consumers are still paying a big portion for their health plans and even higher for various health care services.

These major trends in the US are quite significant in the healthcare market now:

Pressure on medical costs in the United States

There is an increasing need to contain healthcare costs and it is because of the following:

  •  Medicare free-for-service (FSS) payments will be replaced due to the Sustainable Growth Reform which means people will get to pay more for quality instead of quantity in health care services.
  •  Physicians will still likely see more patients due to the increasing ageing population.
  •  Diagnostics and therapeutics are more advanced now and are continuously advancing but these advancements are also very costly.
  •  Patient coverages are more different now with some paying less than others.
  •  Employers are now shifting health insurance costs to employees through deductibles.
  •  Patients would like prices to be more transparent for them and because of this, they have become more cost-conscious.

Transition to value-based care

At the moment, the U.S. health system is transitioning to value-based care from volume-based care in an effort to control and reduce costs, improve outcomes, and acquire more value for money spent.

But will physicians be in favor for this kind of approach? To boost physician engagement with this kind of approach, health care providers should make sure that the strategies will be centered around physicians. Physicians would like to be reassured that risks can be managed financial interests to be protected.

Consolidation among health care providers

Rapid consolidation among health care providers is happening due to changes in regulation, technological innovations, financial pressures, and market dynamics. Physicians are shifting from private practice to being employed by health systems. Soon, health plans will be offering more clinical services.

Regulatory pressure and privacy

The regulatory systems that govern health care systems are changing and it is in this light that they should consider reassessment of compliance programs and invest in them. However, not everyone has the luxury to do this especially those small health systems who lack funding and infrastructure to meet requirements.

Safeguarding security and privacy poses a challenge with the evolving healthcare environment. Increased amounts of data being shared is at risk of being hacked and infected.

The healthcare market in the US is growing but not without threats to its integrity. Nevertheless, country data tells us that it can manage to find a way to grow. We just need to be mindful of the trends that influence the growth of the healthcare market.

This entry in America was updated on May 21, 2021 by specialist.