The healthcare landscape in the US is rapidly changing, with self-insured employer plans becoming a major influence in the transformation of care delivery. These plans are expanding rapidly as employers seek greater control over healthcare costs and outcomes. By utilizing newer models and technologies, employers are addressing the complex needs of a diverse, multigenerational workforce while transforming the future of healthcare. Here are five trends driving this next phase of health and care delivery transformation:
- Self-insured employer growth to surpass population growth: Self-insured employer plans are projected to grow at a CAGR of 1.25%, significantly outpacing US population growth of 0.4%—underscoring the urgency for service providers and stakeholders to align with employer-led strategies.
- Employers emerging as healthcare leaders: Employers are increasingly recognizing employee health as a vital economic imperative that directly influences productivity, retention, and overall business success. This awareness has driven employers to take a leadership role in redesigning care delivery models, with a strong focus on prevention, employee wellness, and ensuring access to high-quality care.
- Newer care models: Traditional insurance models are becoming less popular as employers explore innovative care models such as subscription-based primary care and direct-to-provider (capitated) contracts—resulting in more predictable costs and enhanced transparency.
- Role of technology: Employers are leveraging digital health platforms, telemedicine, and AI-driven analytics to address the diverse healthcare needs of a multigenerational workforce. From streamlining claims to offering virtual consultations, these technologies enable personalized care delivery, enhance efficiency, and help reduce costs.
- New entrants driving disruption: A new generation of service providers is emerging to cater to this market, challenging traditional players to innovate or be disrupted. Unlike legacy payers, these entrants are agile, innovative, and hyper-focused on employer needs.
The Bottom Line: Employers must lay the groundwork for a new healthcare marketplace that enables direct purchasing of services from providers and curated ancillary platforms—transforming employee health and care delivery into a sustainable and transparent model for the future.
