img-1

What's Beyond the Horizon?

"Employee benefit consulting firms that provide strategic value, drive innovation, create customized solutions and deliver optimal services will be the trendsetters during the New Healthcare Era."
~ Ray Fernandez, Owner and Managing Partner

Heightened Client Expectations

Employers are facing numerous challenges in their businesses.  The lagging economy, shortage of personnel and resources, rising healthcare costs and uncertainty of healthcare reform legislation are just a few of the challenges that employers are facing today.  These challenges have an affect on employer business partners and vendors as pressure mounts to maximize resources at minimal cost.  

At Optimal BenefitsTM, we have observed an emerging trend of "Heightened Expectations" from employers who are seeking to maximize all available resources from existing business partners.  Employers are demanding more strategic value from their benefit advisors in addition to the expected standard of traditional benefit consultation.  This is particularly evident, for example, with mid-size employers that are considering business globalization as a strategic goal to increase profitable growth.  We recognize that benefit consulting firms who have the expertise, resources and dedicated professionals qualified to assist employers with international needs will be well positioned to gain a competitive edge in the marketplace.

The New Healthcare Era

2012 marks the year of uncertainty for the healthcare industry.  Aside from the fact that 2012 is a Presidential election year and, as such, creates its own dynamic circumstances, there are a number of other meaningful events occurring this year that will significantly impact the healthcare industry.  Below is a brief list of significant events that we predict will most likely impact the healthcare industry and result in new emerging trends:

  • The Supreme Court hearings and the Justice's opinions surrounding the state's claims of the individual mandate within the PPACA being unconstitutional, will certainly contribute to the dynamic changes in the healthcare industry.  While the Supreme court recently ended the hearings in early April, there is much anticipation about the future legislative outcomes that are due to be published in a few months.
  • Numerous healthcare providers, particularly medical insurance companies, are preparing for their requirements relative to the Medical Loss Ratio (MLR) and the customer rebate potential inherent to the MLR regulations.  We have already observed significant health insurance pricing adjustments in the first quarter of 2012, reflecting fierce marketplace competition and significantly lower insurance premiums that has not been prevalent in several years.
  • Several states are preparing for statutory legislation regarding the structure of state health insurance exchanges as a viable option for consumers to consider, versus the traditional private healthcare options. Regardless of the outcomes at the Supreme Court level, the large majority of well-known healthcare study groups, academics and lobbyists agree that states will have control to determine the suitability and structure of offering health insurance exchange programs.  In California, for example, local providers are already setting up their internal structure to offer insurance options within the exchange so that these providers are ready and prepared to release to the public in the near future.

Clearly, 2012 will be a fascinating year largely due to the healthcare industry activity and future landmark legislative changes.  As a result, clients will have "heightened expectations" from their benefit advisors to deliver updated information as an important resource channel to be well-informed.

Should you have interest in obtaining more information about the emerging trends in the healthcare industry, please feel free to contact us.