Top 5 Predictions for Healthcare Consumerism in 2015

By Lisa Maki,

Across the country and the industry, from the Advisory Board Company’s annual summit in Nashville to World Congress’ annual gathering on Health Plan Innovation in Florida, “Healthcare Consumerism” is the dominant headliner. Healthcare leaders are no longer speculating as to whether or not healthcare consumerism will arrive, they’re addressing how to respond to it, now that it already has.

This year the World Congress will hold three co-located events in February entitled “Healthplan Innovation through Consumerism”, “Insurers Retail Strategy” and “Medicare Marketing and Enrollment”. The business of Healthcare is definitely not what it once was, so the question now becomes, what is the new business of health?

There has been a lot of talk around Consumer Centered Design and new payment models for the healthcare space but what specifically does that mean? In an attempt to answer that question, here are 5 predictions for 2015 that I believe the winners in the new Healthcare economy will deliver:

  1. “Price Transparency” becomes Payments: Consumers pay for more of their healthcare out-of-pocket and from within their own pockets via mobile device - whether it’s due to high deductible plans, a flu shot at Safeway or a trip to the “I only accept cash or credit” psychiatrist.  In every industry, consumer payments are increasingly integrated into the consumer shopping experience and health is no exception. The company and product removing the most friction from healthcare booking, payments and service delivery wins. Period. “Price Transparency” has been a great transition tool but is ultimately only a stepping-stone to inevitable real-time payments.
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  2. Healthcare Service Marketplaces Integrate with Exchanges: Exchanges are here to stay, but the “enrollment once a year” business model stops short. Integrating health provider search, book and pay into the private exchanges ensures consumers/employees come back 365 days a year and the exchanges become the distribution channel for far more than annual enrollment. All in one, “Health as a Service” companies will continue to build and partner to provide this and more becoming the choice of cost conscious enterprise and SMBs.
  3. Healthcare Embraces Consumer Marketing and Design: How do healthcare providers and insurance companies build great consumer brands?  The same way everyone else does for crying out loud—go to the professionals! Lisa Suennen, of Venture Valkyrie, wrote a fantastic post on Health Literacy in a Consumer-Centric Healthcare System describing how Lily, the pharmaceutical company, hired Disney to create educational material to explain Type 1 diabetes. Lily accepts that its area of expertise is making incredible, life saving drugs, not creating consumer marketing content. So what did they do? They went out and hired the best in any business to create award-winning, educational, engaging, consumer-friendly content. Bravo! We will surely see the same out-of-the-box thinking (see adidas and Sid Lee for another amazing example) for delivering engaging websites, mobile apps, campaigns, and even building designs - and healthcare will be all the better for it.
  4. The API Economy Arrives: Satisfying experiences that win today’s consumer loyalty cannot be built on decades-old infrastructure or written in COBOL. It’s not just a question of cost; the transactional capacity required to support an “Amazon-like” experience in health was invented well after healthcare infrastructure was implemented.  The teams that build and maintain legacy health infrastructure are fantastic, and clearly needed, but they are not the same people trained to create the modern, real-time, HIPAA-compliant consumer engagement, payment and access tools we need today.

  5. Cash is King (and Queen):  In 2015, consumers with high deductible plans (at least 41% of us with deductibles of $1000 or more as of 2014) realize they can and should negotiate the price of their healthcare. Healthcare providers realize getting paid up front offsets what they're losing to collections with the shift to high deductible plans. Employers and insurance companies realize low cash prices for quality service is good for their bottom line as well. The new business of health must flexibly manage both cash and claims-based payments on one platform so consumers can get credit against their deductible for their $40 primary care visit at Walmart and providers can offer both cash prices and contracted rates transparently without penalty.

Rebuilding legacy infrastructure to meet the challenge and opportunity of healthcare consumerism is costly and difficult, claim the naysayers. Yes it is.  Many companies, like my own, are building APIs to allow healthcare companies access to modern data models, analytics and services with low friction and high scalability, at a fraction of the cost. This coming year will see the benefits reaped from this type of open source movement in Healthcare, and PokitDok is paving the way. I, for one, am excited to be in the front row and am looking forward to 2015 being a transformational year for our industry.

The opinions expressed in this blog are of the authors and not of PokitDok's. The posts on this blog are for information only, and are not intended to substitute for a doctor-patient or other healthcare professional-patient relationship nor do they constitute medical or healthcare advice.

  Tags: Health Innovation, Healthcare consumerism, Providers


  Comments: 5

  1. Lisa-couldn't agree with you more. The winners are going to have to get on this train or be under it.

  2. Great post, Lisa.

  3. Wayne Caswell, Modern Health Talk

    Consumerism is just one of the major trends affecting healthcare. It has executives nervous, because as Charles Darwin said, “It is not the strongest or the most intelligent who will survive but those who can best manage change.”

    That, and the fact that 429 of the original Fortune 500 companies [1955] are no longer in business today, is a scary thought for those sitting at the top of the healthcare mountain. They know they must adapt to the megatrend of health reform or die. And they are looking down with fear at hungry innovators who are already exploiting the many related MiniTrends and their important intersections, because for them these are times of great opportunity. See

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