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TransUnion Healthcare 2021 Forecast: Four Trends to Watch

Jonathan G. Wiik
Blog Post01/27/2021
Business
TransUnion Healthcare 2021 Forecast: Four Trends to Watch

The operational, financial and economic impacts of the COVID-19 pandemic continue to affect the healthcare industry — providers, payers and patients will face these ongoing challenges well into 2021 and beyond.

TransUnion Healthcare’s latest analysis found hospital patient visit volumes stagnated below pre-COVID-19 levels in the last 25 weeks of 2020. As a result of the pandemic, it’s likely volumes will experience continued volatility over the next 12 months.  

With these challenges top of mind, here are four trends to watch for in 2021:  

Trend #1: Healthcare consumerism is here to stay and will continue to impact how the industry approaches transparency, affordability and care delivery.

As patients face the economic and financial challenges of the COVID-19 crisis and shoulder more of the burden of healthcare costs, the industry has experienced growth in healthcare consumerism that will likely continue in 2021 and beyond. Increasingly, patients are shopping around to determine which healthcare provider is safe, accessible, convenient and cost effective. Findings from TransUnion Healthcare’s annual patient survey indicate 80% of patients researched healthcare costs prior to receiving treatment.

One way the healthcare industry has responded to growing healthcare consumerism is with the final CMS price transparency rule which went into effect on Jan. 1, 2021. The new mandate requires healthcare organizations to have clear, accessible pricing information available to consumers before service.

It’ll be imperative for healthcare providers to develop strategies to provide accurate, online price estimates; improve patient engagement efforts; and consider weaving quality data into negotiated price rate information.

Trend #2: The industry will continue to experience health insurance coverage disruptions resulting from COVID-19.

The economic impacts of COVID-19, such as rising unemployment and income loss, will continue to play a major role in health insurance coverage disruptions across the nation. Our Oct. 2020 patient survey also found 22% of patients reported COVID-19 impacted their health insurance coverage; this percentage increased to 33% for Gen Z patients and 29% for Millennial patients. Per a Kaiser Family Foundation Report, Medicaid enrollment has increased over 4 million members since the pandemic. As the payer mix dilutes, providers will need to ensure they’re acutely focused on capturing every last dollar.1

Even before COVID-19, the number of uninsured patients was rising. An analysis from Kaiser Family Foundation indicates 28.9 million nonelderly individuals were uninsured in 2019, an increase of more than 1 million from 2018, and it’s likely this number grew further in 2020.2

With the economic instability and uncertainty that remains due to COVID-19, healthcare organizations need to identify insurance coverage and ensure earned revenue gets paid, as well as offer financial assistance programs to support patients facing financial distress. 

Trend #3: Healthcare organizations will face ongoing challenges due to COVID-19’s financial impacts.

Amid the pandemic, many hospitals and patients deferred elective procedures and experienced sustained, lower levels of hospital visits. The financial impacts of these factors, paired with a declining payer mix, indicate healthcare providers will face significant cash flow constraints in 2021. Further, healthcare CFOs anticipate the economic impact of COVID-19 will be long and significant, ranging anywhere from 3–24 months.3

Telehealth use grew exponentially in response to COVID-19 exposure fears, medical guidance and mitigation efforts, yet unknown long-term reimbursement plans pose further headwinds for profitability. According to our recent survey, 60% of patients used telehealth instead of visiting their primary care physician in person. And while telehealth adoption will continue to grow in 2021, it remains unclear how payers will approach this care delivery option post-pandemic. 

In the year ahead, healthcare organizations will need to maximize revenue recovery opportunities by having the right partners and resources in place to do so.

Trend #4: Stabilization of the Affordable Care Act will be a priority.

With the recent inauguration of a new administration, immediate healthcare priorities in 2021 will likely include COVID-19 response efforts and the re-stabilization of the Affordable Care Act.

Bipartisan healthcare policy efforts are expected to focus on price transparency/costs, drug pricing, out-of-network surprise billing and telehealth services, among others.

Amid the uncertainty ahead, it’ll be important for healthcare organizations to implement strategies and seek partners allowing them to build trust with patients and influence profitability.

For more information on the ongoing impacts of COVID-19 on the healthcare industry, as well as additional resources from TransUnion Healthcare, visit transunion.com/healthcare-covid-19

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