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How Will Hospitals Have Doctors and Nurses?

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What You Need to Know

  • Insurers worry about their provider networks.
  • Employers face pressure to hold premiums and deductibles down.
  • Use of clinics in supermarkets and drugstores is growing.

Two years ago, the last time we created a health insurance market question list, we included two questions about the supply of providers, but we were thinking mainly about insurance.

This year, provider supply questions are top of mind.

Some hospitals have produced heartwarming TV commercials emphasizing how grateful they are to their doctors, nurses and other workers.

But in many cases, they couldn’t supply enough masks, gloves and gowns to keep these workers safe. They are now paying huge amounts to temporary nurses but declining to offer their full-time permanent nurses significant salary increases.

Doctors are giving one another advice online about how to change careers. Nurses are simply quitting in huge numbers.

The result is that, as new waves of COVID-19 appear, and patients with severe COVID-19 gasp for air, hospitals lack the skilled workers they need to get all of their intensive care unit beds up and running. Some staff-starved hospitals have had to send patients to hospitals hundreds of miles away.

When eHealth, an online health insurance web broker, polled about 15 health insurance company representatives in the fall, it found that 38% of the insurer reps said they were concerned about staffing shortages at their provider networks.

Here are four of the five other key questions we expect to shape our health insurance market coverage in the coming year.

2. Will patients lash out?

When Mercer, a Marsh McLennan benefits company, surveyed about 1,700 U.S. employers earlier this year, it found that, because of a tight labor market, many employers feel pressure to swallow increases in benefits costs.

Employers expect costs to rise an average of about 4.4% in 2022, but they have reported increasing workers’ share of the premiums only slightly this year, and the average size of deductibles appears to be falling, according to Mercer.

3. Will the No Surprises Act help calm things down and make workers feel the world is being more fair?

VisitPay, a medical payment technology, reported in a summary of a recent survey of about 1,000 U.S. adults that one-third of participants often feel intimidated when paying medical bills and that one-third had received surprise bills in the past year. About one-third said they had considered switching providers due to negative billing experiences.

When eHealth surveyed its customers, it found that demographics had a big effect on which insured patients received big, unexpected medical bills in the past year.

Only 45% of the men who participated and 46% of the white participants said they had received surprise bills.

About 54% of the women, 56% of the Black participants and 60% of the Hispanic participants reported receiving surprise bills.

4. Will clinics in stores and other walk-in clinics grow in popularity?

After years of operating in a work-from-home world, will the people looking for work have the energy and skills to persuade other people to buy life insurance?

Oliver Wyman, Mercer’s sibling, found that even though about 90% of the consumer participants in a survey it organized had primary care doctors, about 33% sought in-person care at urgent care clinics and 20% had received care at clinics in supermarkets or drugstores. Use of those clinics has doubled since 2018, the firm says.

More on this topic

5. What will Congress do?

A year ago, Democrats in Congress talked about replacing every bit of U.S. health-related insurance programs with one giant, government-run program.

Now, the focus for health insurance for people under age 65 has moved to, possibly, extending some of the temporary, pandemic-period increases in Affordable Care Act premium tax credit subsidies for unemployed people and for people with an income over 400% of the federal poverty level.

How We Did Two Years Ago

Here are the questions we came up with in 2019, for 2020, and how we would answer those questions now.

1. Will more companies try to disguise more major medical insurance products as something else?

Answer: No. This didn’t happen.

2. Will everyone get religion?

Answer: No. State insurance regulators, including those in states such as Texas, cracked down on health care cost-sharing ministries that have tried to reach beyond their traditional market.

3. Will hospitals collapse?

Answer: To be determined.

4. Will doctors go fishing?

Answer: Maybe that’s happening now.

5. Will health savings accounts shine?

Answer: HSAs may be doing well, but the Biden administration is not a natural benefactor of personal-account-based health finance arrangements.

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An intubated patient inside a negative pressure room in the COVID-19 ICU at Freeman Hospital West in Joplin, Missouri, in August 2021. (Photo: Angus Mordant/Bloomberg)