Predictions of Upcoming Changes for Healthcare in 2023

A new year on the horizon means new developments and trends for any industry, but especially for the health, group benefits, and senior market insurance industry.

2022 brought in an expansion of medical coverage choices for consumers. Now, 98% of consumers have access to more than one insurer. Annual premiums for healthcare plans rose but remained largely stable due to the American Rescue Plan, which made use of federal subsidies to keep the cost of healthcare manageable for the average consumer.

We also saw both the expansion of telehealth and telemedicine fill the demand for virtual doctor visits in the wake of the COVID-19 pandemic and expanded mental health coverage. In fact, California passed the Mental Health Parity Act, which required all state-regulated commercial health plans to offer full mental health coverage. This trend could continue in other states.

In our research for 2023, we found that some predictions from years past will remain and continue to grow in 2023, such as the rise of telehealth and telemedicine services and the rising costs of healthcare. There is also a growing trend toward laws that increase the transparency in what agents have to disclose to their clients.

Read on to see healthcare predictions for 2023 and how AgencyBloc solutions can help you streamline your efforts, maximize productivity, and bring more value to your clients as you navigate the ever-changing regulatory landscape.

Growth in Telehealth & Telemedicine Coverage

Before 2020, the concept of telehealth or telemedicine and the distribution of healthcare services through digital platforms, like the internet, were a bit foreign to the average consumer. They were sometimes offered within benefits packages but weren’t widely used. Today, telehealth and telemedicine are more familiar as usage of both has surged since the COVID-19 pandemic began.

In recent years, there has been an expansion of virtual medical care for and diagnoses of chronic health conditions — conditions whose symptoms exceed a year and can inhibit mobility and/or daily living. This growth is likely to continue as the market is projected to experience a compound annual growth rate of 35% (CAGR, an annual rate that expresses the growth of a return on investment) until 2033.

Furthermore, life and health insurance carriers are expanding their coverage to offer more robust packages and features. Kaiser Permanente is already doing so with their Virtual Complete plans, which offer comprehensive coverage from a virtual setting.

As telehealth and telemedicine get more popular and more carriers start to offer healthcare plans with them included, your clients are likely to want to know more about them. Using AgencyBloc’s industry-specific agency management platform (AMS), your teams can store detailed client and policy information, plus carrier documents, in one centralized, secure location. With this, your company is able to easily and quickly access client information and provide tailored service. 

Increased Transparency Requirements

Another trend that is most likely to continue throughout 2023 is a push towards seller transparency of federally-funded healthcare products, like Medicare or Medicaid, as well as employee benefits.

In late 2021, the Consolidated Appropriations Act 2021 (CAA) went into effect. This act, also known as the Broker Compensation Disclosure rule, requires “all brokers and consultants to disclose their compensation to plan sponsors if they anticipate earning $1,000 or more in direct or indirect compensation.” The goal of this requirement is to increase transparency between the broker and the client on how much the broker is earning on policies sold. This requirement includes all new, extended, or renewed plans that go into effect on or after December 27, 2021.

Earlier this year, the Center for Medicaid and Medicare Services (CMS) released the CMS Final Rule 2023. Part of this ruling, which went into effect on October 1, 2022, requires agents to record any marketing calls or telecommunications made during the enrollment process for both new and existing clients as they relate to Medicare or Medicaid. In addition to the recording, brokers are expected to store these call recordings for up to seven years.

NABIP further outlines this ruling: “The recording requirement applies to all agents who enroll beneficiaries into new plans, whether they are current or new clients. The wording of the rule references “marketing” calls, but NAHU confirmed that CMS interprets “enrollment” as “marketing.” Online applications that agents walk through with their clients are also subject to recording. SHIPS are exempt from the rule.”

With two major rulings in the last year, it’s safe to say we’ll likely see more changes like these in the near future. 

New changes are hard, so it’s important to have technology that can adapt with you. AgencyBloc’s Broker Compensation Disclosure Report can help you quickly identify qualifying clients. Then, using a sample disclosure communication, you can quickly fill out the necessary information and issue it to your clients, helping you stay compliant with regulations and make the new processes more efficient.

For Medicare call recordings, AgencyBloc's AMS+ solution has an integrated insurance VoIP (Voice over Internet Protocol) that automatically records all incoming and outgoing calls. Your team can also add pre-recorded compliance-friendly messages to all calls to ensure transparency. Then, once the call is completed, the recording will automatically be added to the contact's profile for easy access and simplified compliance. Learn more about the electronic compliance tools in AMS+

Rising Costs of Healthcare Coverage

In addition to the rise of telehealth and increased transparency, we can also anticipate an overall increase in healthcare costs for 2023. According to Aon, a leading global professional services firm, the costs of group benefits packages will experience an increase of up to 6.5%, on average, in 2023—with the sum of the cost totaling ~$13,800 per employee.

In regards to Medicare, the cost is increasing for Part A plans and decreasing for Part B plans. Medicare Part A plans will experience a growth of $44 annually. Part B services will experience a decreasing monthly premium of $5.20 and a decreasing annual premium of $7 in 2023.

In 2021, the projected growth was 3% — 2023’s increase is set to double that amount. This increase in costs is primarily due to the actions taken by healthcare providers during the first year of the pandemic. As economic uncertainty took hold, payments were delayed, and providers shouldered a lot of those initial costs. As a result, due to the biannual (every other year) timeline that healthcare contracts follow, consumers are feeling the effects several years after the fact.

How to Stay Compliant & Navigate the Changes of 2023 with AgencyBloc

2023 is slated to bring in new changes while also maintaining existing trends from the last few years. Industry experts predict the growth of new forms of healthcare for the digital age, like telehealth and telemedicine, rising costs of healthcare nationwide as the population feels the effects of inflation, and an increase in transparency that brokers will need to provide.

To prepare for the upcoming year, ensure you have the right technology. AgencyBloc’s industry-specific management system (AMS) is built specifically for independent health, group benefits, and senior insurance agencies, GAs, IMO/FMOs, and call centers. From sales to quoting to servicing, your team can easily track and manage the data your organization needs to succeed. Leverage robust automation tools to automate client messaging, stay on top of routine tasks, and more to help you maximize your efficiency.

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Posted by Allison Babberl on Tuesday, December 20, 2022 in Independent Insurance Agencies

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About The Author

Allison Babberl

Allison is the Content Lead at AgencyBloc. She manages the creation and schedule of all educational content for our BlocTalk and Member communities. Favorite quote: “Conversation is the bedrock of relationships. Without it, our relationships are devoid of substance.” -Maribeth Ku ... read more