The health care system is undergoing a fundamental shift towards consumer-driven health care (CDHC) that in many ways resembles the late 1980s’ migration from indemnity insurance to managed care. In both cases, rising costs led to the demand for alternative, new solutions. As each paradigm shift gained acceptance, it added complexity to the health care marketplace, requiring new infrastructure, and reallocating responsibilities throughout the value chain including among health plans, providers, and members.

CDHC places greater accountability for expenditures on consumers, and away from employers and payers, and necessitates innovative integrations between companies offering health care solutions today and new entrants in the value chain, such as financial institutions and payments processors, to provide viable, enabling solutions. The emergence of CDHC is being facilitated through the growth of accounts such as Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), and Flexible Spending Accounts (FSAs), and is driving an unprecedented convergence of health care and financial services. CDHC requires that all stakeholders work in an efficient, streamlined fashion to facilitate transactions, reduce costs, administer claims, enhance health, pay providers, and educate plan members.

 

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