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HITS & MISSES: My 2020 Predictions Scorecard

Jan 19, 2021

Each year I take a risk and make some predictions for the benefits industry in the year ahead. 

For this year’s predictions, I thought it’d be worth a laugh to make them alongside a review of my 2020 predictions and see…

  • which were a HIT?
  • which just kind of stayed EVEN?
  • and which were a complete MISS?

I posted the article 2020 Healthcare & Employee Benefits: What's Next? on January 6th, 2020. Let’s take a look back and see how I did…

Macro trends

I started last year’s article with the belief two overall trends would remain:

  1. Extremely low unemployment   MISS?
  2. Extremely high cost of healthcare that drives high premiums and out of pocket costs   EVEN?

Ok, so not the best start. But below are the other points in my 2020 predictions article and how each turned out…

1. Behavioral Health booms  HIT?              

This was the biggest prediction HIT of the year. When I pointed to this, I had NO IDEA about the challenges 2020 would bring us. But COVID-19 caused tremendous rises in the national level of stress, depression, isolation, relationship hurdles and just plain anxiety! 

My suggested strategy was Behavioral Telehealth. Turns out the shift to remote living in 2020 literally doubled demand for this service. It went from a “Hey, you could do this” to “If you at all want your employees to know you care about them, you NEED this benefit.” 

2021: One of my strongest predictions is this demand for Behavioral Telehealth will continue to skyrocket.

2. Advocacy advances  EVEN? 

I call this prediction EVEN. While it’s a complete HIT that the healthcare system got more complicated this year, the issue was balanced out because the system shut itself off for much of the year. Literally millions of services just didn’t occur. But when people start to rebook all the elective services they skipped last year, this need will rise to the top again.

Imagine there’s a Healthcare Genius Bar. People walk up with all kinds of crazy questions about this super-complicated system of ours. And they walk away feeling empowered to make smarter healthcare decisions. This is what a premium Advocacy service delivers

2021: I re-predict a huge surge in Advocacy services this year driven by both greater volume of healthcare needs and increased appetite for consumerism tools among employees.

3. Legislation languishes  HIT?

This was a 100% HIT.

  • Lots of election-year healthcare discussion. Check.
  • Dems spoke a lot about Medicare For All but didn't get a bill through the Senate. Check.
  • Most change came from new rules and processes via the system, rather than new laws. Check. 

2021: With a Democratic sweep, my biggest prediction is they WON’T push for a full Medicare For All program. However, I believe they’ll push for a Medicare option. I’ll save the details for another class and article. But, if this happens, I believe it’s just a steppingstone to destabilizing the free-market healthcare system, resulting in a Medicare For All program on the horizon.

Why freshbenies gets results

4. Digital developments  HIT?

Not a wild prediction on my part that tech advancements would grow in 2020. But the key factor of my prediction was only systems that achieve huge usage and engagement would win.

Who could’ve foreseen social distancing and the resulting surge of people searching for every remote healthcare tool they could find? One telehealth vendor put it to me this way last spring, “The industry moved forward more in 4 weeks than in the past 4 years!” 

2021: As the pandemic slows, my adjusted prediction is only digital tools with a fantastic user experience will remain. In an emergency, everyone got business. But soon, people will grow very picky and only use virtual platforms that quickly and easily meet their needs.

5. Personalization proliferates  MISS?

In an emergency situation, personalization went out the window. As early as April effective dates, employers started (appropriately) freaking out over budgets, communication channels, and various other points of confusion. Hundreds of thousands of employers this year answered, “A new personalized ancillary product? No way. Heck, let’s just keep everything like it was last year.” 

And many employees did the same. They stopped moving jobs as much as in prior years. 

2021: I believe the need for personalized benefits will resurface as we ease into a future normal. Talented employees will get back to jumping ship for better cultures, opportunities, incomes, and tailored benefits. I’ll go out on a limb and say this won’t be a huge need in the first half of the year but will ramp up to a frenzy among the best consultants and employers by fourth quarter.

5.5  A Look Forward

How will I summarize my 2021 predictions in a way that’s well-reasoned, but a bit out there? 

  • We’ll continue with similar levels of lockdown for Q1 and Q2. Then, we’ll start getting out in person again during Q3 and Q4. 
  • The stock market will continue to rise on rosy expectations of a good economy throughout the end of 2022. 
  • There’ll be tons of investment money for healthcare, so I think we’ll see even more consolidation of doctors and facilities into large, regional health systems.
  • We’ll also see more consolidation of independent brokers. The only ones who’ll remain independent will be those who choose to reinvest in creative approaches, client tools, and target-marketing. 
  • Carriers will continue to roll telehealth visit fees back into their plans. As a result, there’ll be even more hunger for $0 visit fee telehealth. While many people will go back to in-person visits, telehealth has gained usage that will stick for simpler, acute care needs. 

I look forward to running the race with you in this unique decade. Meet me here in a year and we’ll take another look back at these predictions. 

Until then, please comment, email, call, Zoom, or invite me for a coffee to debate our opinions of the future! I love the discussion of how to best serve our clients.


Reid has a passion for helping brokers & employers strategize fresh approaches to benefit plans that contain costs and increase access to care - helping employers & employees control their healthcare dime, time, and peace of mind. He writes & speaks around the country and is the Co-Founder & CEO of freshbenies.

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