Institute For The Future

Health Care in a Post-ACA World: Navigating the Second Curve

Welcome to the post-Affordable Care Act decade in U.S. health care

We are at a pivotal moment for health care in the U.S. We can resist change, and work to keep the status quo in place. We can muddle along and scramble to react to change as it unfolds over the coming years. Or, we can view this next decade, one with significant volatility and uncertainty, as an opportunity to rethink, redesign, and, ultimately, reimagine the provision and finance of health care in the United States. In other words, we can proactively embrace a new ascending “second curve” of health care, one that puts the person at the center and coordinates around them, and break up with the old, declining first curve that is today’s fragmented system.

In 2015, IFTF is launching a foresight project, Health Care in a Post-ACA World: Navigating the Second Curve, to explore the emerging innovations that will help shape the future of health and health care over the next decade. Starting from the ground up with the fresh perspective of today’s pioneers in digital health startups, biohacker movements, social entrepreneurship, and systems thinking, and blending it with the knowledge and insight of seasoned experts in health care finance and delivery, we will map out the innovation models for a post Affordable Care Act health care environment.

Change that’s been a decade in the making

We’ve been at a moment like this before. In 2004, IFTF launched an exploration into the growing health care economy. A decade ago, the definition of health was expanding to include more wellness (which then morphed into well-being), and a new set of players—from financial services to retailers and technology companies—were actively moving into the health care space. Social media was on the rise, with pharmaceutical companies, payers, and providers all struggling to find the right way to engage with people discussing treatment and services in chat rooms and, what back then we called “health-related social networking” sites. And patient engagement and what we termed the “burden of empowerment” was just popping up in health care circles.

After a year-long research effort, we developed the Global Health Economy Map of the Decade to help guide organizations through “the blurring and expanding boundaries of risk, opportunity and innovation.”

Fast forward a decade and here we are again facing yet another moment of change in how we understand and pursue health and well-being. Already, of the almost 45 million Americans enrolled in Medicare, 20 million are over the age of 75. These septuagenarians, octogenarians, and nonagenarians will implement new strategies for aging well and end-of-life care. And they will pursue offerings that reflect their preferences, and not the preferences of the preceding generations. Likewise, the expectations of younger Americans will yet again demand that players in health care adapt to new practices and values. Beyond demography, advances in technology are propelling digital health and digital medicine to transform more about what we know about our bodies and our minds, and what we do to take care of ourselves and others. And while the abiding controversy over the Affordable Care Act shows no signs of resolution in the next few years, new economic incentives and regulatory standards are ushering in new care and business models focused more on health outcomes and quality of care.

So, how will we make the most of these opportunities in the next decade? Next year, we’re surveying the range of emerging innovations to identify the ideas that will form the most successful business models on the second curve of health care. We will examine future scenarios in which insurance companies operate as risk management reinsurers, most states use the Federal Health Insurance Marketplace, and a multi-tiered health care system emerges in the United States to examine how to design offerings that take advantage of the new realities emerging in the changing healthcare landscape. By looking at this new landscape as one of opportunity rather than one of constraint, we can reimagine health care and create more sensitive, sustainable, and effective models together.

Join us as we co-create the post-Affordable Care Act decade in U.S. health care.

For more information

Please contact Dawn Alva at [email protected] or 650-233-9585.