Repeal? Replace? It’s anyone’s guess. The one thing we can becertain about following this election is more changes are coming tohealth care and, as usual, employers will need to adapt. Butregardless of what happens in Congress, what President Trump orSpeaker Ryan propose, or who is the new head of CMS, my money is onsome things staying exactly the same. Our employer-based healthcare system is not going away. I speak to a lot of health careleaders every day, and getting out my crystal ball, here are fivehealth care trends I don’t see abating any time soon. With theright strategies, benefits professionals can stay ahead of thecurve in trying to manage costs and quality in these turbulenttimes.

1. High deductible plans and cost sharing are here to stay. Ifanything, the newleadership’s plans place even greater reliance on HSAs. Most ofus have already been getting our employees used to cost sharing,and this trend is expected to continue and even accelerate. Butjust offering high deductible plans is equivalent to throwing youremployees into the deep end of the pool; several studies showemployees don’t often shop around and do often skip neededcare. Our own research last summer found that 42 percent of employees believe they don’t have the informationthey need to make important medical decisions. We want them tospend their money (and yours) wisely and go to high qualityproviders to get the care they need (and not care they don’t need).To accomplish this, savvy employers must continue to turn tostrategies like partnerships with organizations that offer consumereducation and navigation. We want our employees shopping aroundbased on cost, but also based on quality.

2. Transparency will be huge. It has been a cornerstone ofPresident-elect Trump’s health care policy platform since thebeginning. And yet, we know from studies that very fewemployees who are offered price transparency tools actually usethem. That is because price information alone is befuddling; itdoesn’t help employees understand what care they need or who is theright doctor given their condition; and they’ve never been engagedconsumers before. For these reasons, savvy benefits professionalswill pair transparency tools with other tools or coaches who serveas a medical ally and help with consumer navigation.

3. A small percent of employees will always account for most ofyour spending. This mathematical fact isn’t going away, no matterwho is in the Oval Office, so employers need a strategy to addressthe fact that 1.2 percent of employees typically account for 31 percent ofemployer health care spending. The name of the game here isintervention with your employees that have high cost conditions. Inthis realm, programs like surgical decision support, second opinionservices, and shared-decision making can help ensure theseemployees choose better providers, and high-quality treatmentoptions that are appropriate. Otherwise you may end up spending afortune on spinal fusion surgery for an employee who really onlyneeds physical therapy. Our own research has found, for example, acompany can reap $5.6 million in direct savings if just a fewhundred employees participate in surgical decision support forconditions that have huge variation in cost and quality. And whenyou are certain employees need that surgery, a strategy likereference pricing can help ensure they see a high quality, yetaffordable, provider.

4. The march toward paying for value will continue. Part of theACA may be repealed, but Republicans and Democrats alike agree on“MACRA,” which changes the way Medicare pays doctors by tyingreimbursement to quality. What this means is that the commercialinsurance sector will continue to follow suit, and we will continueto hear about “paying for value, not volume in health care.”Benefits professionals can get the most out of this trend — paymentreform — by implanting benefit designs that pair well with paymentreform. The nonprofit Catalyst for Payment Reform offers some greatinsights. For example, your benefit design and related servicescan encourage employees to have surgery at Centers of Excellencewhere the quality of care is better (and providers are paid basedon value).

It is indeed time of great change, but as the old adage goes,the more things change, the more they stay the same. Health carecosts will continue to rise, and quality will continue to lag andvary from provider to provider. As always, our challenge is to getemployees more engaged in the process to steer them toward the carethat is highest quality and most efficient. We want them to beconsumers, but they can’t do that on their own. They need the rightbenefit design but also the right support and related programs andto help them understand and get there.