Tag: trilliant

Trilliant Health just released its 2025 Trends Shaping the Health Economy Report, delivering a uniquely holistic perspective on the healthcare market through the lens of supply and demand.

Here’s the state of play. Health expenditures are growing faster than the rest of the economy, and they’re projected to represent 20.3% of GDP by 2033. 

• The U.S. spends more and gets less than peer nations, which might have been tolerable when our federal debt was at $800B in 1980, but definitely isn’t now that it’s at $37T.

What levers can we pull? This year’s 115 page analysis looks into six macro trends driving the healthcare economy, and underlines each of them with concrete stories from real-world data.

• 1) Affordability concerns are reshaping demand. Medical prices are up 54.5% since 2009, and they’re pressuring patients and employers to weigh their options – especially when rates for an inpatient procedure can vary as much as 7x within the same facility depending on the payor (p. 19).

• 2) Stakeholders are slow to adapt to demographic trends. Mortality rates among adults aged 18-44 have been rising as the fertility rate falls, shrinking the share of Americans with employer-sponsored coverage (p. 22).

• 3) Specialty care intervention is incentivized over primary care prevention. In 2024, behavioral health visits rose 11.4%, while primary care visits declined 5.6%, marking the first time behavioral health utilization surpassed primary care (p. 43).

• 4) Fraud, waste, and abuse are pervasive. The share of high-complexity ED visits has risen sharply, increasing from 36.6% to 47.8% of visits between 2018 and 2024, underscoring the financial impact of upcoding (p. 57).

• 5) Alternative therapies are accelerating. GLP-1 utilization increased 745% from 2018 to 2023, while bariatric surgery volumes were flat to declining, illustrating how high-margin procedures face growing competition from medications (p. 86).

• 6) If the industry won’t deliver value, the government will. Federal programs have consistently failed to bend the cost curve (MSSP savings are less than 1% of Medicare spending), and there’s mounting political pressure for top-down structural reform (p. 89).

The Takeaway

The U.S. healthcare system is at a crossroads. As Trilliant put it so nicely, the choice for all health economy stakeholders is whether to implement “radical change from the inside” or “to be subjected to such change by external forces.”

Trilliant Health just released its 2024 Trends Shaping the Health Economy Report, delivering a unique perspective on the healthcare market through the lens of supply and demand.

The fourth edition of the report builds on the core findings from the previous three:

• 2021: Healthcare is a negative-sum game.
• 2022: Every part of the health economy will be impacted by reduced yield.
• 2023: The victors in healthcare’s negative-sum game will be those who deliver value.

This year’s 164 page analysis is organized into eight sections, each examining a significant macro trend and supported by a wide collection of data-driven stories:

• 1) The healthcare system is disproportionately expensive. Despite spending nearly 2X more on healthcare than peer countries, utilization has remained largely unchanged, while increasing 7% in peer countries since 2000. U.S. outcomes are also far worse. (Page 11 Chart)

• 2) Health status continues to decline. We’re seeing higher volumes of early onset cancers in patients under age 45 for breast (+6.6%), colon (+10.0%), and kidney (+2.1%) between 2018 and 2023. (Page 22 Chart)

• 3) Government regulation is failing to produce value. This one’s a mixed bag. Regulating cigarettes decreased usage by 30%, but mandated reporting of quality measures hasn’t yielded enough improvement to offset the cost of reporting. (Page 46 Chart)

• 4) The value of tech advancements is uncertain. Since 2018, multiple AI CPT codes have been introduced, but utilization remains infrequent and concentrated among cardiac conditions such as coronary artery disease and ECG cardiac dysfunction. (Page 77 Chart)

• 5) Supply constraints are correlated with inadequate yield. The decrease in practicing physicians from 2019 to 2023 resulted in a -0.9% workforce reduction. Notably, 31.3% of physicians changed practice location over that time period. (Page 89 Chart)

• 6) Forced consumerism has fostered fragmentation. Over 14% of patients with commercial coverage go out-of-network for behavioral health services, versus just 2% for physical care. (Page 111 Chart)

• 7) Lower-cost care settings can offer better value. New treatment paradigms often start in the hospital but shift to new settings over time (due to new tools, reimbursement reform). How long will that continue? (Page 125 Chart)

• 8) Employers are better equipped to demand value. Employers have historically been relatively passive in managing healthcare costs., but new transparency requirements compel them to change that. (Page 148 Chart)

The Takeaway

Trilliant’s report showcases the fact that the inputs of the U.S. healthcare system, as measured by cost, exceed the outputs, as measured by the actual value received by Americans. As Trilliant’s Head of Research Sanjula Jain puts it, “every stakeholder can – and must – deliver more value to their customers.”

Trilliant Health just released its 2022 Trends Shaping the Health Economy Annual Report, providing a unique perspective on the healthcare market through the lens of supply and demand.

Even though these dynamics don’t play out in healthcare exactly how they would in an “ideal market,” the 147-page report does a good job turning the core principles into a framework for examining 13 different secular trends.   

Perhaps the biggest trend, at least on the demand side, is what looks to be a shrinking total addressable market. The share of Americans with commercial health coverage dropped 0.6 percentage points from 2020 to 2021.

• On top of this, care forgone during the pandemic appears to be permanently lost rather than delayed. Pandemic-related care is driving the appearance of a rebound, but with COVID treatment and vaccination omitted, healthcare encounters are down 6.2%.

• The widespread availability of virtual care options hasn’t saved the day either, with Trilliant’s data showing that half of telehealth users in 2021 only used the modality once.

At the same time as demand is contracting, a growing supply of new entrants like CVS, Walmart, and Amazon is making consumer loyalty harder to capture. 

• Trilliant makes the case that these retailers are commoditizing low-acuity services, leveraging their scale and large customer bases to pressure established players. 

• This is taking place against a backdrop of burnout among traditional providers, with 9.8% of physicians leaving the field between 2019 and 2022. When accounting for new physicians entering the industry, the U.S. saw a -2% reduction in the physician workforce during the same period.

The Takeaway

If the full report makes one thing clear, it’s that the health economy is quickly turning into a negative-sum game as the number of patients with commercial health coverage decreases and new entrants swarm the field. Even though Trilliant doesn’t set out to give a solution to this problem, its research is a solid tool to help each stakeholder make sure they’re at least asking the right questions.