For quite some time, I have been tracking the Millennial population in the United States. As someone who is asked to think constantly about where things are heading in healthcare, it is very hard to ignore these 75.3 million new consumers (on their way to 81.1 million by 2036) and trend makers that are roughly between 18 and 34 years old today (source: Pew Research).

I will not bore you with a deep rundown on who these folks are (but, if you have a little time to kill, you can take this short quiz to see how Millennial you are here). What I want to focus on are three trends that are developing as Millennials reach their adulthood years.

1. They are untethered in many ways (less attached to religious & political institutions along with being predominantly single)

2. They are broke (due to the impact of student loan debt, unemployment & under-employment)

3. They have trust issues despite exhibiting huge levels of optimism at their core

As it relates to the future of health insurance, the second point above is one to highlight. I keep asking will this new, very large purchasing class force the players in the healthcare ecosystem to end the era of cost shifting? This is a key question I have been thinking about a lot lately given these new commercial customers don’t appear to have the savings to withstand the costs associated with an unfortunate health issue.

The Kaiser Family Foundation reported in 2014 that premiums have risen 26% while the average deductible has grown by 47% over the last five years. There are those in the industry that are fine with this news, as it is evidence that consumers are putting more skin in the game as the insurance product mix shifts more toward high deductible designs. As a short-term play, that’s okay. But, like most short-term plays, that strategy has a shelf life.

Lately, there have been more reports and studies on plan adoption rates of Millennials given they are a key class needed to make the ACA work. The findings have led to stories like this in Time. Do Millennials really hate their low-premium, high-deductible health plan options? That’s a subject for debate that will roar on for several more years, but the early findings seem to point more to yes than no.

If this ends up being true, then the players in healthcare have a dilemma. It’s going to get harder to keep driving this cost-shifting game forward. The time to start collaborating to address the bigger structural problems with healthcare seems to be upon us. There are interesting windows for disruptive innovation opening up–the kind of innovation we are starting to see with the #mHealth phenomenon (Dr. iPhone), convenient & customized urgent care experiences, smart/self-learning data intelligence capabilities, better customer-level (not aggregated) communication and well-defined value network plays.

It will take time to peel this onion, but I know the world works on incentives. If one player figures out the right product mix and engagement strategies that attract a disproportionate share of Millennials, that will change the game.

I’ll leave you with three questions to consider to conclude this post:

1. If this big consumer group is trending more toward being risk-adverse, is your product portfolio ready to meet those needs

2. Given this group is technologically brilliant but healthcare illiterate, how does your 3-year strategy leverage emerging technologies like private exchanges, mobile engagement platforms and healthcare CRM/marketing approaches to educate and lead them to better decision making on their terms

3. What are you doing to innovate with your network strategy on the insurance side and your services strategy on the hospital side to better control costs (are you testing #mHealth capabilities, partnering with retailers to better serve these consumers, looking at different incentive structures in your plan designs, investing in self-help & virtual treatments, etc.)

Let me know your thoughts. Was anything missed? I think this is only the beginning.

As always, keep innovating…