Are the public insurance exchanges just a temporary bridge to a world in which most people find health insurance through privately run exchanges?

That's the prediction from Grand Rounds, a company that offers virtual second opinions and related medical advice from a team of top medical specialists.

"The government will drop public insurance exchanges for private exchanges," Grand Rounds predicted. Citing a study by consultants Oliver Wyman, Grand Rounds said between 20 percent and 30 percent of the exchange marketplace "will gravitate to a private exchange over the next 3-5 years regardless of employer size."

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The emergence of private exchanges such as those operated by Aon Hewitt, Mercer and GetInsured.com, and their early successes, will pave the way for a robust private exchange marketplace, Grand Rounds said.

Grand Rounds' "2014 Healthcare Predictions" also forecasts the rise of the "virtual clinic." This phenomenon, where patients never set foot inside a medical clinic but receive all the services of a clinic more efficiently and on their schedule, "will drive unprecedented access, demolishing geographic barriers between expert specialists and patients.  All patients will be able to access state-of-the-art care," Grand Rounds said.

"Health care is an industry that has resisted yielding power to the consumers in the way that other industries have," said Owen Tripp, co-founder & CEO of Grand Rounds. "Just about every industry from real estate to retail has made tremendous concessions to the consumer, thanks to the openness of the Internet. But you can only slow consumer access for so long, and health care is about to follow the same path. Key advances in medical records technology and portability will give consumers power over their medical care in a hugely disruptive way, starting in 2014."

Other crystal-ball gazing predictions included:

PPOs will continue to decline. "High deductible PPOs with narrow networks will face increasing resistance from consumers, resulting in a shift away from PPOs towards more affordable and flexible healthcare options" as consumers increasingly take control over their health care and health insurance, the firm said.

Health care apps will explode. "Employers will explore consumer-friendly mobile services as they recognize the benefits of healthcare-specific apps," Grand Rounds said. "At the same time, employees will download apps to manage conditions such as diabetes and Parkinson's. Employees will also use apps to access medical guidance online when they find themselves diagnosed with highly specialized conditions —although, as noted above, without sacrificing the quality of treatment they receive."

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.