Stefanie Asin and Mackenzie Bean – Becker’s Hospital Review
A decade has passed in what feels like the blink of an eye for many, yet the events of 2015 marked a landmark year in healthcare — one whose influence remains deeply relevant today.
The U.S. Supreme Court upheld the Affordable Care Act, ensuring its longevity, while ICD-10 was implemented with much handwringing, among other notable milestones. These major healthcare decisions made 10 years ago continue to shape the industry.
As we reflect on the past decade, here’s a look at 10 major issues that defined healthcare in 2015 and their lasting impressions.
1. The U.S. Supreme Court ruled in favor of the Affordable Care Act. In a pivotal 6-3 ruling in King v. Burwell, the Supreme Court upheld tax subsidies under the Affordable Care Act for all eligible Americans, including those from states without their own health insurance exchanges. Had the decision gone the other way, an estimated 6.4 million people would have lost premium subsidies, resulting in 8.5 million more uninsured people by 2016, according to a study published in Public Health Reports. The study also projected a 35% premium increase for everyone in the individual insurance market as healthy people dropped out. Enrollment in the marketplaces grew to almost 10 million, and experts expect enrollment to increase to more than 40% during the next decade.
2. Healthcare consolidation continued at a rapid pace. Hospital mergers and acquisitions surged in 2015, leading to significant regional and national consolidation. That year, 112 hospital transactions were announced, up from 95 transactions in 2014 and 66 in 2010. The pace of transactions was especially strong in the second half of 2015, as larger systems sought hospitals to expand their market reach. This trend has accelerated in the years since, reshaping healthcare’s competitive landscape. Though M&A dipped in 2024, it remained 70% higher than pre-pandemic levels, with an increase in deals expected for 2025, according to PwC.
Meanwhile, big insurance companies also tested the market in 2015 with plans of major mergers but their attempts were largely held back by regulators. This regulatory pushback foreshadowed the heightened scrutiny that healthcare mergers have faced in recent years from the Federal Trade Commission and Department of Justice, particularly regarding concerns about reduced competition and rising costs.
3. Digital health records hit an all-time high. By 2015, around 80% of U.S. hospitals had adopted an EHR system, marking a significant shift in healthcare technology and data management. EHRs also transformed the patient-physician relationship, becoming a central tool in primary care settings. While they improved safety, care coordination and access to medical histories, widespread adoption was hindered by ongoing concerns around privacy, security and interoperability, according to a 2016 study published in the Yearbook of Medical Informatics. Over the past decade, EHRs have continued to evolve, expanding into new care settings and further embedding digital records into the healthcare ecosystem, solidifying their role as a cornerstone of modern healthcare.
4. Providers made ICD-10 upgrades. After multiple delays, healthcare switched to the International Classification of Diseases 10 on Oct. 1, 2015. The transition added 55,000 new diagnosis codes and 84,000 procedure codes to medical billing systems. Enhancing the codes was deemed necessary for proper documentation of patients’ medical conditions to improve continuity of care. Healthcare was challenged, however, by implementation costs, possible shortages of qualified coders and possible losses in productivity and reductions in revenue.
A decade later, the U.S. healthcare system has fully integrated ICD-10 into healthcare operations, improving data access for clinical research, public health surveillance and value-based care efforts. While the World Health Organization introduced ICD-11 in February 2022, the U.S. has not set an official adoption date.
5. Telemedicine became indispensable. The number of providers offering telemedicine and telehealth services dramatically increased in 2015, largely due to lawmakers’ success at loosening barriers to telemedicine expansion, including licensure and reimbursement. Twenty-seven states permitted telehealth to be used in primary care settings, up from 17 in 2008. Triple the number of states also required private insurers to cover telehealth services over that time period. Additionally, several provisions in the ACA laid the groundwork for broader adoption of telehealth. Since 2015, telemedicine has had even broader adoption, especially during COVID-19. Nearly 50% of primary care visits were conducted virtually in April 2020, compared to less than 1% before the pandemic.
6. Superbugs made headlines. In 2015, many healthcare experts and associations sounded the alarm on antibiotic-resistant infections or “superbugs.” The World Health Organization and the European Union called the rise of resistant bacteria one of the world’s most serious health crises. Responding, the White House outlined an aggressive plan to invest in new diagnostics and antibiotics to reduce the most dangerous superbug infection rates over a five-year period. In 2015, Congress approved $375 million in additional funds to fight superbugs. While hospitals are making progress on healthcare-associated infections, antibiotic resistance remains a key concern for healthcare in 2025.
7. Online ratings and reviews became commonplace. In the push for transparency, consumer rankings gained popularity in 2015. Consumer Reports diversified its resources for patients choosing a provider by publishing infection rates of more than 3,000 hospitals, along with ratings that included patient safety scores, patient experience, patient outcomes and other metrics. Healthcare consumerism has only increased since then. Today, patients turn to the internet first for information on healthcare and providers. In addition, younger generations now place more importance on fast, convenient care over brand loyalty or personal, long-term relationships with a single physician. In response, health systems have focused on ramping up their online presence and spotlighting their performance in national ratings and rankings.
8. Advanced practice providers stepped up to fill physician shortages. As the physician shortage started to hit a critical point in 2015, more states allowed physician assistants, nurse practitioners and pharmacists to practice at the top of their licenses. Americans also expressed an openness to the shift. A 2015 report from PwC found three-quarters of consumers were willing to see an advanced practice provider, leading the consulting firm to identify this workforce shift as one of the year’s top healthcare industry trends. This trend has continued through 2025, with the APP workforce seeing significant growth and many health systems increasingly leaning on these clinicians to meet growing care demands amid the physician shortage.
9. Healthcare costs rose despite high insurance rates. While more people were privately insured than ever before in 2015, many still struggled with the financial burdens of healthcare. High deductibles and cost-sharing measures significantly increased out-of-pocket expenses, making care unaffordable for many. More than 25% of privately insured consumers had premiums, deductibles or out-of-pocket costs that were unaffordable. A growing trend among employers to shift more of the costs onto employees — combined with insurers offering more high-deductible health plans — exacerbated these challenges. Healthcare financial issues have only magnified since then, with PWC projecting an 8% increase in medical costs in 2025, largely driven by inflation, high prescription drug spending and increased behavioral health utilization. Additionally, high-deductible plans remain prevalent, employers continue to shift costs to employees and more than 100 million Americans are in medical debt.
10. Pharmaceutical costs soared. In 2015, prescription drug spending increased 9%, following a 12.4% rise in 2014 and far exceeding the 2.3% growth seen in 2013. Overall spending on drugs increased by 4.5% for private health insurance, 1.7% for Medicare and 3.8% for Medicaid, fueling public outrage and prompting legislative action. Martin Shkreli, the former CEO of Turing Pharmaceuticals, made national headlines when he raised the price of Daraprim, a years-old antiparasitic medication, by 5,000% overnight, from $13.50 to $750 per pill. At the federal level, the push for Medicare to negotiate drug prices gained traction, ultimately becoming law in 2022. Today, high drug prices remain a pressing concern, with federal lawmakers increasing scrutiny on pharmacy benefit managers and their potential role in driving up costs.
