By Ashley Fuoco Antonelli, Senior Editor

Here's the bad news: Millennials are delaying care because of costs, have higher medical debt than previous generations, and are sicker than earlier generations were at the same age.

Infographic: What your patients expect from their care—from millennials to Gen Z

But millennials also are poised to spur change in the U.S. health system, as health care providers and other stakeholders adapt to the new ways millennials want to receive care. And research suggests millennials have growing control over exactly how their health coverage and care are designed.

The troubling state of millennials' health (and wealth)

Various studies have shown millennials have worse health than previous generations, and they're also more likely to have a hard time affording health care.

For instance, a study published last year found younger adults today have a higher risk of developing several obesity-related cancers when compared with other generations, with millennials almost five times as likely as baby boomers were to develop kidney cancer at the same age.

Further, a 2019 study from the Blue Cross Blue Shield Health Index found one-third of millennials have a health condition that will lower their life expectancy and quality of life. And, when compared with Generation Xers at the same age, older millennials had a significantly higher incidence of several common health conditions, including Type 2 diabetes, high cholesterol, hypertension, and major depression. Millennials also are experiencing higher rates of accidents and suicides than Gen Xers did when they were the same age, according to recent research.

One contributing factor may be that many millennials have reported not having enough time to focus on their health, and Advisory Board has found that 93% of millennials say they don't schedule preventive health visits. Perhaps even more disconcerting is federal data showing millennials are struggling financially. As Federal Reserve researchers wrote in a 2018 paper, "Millennials are less well off than members of earlier generations when they were young, with lower earnings, fewer assets, and less wealth."

Advisory Board's Emily Zuehlke Heuser notes that, even though millennials tend to be well-educated compared to prior generations, with 72% graduating from high school, "an average of $25,000 of student debt have made them financially cautious"—as has the formative experience of living through the Great Recession. Research has found that millennials in 2016 had roughly $36,000 less in total assets, $5,000 more in total debt, and $41,000 less in net worth than Gen Xers did when they were a comparable age in 2001. Yet millennials are spending nearly twice as much on health care as the previous two generations.

So it's not all that surprising a recent report found millennials are twice as likely as baby boomers to forego medical care because of cost.

How millennials are changing health care

But millennials also are spurring some major changes in the U.S. health system at large.

For example, millennials are increasingly expecting medical services on demand. Some of millennials' key health care priorities include same-day appointments, local providers (rather than top experts who are farther away), and walk-in care with low wait times, according to Advisory Board research. When a timely in-person visit is not available, many millennials are willing to have virtual visit. 

On the other hand, millennials are less worried about provider continuity. In fact, 51% of millennial patients use urgent care centers, retail clinics, virtual visits, or a concierge care practice as their regular form of primary care. To meet the demand, providers in recent years have been increasing telehealth services and offering concierge health care services, and there's been a surge in walk-in, retail, and urgent care clinics.

Millennials also are more cost-conscious than older generations. Today's patients want to know what their care will cost, and in some instances prioritize their access to billing information over convenience and quality of care. So perhaps unsurprisingly, millennial patients generally are more likely to know the costs of their care before receiving it, and they don't hesitate to shop around—driving increased price transparency in the health care market as a whole.

And millennials aren't just sparking change in the provider space. A recent HealthEdge survey found that, as millennials gain more influence in their workplaces, they're pushing for changes in employer-sponsored health benefits. According to the survey, only 53% of millennial respondents said they believe their current health plan is most effective at administering benefits, which FierceHealthcare's Paige Minemyer writes was the lowest percentage among all age groups. Millennials also were the least likely group to say they like how health insurers communicate with members.

What all of this indicates is that, as millennials increasingly become key health care purchasers, both providers and insurers need to modernize to remain competitive in the marketplace.