a decade. With more people moving to the metropolitan areas, there is a decrease in consumers utilizing health care facilities, which has led to a decreasing number of physicians in the rural areas (Vogenberg & Santilli, 2018). Healthcare consumerism is another trend on the rise. As costs for consumers continue to rise, consumers become more engaged in making certain they are getting the best value for their money (Vogenberg & Santilli, 2018). Effects of Managed Care from Trends 1 With rural healthcare providers being in crisis, they will have to continue to leverage new technology as they experience population loss. Technologies, such as telehealth and telemedicine will enable rural-based care systems to consolidate specialty care and referrals for ways to survive and grow in the changing market (Vogenberg & Santilli, 2018). The difference in the generations, baby boomers to millennials, will have an influence on the future in healthcare in new ways to save money. Like baby boomers and Generation Xers

TRENDS IN MANAGED CARE 3 changed aspects of healthcare, millennials are fully the first generation expected to share the burden of their health benefits. They believe that healthcare costs are too high and that third- party health payers or insurers have too much power (Vogenberg & Santilli, 2018).