Services Insights

Articles

Looking ahead in Medicaid: Options for states and the implications for payors and providers

This paper explores opportunities states could consider to improve their Medicaid programs, both to control spending and improve the program's performance.

Articles

Navigating the uncertainty of potential ACA ‘repeal and replace’: A preliminary analysis

The findings in this Intelligence Brief provide an introductory perspective on how the next US administration and Congressional Republicans may approach altering the ACA and related legislation. The information is based on publicly reported information released through December 8, 2016. Our Reform Center team is continuing to refresh this perspective on a real-time basis and is closely analyzing potential implications and economic impacts for each policy element under a full range of scenarios.

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The next imperatives for US healthcare

Two steps—increasing healthcare-sector productivity and improving healthcare-market functioning to better balance the supply of and demand for health services—would likely produce sufficient savings to lower medical cost inflation to the rate of GDP growth.

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Improving care delivery to individuals with special or supportive care needs

What states, private payors, providers, and technology companies are doing to control costs and improve outcomes for individuals with behavioral health conditions or in need of long-term services and support, including those with intellectual or developmental needs.

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Breaking down the gender challenge

To make meaningful progress on gender diversity, companies must move beyond the averages and focus on the biggest pain points.

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Women in healthcare: Of leaky pipes and sluggish middles

Last year, in partnership with LeanIn.Org, we conducted the first annual comprehensive study of the state of women in corporate America. The findings reveal challenges – but also optimistic notes – for women in healthcare.

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How healthcare systems can become digital-health leaders

The potential of digitization is well understood, yet healthcare systems are struggling to convert ambition into reality. Here’s what we recommend.

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Capturing returns in healthcare

New research finds that the healthcare sector has been very good to private equity, especially payor and pharmaceutical services. And specialist firms seem to have an edge over generalists.

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Unlocking the potential of the Internet of Things

More objects are becoming embedded with sensors and gaining the ability to communicate. The resulting information networks promise to create new business models, improve business processes, and reduce costs and risks–including for healthcare.

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Unlocking digital health: Opportunities for the mobile value chain

Can the mobile value chain complement its traditional core with adjacent growth? Yes—by adopting innovative business models and exploring new markets like digital healthcare.

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Individual market enrollment: Early assessments

Our fourth intelligence brief on exchange dynamics shares observations of the individual market through the mid-point of open enrollment.

Reports

The ‘big data’ revolution in US healthcare

Big data could transform the healthcare sector, but the industry must undergo fundamental changes before stakeholders can capture its full value.

Reports

Accounting for the cost of U.S. healthcare: Pre-reform trends and the impact of the recession (2011)

This report analyzes US healthcare spending trends overall and by category of care, and compares US healthcare expenditures with other developed countries.

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Cross currents in the health economy

This paper outlines five broad changes in the U.S. healthcare system and the likely strategic responses across the value chain.

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How IT can help fix hospitals

Mandated upgrades to healthcare IT will demand heavy investments by providers but will help them minimize waste and standardize best medical practice.

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The new IT landscape for health insurers

A volatile new healthcare environment is emerging in the United States. These are times of trouble—and opportunity—for the payors’ CIOs.

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The next wave of change for US healthcare payments

The development of an automated payment network would reduce bad debt, cut administrative costs, and save billions of dollars.

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Revisiting healthcare payments: An industry still in need of overhaul

While pilots are underway and some progress is being made to restructure US healthcare payments, there is still much more to be done.

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How sourcing excellence can lower hospital costs

Better procurement practices can help hospitals achieve rapid supply cost reductions of 20 percent or more and keep future cost escalations under control.

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The US stimulus program: Taking medical records online

Electronic Medical Records (EMR) is a technology whose time has come. Whether or not EMR can deliver on its promise, it will change healthcare profoundly.

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US healthcare payments: Remedies for an ailing system

As American consumers shoulder more of the burden of healthcare costs, new models are needed to facilitate payment flows, combat growing bad debt, and improve efficiency across the value chain.

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Why Americans pay more for healthcare

The United States spends more on healthcare than comparable countries do and more than its wealth would suggest. Here’s how—and why.

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Three imperatives for improving US healthcare

Making healthcare more affordable is the key to making the US system sustainable. Bringing the three largest sources of underlying costs and their growth under control is necessary.