Topic Commercial group insurance/private payors


Against the odds: How payors can succeed under persistent uncertainty

The US health insurance industry continues to be defined by uncertainty. The 25 articles in this compendium can help health insurers navigate the changes ahead.


Why agility is imperative for healthcare organizations

A new concept, organizational agility, can help healthcare companies adapt more quickly to changing customer needs, competitor responses, and regulatory guidelines—without requiring a full-scale restructuring.


US health insurers: An endangered species?

Converging trends are disrupting the US healthcare industry. Health insurers are not likely to disappear, however, despite predictions to the contrary. Insurers that can take advantage of these trends are likely to find that their best years are ahead.


Where to compete in today’s healthcare market

To select which markets to focus on—both within health insurance and in adjacent businesses—payors must have strong market insights, the fortitude to make tough decisions, and the agility to alter course rapidly.


Why understanding medical risk is key to US health reform

In our healthcare system, those in the best position to control risks and costs often have inadequate incentive to do so. Refining healthcare financing and reimbursement requires a deep understanding of the nature of medical risk.


Value-based care: Is it sustainable?

Four fundamental questions can help payors and providers improve productivity and better control utilization—the prerequisites for making value-based care sustainable.


Winning in private health insurance through technical excellence

In private health insurance, a focus on technical excellence in product development, pricing, underwriting, and claims handling can improve insurers’ bottom line—while easing their dependence on investment returns.


Transitions in coverage type are the norm for most consumers over time

New McKinsey research shows that changes in health insurance type are a common event for most Americans.


Employer interest in transformative healthcare

What insights from a large employer survey tell us about the current and future state of employer health benefits.


One-on-one with Giovanni Colella, MD: Enterprise Healthcare in the Cloud

Businesses know the cost and benefits of every item they buy -- except when it comes to healthcare.


One-on-one with Mark Keim: Sustainability of Private Exchanges

Will private exchanges reach a tipping point by 2018?


Reform Center video series: Private exchanges

Private exchange enrollment is projected to nearly double in 2014 and could comprise 20% of the employer market by 2019.


Navigating the coming changes in the commercial group market

While recent attention has focused on public exchanges, the commercial group market will be a hotbed of change over the next five years. Unmanaged, the segment faces profitability pressure, but payors who take proactive measures to redesign their health benefits product portfolio and optimize their pricing approaches will find revenue and earnings growth.