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.
Topic Outpatient care
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.
Consumers’ accountability for healthcare spending is increasing, and more than a thousand companies are developing new digital/mobile technologies that should allow consumers to take greater control over their healthcare choices. This combination may disrupt the industry’s migration toward larger, more integrated systems and put almost $300 billion—primarily, incumbent revenues—into play.
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.
As consumers take an increasingly active role in healthcare decision making, payors and providers need an accurate understanding of how healthcare consumerism is playing out. Using data from surveys of thousands of people across the U.S., we debunk eight of the most common myths circulating in the industry.
The newer approaches to managing oncology care have been somewhat effective in controlling near-term costs, but are often cumbersome and create friction between stakeholders. A more integrated program, however, can deliver long-term benefits to both payors and providers.
What happens when our paradigm of care is challenged, and a new model is built from the ground up?
To address the rising cost of chronic conditions, health systems must find effective ways to get people to adopt healthier behaviors. A new person-centric approach to behavior change is likely to improve the odds of success.
Getting physicians to make significant changes to their day-to-day activities can be difficult. But the result can be better patient outcomes and lower healthcare costs.
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.
Care pathways enable health systems (and other healthcare organizations) to make evidence-based decisions about where to focus improvement efforts.
At the time of publication, the United States spent $650 billion more on healthcare than expected, even when adjusting for the economy’s relative wealth. This report examines the underlying trends and key drivers of these higher costs.