Topic Public exchanges

Reports

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.

Multimedia

Hospital networks: Perspective from four years of the individual market exchanges

An analysis of the individual market health plans being offered across the U.S.reveals that the trends toward narrowed hospital networks and managed care continue.

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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2017 exchange market: Pricing trends

Analysis of exchange premiums indicates that overall prices will continue to increase in 2017. Despite this, some consumers will see their premiums decline given the effect of government subsidies.

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2017 exchange market: Plan type trends

Analysis of exchange plans indicates that a majority of carriers are continuing to shift toward managed offerings, and consumers will see less unmanaged plan designs available to them than in previous years.

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2017 exchange market: Carrier participation trends

Analysis of exchange carrier participation nationwide indicates that the overall number of carriers has dropped below 2014 levels. However, a majority of markets will continue to have more than one carrier participating.

Articles

Understanding consumer preferences can help capture value in the individual market

As consumers gain experience purchasing health insurance in the individual market, their attitudes are evolving—and so is the market. McKinsey’s 2016 Individual Market Open Enrollment Period Consumer Survey reveals the changes.

Articles

Exchanges three years in: Market variations and factors affecting performance

While the individual market is still in flux, careful analysis of carriers’ performance reveals several factors are associated with better results.

Articles

2016 OEP: Consumer survey findings

As the Affordable Care Act (ACA) third individual-market open enrollment period (OEP) came to a close in January, McKinsey’s Center for U.S. Health System Reform conducted its eighth national online survey to gather insights into how the individual-market and consumer behavior have evolved.

Articles

The market evolution of provider-led health plans

Offering a health plan can give health systems an opportunity for growth, but it is not without financial risk. To benefit from this move, health systems should use a different lens to understand both consumers and risk, know where the best growth opportunities are, rethink their payor-provider interactions, and take advantage of integrated claims and clinical data.

Articles

2016 Individual Exchange Rates

Based on nationwide 2016 individual exchange rates, here are overall and state-by-state insights on carrier participation, price leadership shifts, gross premium changes, and the impact of subsidies on 2016 rates.

Articles

2016 exchange market remains in flux: Plan type trends

Facts on the shift toward HMOs on the public exchanges.

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The emerging story on new entrants to the individual health insurance exchanges

How the competitive landscape on the public exchanges is continuing to unfold

Articles

Insights into Hispanics’ enrollment on the health insurance exchanges

New McKinsey research sheds light on why Hispanic enrollment rates continue to be low – and how these numbers could be improved.

Articles

Hospital networks: Evolution of the configurations on the 2015 exchanges

Updated 2015 network data, including a comparison of networks offered on the 2014 and 2015 exchanges, insights into how networks’ pricing structures are evolving, and insurer and provider participation.

Articles

2015 OEP: Insight into consumer behavior

As the Affordable Care Act’s (ACA’s) second individual market open enrollment period (OEP) came to a close in February, McKinsey’s Center for U.S. Health System Reform conducted our seventh national online survey to discern insights into how the individual market has evolved.

Articles

Exchanges year 2: New findings and ongoing trends

This brief provides a full view into the 2015 exchange landscape.

Reports

2015 Individual Exchange product information

State-by-state data and analysis on approved 2015 products offered on federal and state Individual exchanges

Infographic: On the Eve of Open Enrollment 2015

Survey findings shed light on how a variety of factors could affect the decisions consumers make about enrolling: eligibility for subsidies, penalties for not enrolling, satisfaction with 2014 plans, and increases in premium rates.

Articles

2015 OEP: Emerging trends in the individual exchanges

An analysis of the 2015 exchange landscape, with a view to gaining a preliminary understanding of how the 2015 OEP will differ.

Multimedia

Reform Center video series: Exchange network

A close look at the public exchange network in 2014.

Multimedia

Reform Center video series: Public exchange landscape

With the first OEP concluded, this retrospective overview shows how the market landscape has evolved.

Multimedia

Reform Center video series: Consumer engagement on the public exchanges

The first Open Enrollment Period (OEP) provided early insights into the new on-exchange, individual market consumer.

Reports

Individual market: Insights into consumer behavior at the end of open enrollment

This intelligence brief discusses the results of our April individual-market consumer survey, which confirm observations from the first open enrollment period and indicate possible future behavior.

Articles

Exchanges go live: Early trends in exchange dynamics

Our second brief on exchange dynamics is based on a comprehensive analysis of all exchange offerings across the entire US—more than 21,000 unique qualified health plans filed on the public exchanges in all rating areas.

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Emerging exchange dynamics: Temporary turbulence or sustainable market disruption?

This brief comprises an initial set of analyses regarding the structure, competitive dynamics, and pricing on the exchanges, and their implications.

Articles

Maximizing value in high-performance networks

Many payors now have experience developing value networks, but they may not yet have optimized their network configuration or approach. Over the long term, payors must be able to maximize the value these networks deliver.

Articles

Winning strategies for participating in narrow-network exchange offerings

In the post-reform era, payors will attempt to capture savings by creating limited networks with reduced reimbursement rates. To respond, health systems need a clear understanding—market by market—of their competitive advantages and of when, if, and how to trade price for volume.

Articles

The post-reform health system: Meeting the challenges ahead

This series of articles examines transformational imperatives specific to health systems in the post-reform era, drawing on extensive work with healthcare stakeholders across the value chain.