Using advanced analytics and digital capabilities to improve the design and implementation of care management programs can promote better patient outcomes and an improved return on investment (ROI).
Topic Consumer engagement
Creating or participating in a digital health ecosystem can allow payers to take advantage of their central position in the healthcare landscape and expand in new directions.
In transformations, healthcare providers and payers must attend to their organizational health, not just their short-term performance.
Next-generation member engagement tools empower members to make higher-value care decisions and enable health insurers to improve care quality, increase member satisfaction, and reduce medical spending.
Process automation at scale is now feasible for most payers. When coupled with other next-generation digital tools, we estimate that it may enable many payers to reduce operational costs by up to 30 percent within five years.
Omnichannel interactions are fundamentally improving the consumer experience in many industries. Payers should act now to keep up with rising consumer expectations.
Although end-to-end digital claims management is still a distant vision, much can be gained from digitizing portions of the claims process today.
Hospital care is changing both rapidly and radically. Because of innovations in care delivery and organisational structures, future hospitals are likely to be very different from those of today.
Technology-driven innovation holds the potential to improve our understanding of patients, enable the delivery of more convenient, individualized care—and create $350 billion–$410 billion in annual value by 2025.
Addressing the social determinants of health: Capturing improved health outcomes and ROI for state Medicaid programs
The social determinants of health (SDoH) strongly contribute to variations in health status. Addressing SDoH can help ensure access to high-quality care, improve outcomes, and manage costs.
Survey findings shed light on how social determinants of health affect healthcare utilization rates and consumers interest in social program offerings.
McKinsey's latest research shows that consumer engagement in healthcare continues to grow, but many payers and providers are struggling to meet changing needs and demands.
McKinsey’s latest research suggests that although the market for individual insurance appears more stable from the consumer point of view, opportunities remain to encourage people to obtain coverage.
Planning for the future of healthcare: A conversation with Penny Wheeler, President and CEO, Allina Health
Penny Wheeler, President and CEO, Allina Health shares her perspective on the importance of partnerships in increasing value and understanding the consumer with Jenny Cordina, Partner, McKinsey and Company in an interview conducted in June 2017.
McKinsey’s latest healthcare consumer research suggests that consumer engagement can improve care access, quality, and affordability. But to be successful, it requires true collaboration.
Challenges with access continue to frustrate consumers and stunt health systems’ financial performance. Engaging clinicians and improving productivity are vital to address this dual issue.
Few healthcare organizations fully leverage customer insights to drive decision making and performance. Here’s how you can translate that data into concrete business initiatives.
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.
Increasingly, consumers are seeking services at sites of care outside of the traditional health system infrastructure. This shift has important implications for how health systems think about their asset base and scale.
Companies that can learn to understand, guide, and engage healthcare consumers, while inspiring their loyalty, have a significant opportunity to change the healthcare landscape.
In October, CMS released the Medicare Advantage Star ratings for 2017. By analyzing CMS’s data, we uncovered trends indicating it will be critical for payors to continue to invest in their capabilities if they want to deliver quality programs that receive a Star bonus.
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.
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.
New McKinsey research shows that changes in health insurance type are a common event for most Americans.
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.
Our research suggests that improving customer experience could lead to significant financial gain, and that an approach beginning with a deep understanding of the consumer's journey could be the key to success.
When people get to the age of 75, chances are they’ll stay put—with their health plans at least. According to our Annual Enrollment Period (AEP) survey of 2,208 senior consumers, the Medicare population is a loyal bunch, and loyalty increases with age.
We analyzed every individual exchange hospital network across the U.S., and here’s what we learned.
The potential of digitization is well understood, yet healthcare systems are struggling to convert ambition into reality. Here’s what we recommend.
Facts on the shift toward HMOs on the public exchanges.
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.
Despite higher increases in lowest-price plan gross premiums this year, a greater share of consumers are seeing less expensive lowest-price silver net premiums.
The mix of carriers and plans is continuing to change, with nearly half of consumers seeing a new entrant, and plan types becoming more managed.
As we near the 2016 OEP, outreach and retention efforts are ramping up. Understanding the different consumer segments is critical for driving uptake.
New McKinsey research sheds light on why Hispanic enrollment rates continue to be low – and how these numbers could be improved.
A comprehensive approach health systems can use to better understand the patient experience and thereby improve patient satisfaction.
CEO Adrian Gore describes how the South African company has been shaking up its industry through business-model innovation and explains what helps to catalyze new ideas.
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.
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.
Observations based on analysis of Medicaid/CHIP enrollment estimates through December 2014.
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.
Go big or go home. Plan for great. Use the power of purpose.
What happens when our paradigm of care is challenged, and a new model is built from the ground up?
The first Open Enrollment Period (OEP) provided early insights into the new on-exchange, individual market consumer.
From 2012 to 2019, Medicaid enrollment is projected to grow by 9-15M lives (16-26%), and by the end of the period managed Medicaid is expected to cover ~80% of enrollees.
This updated view of the network configurations being offered on public exchanges across the country suggests that consumer choice of health plan design is expanding.
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.
A new McKinsey survey offers payors, providers, and state governments a way to understand key differences among Medicaid consumers— differences that have important implications for how to engage current and potential enrollees effectively.
The latest round of our national survey of QHP-eligible consumers tells a story of deeper engagement than previous surveys.
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.
A multiprong approach that puts physicians—and clinical care—at the heart of performance transformation efforts can help hospitals and health systems deliver more financially sustainable, patient-oriented, and physician-friendly care.
This document discusses five strategies adopted by leading consumer companies to engage customers: customer experience and branding, channel excellence, risk management, consumer value management, and product design and innovation.
The United States has a great opportunity to restrain the cost of its healthcare system, improve medical outcomes, and ease the financial and psychological burden on US consumers.
As consumers face more choice, complexity, and financial exposure for their healthcare in an increasingly uncertain world, what they are really seeking is peace of mind.
Most healthcare payors convert less than 10 percent of the customers who move to a new product class. There is substantial room for improvement.