Performance transformation: Opportunities for healthcare payers
With increasing affordability pressure, finding opportunities to continuously improve performance is critical for healthcare payers.
Topic Public exchanges
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Insights into the 2019 individual exchange market
This analysis reflects carrier participation, pricing, and plan type trends for the 2019 individual exchange open enrollment period. Findings are across 50 states and DC.
Multimedia
Insights into the 2018 individual exchange market
This analysis reflects carrier participation, pricing, and plan type trends for the 2018 individual exchange open enrollment period. Findings are across 50 states and D.C.
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.
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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
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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.
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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.
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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.
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Reform Center video series: Exchange network
A close look at the public exchange network in 2014.
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Reform Center video series: Public exchange landscape
With the first OEP concluded, this retrospective overview shows how the market landscape has evolved.
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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.
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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.
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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.
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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.
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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.
