State and federal stakeholders are sharpening their focus on the dual eligible population. What will it take to improve quality, outcomes, and value for this population?
Topic Public payors
Despite the promise of digitization, paper forms will remain for many years. Payers that find a better way to handle both paper-based and digital information will have a competitive advantage.
Survey findings shed light on how social determinants of health affect healthcare utilization rates and consumer interest in social program offerings.
Patterns in how consumers move in and out of Medicaid and Individual market coverage have important implications for both private- and public-sector stakeholders.
For countries that want to provide universal health coverage, defining the benefits package can be challenging. An analytical framework provides insights and action steps for emerging economies.
Many countries with emerging economies are considering health system financing transformation. Five no-regrets tips can help them build a strong foundation for their future health system.
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.
The odds are stacked against healthcare organizations as they pursue sustained growth and differentiated performance. Six strategies can help them achieve successful transformations at scale.
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.
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.
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.
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.
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.
Four fundamental questions can help payors and providers improve productivity and better control utilization—the prerequisites for making value-based care sustainable.