Search Sort by Newest to OldestOldest to NewestRelevanceA-ZZ-A ICHRA: The Great Bifurcation of the Employer’s Role in Health Insurance U.S. employers have played a dual role in the health insurance of their employees – both paying for their health insurance coverage and choosing their health insurance options. These two roles have been tied at the hip, but now, ICHRA (individual coverage Health Reimbursement Arrangement) products offer an opportunity to bifurcate that role. Blog Payer Trends Health Systems Should Watch Closely in 2024 Health system leaders focused on the day-to-day needs of their organization can sometimes lose sight of key developments in other sectors of healthcare. But in an interconnected healthcare ecosystem, understanding the trendlines their payer counterparts are facing is an essential task. Article Health Insurance Exchanges The Health Insurance Exchange (HIX) or Marketplace segment can be considered the largest growth market in the payer sector after Medicare Advantage (MA). From a relative low of 11.4 million members in 2020, the HIX market grew to 16.4 million members in 2023. Blog The Employer Strikes Back: The Hollowing of the Commercial Health Insurance Market and Its Impact on Payers and Providers Today, the commercial group health insurance market is hollowing out, primarily driven by affordability pressures that have been building for decades. Blog Thriving Post-Reset: Payer-Provider Partnerships After the Pandemic In the pre-pandemic era, payer-provider partnerships were often focused on creating value by managing costs of care and delivering high-quality care. In today’s more challenging macro-economic environment, these conversations are becoming more direct and practical, with both payers and providers asking hard questions. Article Emerging Risks to the Medicare Advantage Market Medicare Advantage has been a tremendous growth story in recent years. Today, however, new risks are emerging from both providers and regulators that could stall and perhaps even reverse the growth strides health plans have made in the MA market. Blog Value-Based Care: Why Now? Value-based care has been a “hot” topic for years now. Every conference, every industry meeting, and every publication has talked about the importance of moving “from volume to value.”... Article Healthcare’s Post-Growth Reset echnology and retail-focused companies from Amazon to Oscar Health to CVS/Aetna, just to name a few, have taken ambitious steps into healthcare with offerings for everything from primary care to ambulatory clinics to new, consumer-focused insurance plans. Article The Next Act for Provider Sponsored Health Plans Several health systems launched or ramped up their PSHPs after the Affordable Care Act was passed in 2010, taking advantage of growth in key market segments and providing an additional revenue source while supporting their community-centered missions. Article Preparing for Risk-Based Contracting and Value-Based Healthcare: Challenges and Opportunities In a roundtable discussion, Kaufman Hall Managing Directors Matthew Bates and Nora Kelly and Senior Vice President Max Timm discuss the rise of risk-based contracting in value-based healthcare arrangements, what providers and insurers need to watch out for, and what success in risk-based contracting will look like. Article Building Strong Consumer Relationships in the Value-Based Care Era: A New Approach Organizations that pursue consumer strategies and value-based approaches together will be much more likely to achieve their goals while increasing their ability to effectively compete against new industry entrants. Research Report Operationalizing Value-Based Primary Care: Lessons from the Field For more than a decade, hospitals, payers, and other healthcare stakeholders have experimented with moving healthcare payment from fee-for-service, volume-based contracts to arrangements that reward providers for the value of the care they provide. Article
ICHRA: The Great Bifurcation of the Employer’s Role in Health Insurance U.S. employers have played a dual role in the health insurance of their employees – both paying for their health insurance coverage and choosing their health insurance options. These two roles have been tied at the hip, but now, ICHRA (individual coverage Health Reimbursement Arrangement) products offer an opportunity to bifurcate that role. Blog
Payer Trends Health Systems Should Watch Closely in 2024 Health system leaders focused on the day-to-day needs of their organization can sometimes lose sight of key developments in other sectors of healthcare. But in an interconnected healthcare ecosystem, understanding the trendlines their payer counterparts are facing is an essential task. Article
Health Insurance Exchanges The Health Insurance Exchange (HIX) or Marketplace segment can be considered the largest growth market in the payer sector after Medicare Advantage (MA). From a relative low of 11.4 million members in 2020, the HIX market grew to 16.4 million members in 2023. Blog
The Employer Strikes Back: The Hollowing of the Commercial Health Insurance Market and Its Impact on Payers and Providers Today, the commercial group health insurance market is hollowing out, primarily driven by affordability pressures that have been building for decades. Blog
Thriving Post-Reset: Payer-Provider Partnerships After the Pandemic In the pre-pandemic era, payer-provider partnerships were often focused on creating value by managing costs of care and delivering high-quality care. In today’s more challenging macro-economic environment, these conversations are becoming more direct and practical, with both payers and providers asking hard questions. Article
Emerging Risks to the Medicare Advantage Market Medicare Advantage has been a tremendous growth story in recent years. Today, however, new risks are emerging from both providers and regulators that could stall and perhaps even reverse the growth strides health plans have made in the MA market. Blog
Value-Based Care: Why Now? Value-based care has been a “hot” topic for years now. Every conference, every industry meeting, and every publication has talked about the importance of moving “from volume to value.”... Article
Healthcare’s Post-Growth Reset echnology and retail-focused companies from Amazon to Oscar Health to CVS/Aetna, just to name a few, have taken ambitious steps into healthcare with offerings for everything from primary care to ambulatory clinics to new, consumer-focused insurance plans. Article
The Next Act for Provider Sponsored Health Plans Several health systems launched or ramped up their PSHPs after the Affordable Care Act was passed in 2010, taking advantage of growth in key market segments and providing an additional revenue source while supporting their community-centered missions. Article
Preparing for Risk-Based Contracting and Value-Based Healthcare: Challenges and Opportunities In a roundtable discussion, Kaufman Hall Managing Directors Matthew Bates and Nora Kelly and Senior Vice President Max Timm discuss the rise of risk-based contracting in value-based healthcare arrangements, what providers and insurers need to watch out for, and what success in risk-based contracting will look like. Article
Building Strong Consumer Relationships in the Value-Based Care Era: A New Approach Organizations that pursue consumer strategies and value-based approaches together will be much more likely to achieve their goals while increasing their ability to effectively compete against new industry entrants. Research Report
Operationalizing Value-Based Primary Care: Lessons from the Field For more than a decade, hospitals, payers, and other healthcare stakeholders have experimented with moving healthcare payment from fee-for-service, volume-based contracts to arrangements that reward providers for the value of the care they provide. Article