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.
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.
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.
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.”...
Healthcare’s Post-Growth Reset
While leaders are “keeping the lights on,” where will growth come from? For much of the last decade, rapid revenue growth was the predominant business imperative in the healthcare...
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.
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.
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.
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.
Payer-Provider Economics: Preparing for the New Frontier
Payers and providers are increasingly creating strategic partnerships, with the intent of keeping pace in a rapidly transforming healthcare payment system that rewards value over volume...