State of the Industry 2014
Managed care organizations will be remiss if they don’t seriously consider the evolving competitive landscape.
Clearly 2014 will be the pivotal year in health reform. While designing plan products and pricing them correctly was a huge task in 2013, measuring the market response to rates and benefits will be just as much of a challenge throughout 2014.
And leading managed care organizations will be remiss if they don’t seriously consider the evolving competitive landscape. Unique payer/provider partnerships have created new health plans, and Consumer Oriented and Operated Plans (CO-OPs) are actively signing up members. Each market will emerge from 2014 with a distinctly different health reform story to tell.
Ever since the Patient Protection and Affordable Care Act (PPACA) was signed into law, observers from all corners of the country have made predictions on everything from the ultimate cost of reform to the percentage of the uninsured. There’s a mix of optimism and pessimism. What’s striking though is the opportunity to compare their predictions to reality.
A few weeks ago, Managed Healthcare Executive polled readers on their forecast for 2014 and beyond. Nearly 350 readers responded.
This is the sixth year of our survey, and it’s interesting to take a look back.
For example, 26 states are currently opting out of Medicaid expansion. In last year’s survey, 27% of respondents correctly predicted a range of 21 to 30 states opting out. Yet, more readers (31%) predicted just 11 to 20 states would opt out-quite a bit lower than the actual total. But states can change their minds and expand Medicaid at a later date, so there’s more to come on this issue.
Also in last year’s survey, the majority of respondents (78%) predicted state exchanges would not be ready in time for the October 2013 launch and that implementation would be delayed. The administration did indeed carry on with exchanges, even those operated by the federal government.
Soon, we’ll have the initial findings of health reform’s impact on the country, but until then, we’ll continue to predict and analyze based on the information we do have available.
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
ICER Identifies 5 Drugs with Unsupported Price Increases
December 12th 2024The Institute for Clinical and Economic Review has identified five drugs — Biktarvy, Darzalex, Entresto, Cabometyx, and Xeljanz — with prices increases that are not supported by new clinical evidence, with a total of $815 million in added costs to U.S. payers in 2023.
Read More
In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers.
Listen
