State of the Industry 2014

October 1, 2013

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.