Are you equipped for a new era in collaboration and cost control?
Medicare and Medicaid are expanding and exchanges are brand-new. All three models mean your growth opportunities are funded by the public sector—and more of the rules that accompany that funding. Risk selection, plan design and actuarial calculus may not be the focal points of profit anymore. Instead, plans will need to do a better job of improving quality, engaging customers and controlling costs by reinventing relationships with providers and guiding individual members to make better health care choices.
Plans may also diversify to help members with wellness and prevention, help providers with population management, or move into new markets.
What’s your plan to expand and remain profitable as you grow in government-funded programs? Do you have the tools to support the change as you head into new territory?
See Thinking forward for more insights on this issue.