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Health Plans

New strategies for a new business model.

Complying with the Affordable Care Act mandates is only one of the reasons health plans need to rethink, retool and realign. Reform has far-reaching effects, such as the decline of fee-for-service care and an upsurge in the government’s role as a payor. Other forces include the new consumerism and the reign of analytics. And members will likely seek affordability more than before.

Health plans face more than an adjustment. They are playing a new role in helping new populations get new kinds of care in new ways. Instead of just changing practices, they may have to embrace new value propositions. Does this mean doing business differently? More like embarking on a different business entirely. Which of the capabilities you’ve already built will remain vital? What new ones will you have to develop? There’s hard work ahead, but also opportunity.

More Thinking forward

  • Retail reigns in health care: The rise of consumer power and its organization & workforce implications
    Is your organization and workforce ready to meet the demands of “retail health care”? Deloitte’s health plans paper discusses the emerging trends of the health care retail environment and how to align your organization and workforce to excel in this new market.
  • [VIDEO] The future of health care. It’s in your hands
    Discover a future where technology streamlines the health care experience for consumers, practitioners, hospitals, pharmacies and other stakeholders, by placing pertinent health data at their fingertips in real time.
  • Young adults and health insurance: Not invincible — but perhaps convincible
    Looking ahead to the next open enrollment season, how can health plans and government agencies entice young people to participate? According to Deloitte’s 2014 Survey of Young Adults and Health Insurance, the answer may lie in information, affordability, and value.
  • Good for what ails us: The disruptive rise of value-based care
    The health care industry is ripe for disruptive innovation as systemic challenges continue to face the industry and stakeholders demand increased value. Health care stakeholders will need to change traditional delivery and payment models or risk survival.
  • Infographic: No time to slow down: Looking ahead to 2015 HIX open enrollment
    The 2014 HIX open enrollment season is now over, and the first round of results are in. Initial estimates as of April 19, 2014, suggest that more than 8 million individuals are now enrolled in health insurance coverage through the federally-facilitated or state-based HIXs. What’s behind the numbers? And what uncertainties could the industry face as stakeholders begin placing bets for 2015 HIX open enrollment and beyond?

Transforming the health care industry

Government Programs
Growth and Scale
Retail Consumerism

Risk and Compliance
Value-based Care

Leading the way

Bill Copeland, Vice Chairman, U.S. Life Sciences & Health Care Leader, U.S. Health Plans Leader, Deloitte LLP
Greg Scott, Principal, Deloitte Consulting LLP
Ken Weixel, U.S. Managing Partner, Health Sciences, Deloitte & Touche LLP

Peter J. Micca, Partner, National Health Plans Industry Leader, Deloitte & Touche LLP


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Watch, listen and learn

  • Deloitte at AHIP’s 2014 Operations & Technology Forum
    Register to attend the live session
    November 19, 2014 | 11:00 a.m. - 11:45 a.m.
  • Life sciences and health care deal activity: Is M&A here to stay?
    Register for the November 11 webcast.
  • Live from the Center: Are you prepared for 2015 HIX open enrollment?
    View the archived webcast.
  • Health Care Current
    A weekly newsletter to keep you informed and ahead.
  • A view from the Center
    Read the Center for Health Solutions blog.
  • In the News: Deloitte Health
    Straight from the headlines.

Dig deeper

  • ConvergeHEALTH by Deloitte
    Learn more.
  • 2014 U.S. Health Plans Outlook
    Challenges, trends and strategies that may shape your business.
  • Preparing analytics for a strategic role
    Read the data and analytics case study by MITSloan Management Review.
  • Deloitte health: Resources, reform, results
    A library of resources.
  • Deloitte Center for Health Solutions
    Health care insights start with research.
  • Health insurance exchanges
    Explore the potential opportunities and implications.
  • Health care consumerism
    Consumer attitudes, behaviors and unmet needs.

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