Payers Need to Rethink Modern Business Model – And Focus on Impactful Transformation
Health plans have pursued number of different strategies to achieve the growth rates embedded in their equity valuations. Recently, these strategies have focused on various forms of vertical integration, capabilities enabling value-based care, significant shifts to home care (from acute hospital settings) and riding a wave of government-financed insurance segment growth. Several health plans assert that such investments will permit them to manage care costs more efficiently, enhance member experience, and improve outcomes
Have such integrations produced the desired results? Are these integrations built to sustain upcoming regulatory changes? With nearly all major publicly traded health plan equities down 15-20% YTD (while the broader markets are up by similar percentages) investors are struggling to understand from where the returns on some extraordinarily expensive acquisitions emanate. Post-merger integrations are notoriously difficult. Beyond the basic synergies which are often linked to business process and technical integrations, along with an ability to streamline data and operations, reside the more complex issues of culture and retaining key talent. Our speakers will discuss these challenges and argue why a return to managing core businesses while adapting to a number of major changes in government-funded business segments, may be the strategic path forward.
Key Takeaways / Learnings:
- Healthcare payer strategies and impact of recent business models
- Payer performance and lens of government business (current and future)
- Adapting to changing Medicare Advantage regulations
- Effective transformation and diversification strategies across health plans and providers
Speakers
