The evolving healthcare landscape has created a wealth of fresh opportunities for payers. There is a sense of urgency for payers in leadership roles to leverage technology and successfully transition to a value-driven healthcare system that rewards top performers and high quality standards. Passage of the Patient Protection and Affordable Care Act (PPACA) quickly changed many aspects of payers' business with higher costs, new oversight, more competition and a longer-term promise of millions of new members. Since healthcare insurance reform became law, opponents have vowed changes, if not its outright repeal. While it may be tempting to take as little action as possible and hope that the 2010 mid-term election or 2012 general election will make this all go away, the reality is that repeal is not a likely possibility.
Learn how to maximize efficiencies through greater system integration and automation, enable seamless interactions with providers, members and other constituents, and drive increased healthcare value with automated, value-based programs.
Healthcare reform regulations, increasing costs, and more competition are driving employers and their health plans to focus more than ever on opportunities to reduce cost trends. For example, the country experienced a 3.0% growth in per capita gross (allowed) medical and pharmacy costs from 2012 to 2013. Truven Health Analytics anticipates those costs in 2014 and 2015 will increase by 4% to 5% or more. By taking a data-driven approach, payers can manage costs and, ultimately, make their benefit programs sustainable in the context of healthcare reform. They can also maximize opportunities to improve population health and productivity and optimize the delivery of care.