UnitedHealthcare on the Forefront of Changing the Paradigm

“Do you have the guts to break through where others don’t or won’t?” These are the words of UnitedHealthcare’s CEO on their mission to improve healthcare delivery in the United States. As this blog continuously chronicles, the system is fraught with deficiencies and opportunities for substantive improvement. Medical care has become too expensive. Delivery is… [Read More]

Back to the Future of Healthcare

Today I listened to Cigna leadership discuss how they are responding to marketplace dynamics and I realized that this change is as cataclysmic as the HMO revolution was in the late 1980s. During that era, the number of insurance companies dwindled down to just a handful and the indemnity market went into a tailspin. Flash… [Read More]

Insurers, Providers and Employers on a Collision Course 

Insurers, Providers and Employers on a Collision Course 

Trying to control healthcare costs is like trying to pick up Jell-O pudding with a pair of chop sticks. It is virtually impossible. The employer-based healthcare system relies on their intermediaries – primarily the large national insurers – to negotiate discounts, provide claims-paying acumen, fraud oversight and clinical expertise, among other things, in the administration of… [Read More]

Decoding Network Disruption

Decoding Network Disruption

One of the most critical factors an employer considers when deciding to change medical (or dental) carriers is network disruption. And rightfully so. Improvement or deterioration in the network penetration rate can have a profound impact on the underpinnings of the program. First and foremost, members will be influenced by any change in network coverage…. [Read More]

And You Thought There Was Nothing New in Healthcare? Shifting from “Volume” to “Value”

And You Thought There Was Nothing New in Healthcare

High deductible plans are running their course. Wellness, while useful, isn’t delivering immediate savings. Many of our clients are wondering what “the next big thing” is in healthcare delivery. Alongside the rising trend of healthcare consumerism, Accountable Care Organizations and the buzz of private exchanges stormed into the healthcare delivery conversation. We’re now starting to… [Read More]

Future is Now: Healthcare Delivery Systems

Future is Now Healthcare Delivery Systems

Two years ago I was out to lunch with a well-regarded industry colleague and I asked him his thoughts on the next cost mitigation “silver bullet” for employers who had already adopted high deductible plans. His answer was provider-directed initiatives like bundled payments and value-based contracting. That future is now here and innovators in the… [Read More]