At this year's CEO Special Sessions, our research team presented characteristics of a retail health insurance market, and strategies for securing smart partnerships and building a cost-effective clinical workforce.
Here are the nine most important takeaways from our research this year. You can also revisit our eight insights from last year's meeting on carving a new growth strategy and becoming a successful population health manager.
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1. The health insurance market is becoming more like a retail market every day
Individuals have more control over their health insurance than ever before—and they want lower premiums and more attractive provider networks.
2. Providers must compete at two points of sale
Securing enrolled lives isn't just about being in-network. You'll have to offer low prices, high quality, and convenient access to get chosen in the insurance market and at the point of care.
3. Keep costs low without skimping on population health
In the short term, low unit prices will be a big decision factor at both points of sale. But in the long term, effectively managing population health will be crucial.
4. Hospital partnerships aren’t just about pricing leverage or capital
Partnerships can unify provider approaches and incentives across entire populations, not to mention distributing the burden of expensive care transformation investments.
5. Provider integration is more important than the legal structure of a partnership
A well-executed merger, acquisition, or partnership can be powerful, but only if strategies, cultures, and operations are actually integrated in a thoughtful, goal-focused way.
6. The physician shortage is not a foregone conclusion
Physician shortage projections are based on outdated estimates of physician supply and demand. New care models and technologies are improving physician efficiency, while population health efforts are reducing demand.
7. Hospitals can’t continue to rely on current clinical network strategy
The goal isn't just to amass the most physicians in a market, but to build a cost-effective clinical network.
8. The clinical network of the future must deliver three distinct products
When deploying the clinical workforce of the future, you need to design for three distinct clinical products, each with a different provider staffing model.
9. We’re approaching the end of the generalist PCP model
The industry is moving toward a more customized, consumer-centric version of primary care access, and the standard one-size-fits-all PCP office model won't suffice.
Regionalization and Networks