Payers filed their ACA 2018 rates this week. Learn what happened, what it all means, and what comes next.
Understanding clinical variation is key to identifying inappropriate care; addressing inappropriate care is key to reducing costs and improving quality.
And we’re off! For those insurers who are still offering ACA plans, Oliver Wyman has developed a special series to help them optimize their performance in this complex market.
Insights into how Blue plans can navigate current market pressures and chart a successful path forward.
The results of a study of enrollees under the Affordable Care Act have potentially far-reaching implications for the Blues.
This is not your 2015 exclusive provider contracting. In 2016, these arrangements move beyond traditional narrow networks to deliver meaningful value-based components and differentiated consumer experiences.
The first two years of the exchanges have proven to be as disruptive as industry analysts predicted; yet disruption also provides a pathway to innovation.
The number of chronically ill and poor patients is growing as more people at the margins are receiving insurance coverage through Medicaid. Oliver Wyman research that suggests proper care for these patients, including meeting social needs such as mental illness, addiction, and poverty, could save $300 billion annually.
The Centers for Medicare & Medicaid Services (CMS) proposed last month a new set of rules for Managed Medicaid with the intent to alleviate some of the coverage and access challenges that face the States and their Medicaid populations, as well as align Managed Medicaid to Medicare Advantage and market standards.
Medicaid enrollment across the United States currently encompasses ~50M individuals, of which ~40M are enrolled in some form of Managed Medicaid. The covered population is expected to continue to grow, driven by factors such as Medicaid expansion, population growth, and economic challenges in select States.