Payer Transformation Survey finds that 87% believe health insurers must transform to survive

BOSTON, Massachusetts–October 25, 2012– Payer+Provider Syndicate, the consulting firm which brings health services research into practice, today released findings from its comprehensive Payer Transformation Survey. The survey found that 87% of the health insurance employees surveyed believe that the industry must undergo a transformation in its business model to survive. To assess the degree to which transformation is taking place, the survey also examined the industry’s self-perceived degree of preparedness for reform.

The health insurance company employees surveyed expressed concern that payers are least prepared to understand how their members select products on the individual market. As health insurance exchanges are created in response to the Affordable Care Act, health insurers will increasingly have to sell their products directly to consumers, rather than to employers. Insurers are racing to understand consumer buying preferences, as health insurance exchanges will become nationally available at the beginning of 2014.

“Health insurers are currently pursuing a number of initiatives that all revolve around making their products more consumer-centric. Namely, they are focusing on increasing the value of their plans by both improving member outcomes and reducing costs,” said Adam Powell, Ph.D., President of Payer+Provider Syndicate. “Many of the insurers we contacted have invested substantial resources in developing Accountable Care Organizations, Patient-Center Medical Homes, and in using data to gain insights into how to take better care of members. Going forward, one major challenge that insurers face is determining which tools have the greatest impact on member outcomes. As the desire to bend the cost trend and improve population management is clear, an army of vendors have developed potential solutions. Our survey found that the majority of insurers are using external resources to engage members in managing their health risk.”

The survey behind these findings was developed by Payer+Provider Syndicate, in conjunction with the Physician Performance Improvement Institute. Payer employees were interviewed in August and September 2012, and then a closed online survey was conducted in September and October. A white paper summarizing the survey’s findings is available online at

About Payer+Provider Syndicate
Payer+Provider Syndicate provides market analysis, independent vendor evaluation, and performance improvement strategy to the health insurance and hospital industries. Founded by a Wharton-trained healthcare economist, Payer+Provider Syndicate utilizes teams of health services researchers and physicians to address healthcare’s most complex operational challenges. For more information, please visit

Press Contact
Adam Powell, Ph.D.
Payer+Provider Syndicate
(617) 939-9168

8 Garrison St. Ste. 101
Boston, MA 02116


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