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 payerprovider.com/payer-transformation-survey.
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 payerprovider.com.
Press Contact
Adam Powell, Ph.D.
President
Payer+Provider Syndicate
powell@payerprovider.com
(617) 939-9168
8 Garrison St. Ste. 101
Boston, MA 02116
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Payer+Provider in the News – September 2012
BOSTON– October 16, 2012: During August and September 2012, Payer+Provider Syndicate spent a lot of time thinking about Accountable Care Organizations, hospital mergers, and wellness initiatives. The transition to provider risk-bearing has caused hospitals to consider merging and to seek to better understand the drivers of their financial and medical performance. Dr. Adam Powell spoke with reporters to discuss Steward Health Care’s plan to buy Mercy Hospital and Prime Healthcare’s plan to buy Lower Bucks Hospital. The first article appeared within the online and print editions of the Healthcare Finance News newsletter, while the second was syndicated to NBC News. Dr. Powell subsequently spoke to healthcare leaders at the Massachusetts Health Data Consortium about how analytics can be used to improve performance within ACOs. As was summarized by SearchHealthIT, the talk stated that ACOs will be able to gain a competitive advantage by having a better understanding of cost accounting and by improving the performance of factors driving health outcomes. As improving wellness is one of the key ways in which ACOs can reduce their costs, Dr. Powell provided insights into a series of articles quantifying the impact of wellness interventions published by dailyRx. The articles discussed the financial impact of interventions related to smoking, weight loss, dialysis, substance abuse treatment, and chronic pain management. dailyRx also wrote an article highlighting Payer+Provider’s findings on the negative impact of provider fatigue on claim quality.
Other Payer+Provider experts have recently been featured in the news as well. Dr. Michael Housman spoke on NPR’s Marketplace about how analytics can be applied to workforce decisions. Meanwhile, Dr. Ashwin Patel was featured in an article describing how hospitals have been working to forge closer relationships with women in the wake of healthcare reform. As Payer+Provider Syndicate is a recognized leader in assessing healthcare markets and the return on investment (ROI) of wellness interventions, numerous media outlets have relied upon Payer+Provider’s opinions when substantiating their articles.
The Business of Healthcare Innovation is Available
The 2nd Edition of The Business of Healthcare Innovation, edited by Lawton Robert Burns, is now available in print. The book provides an overview of the innovative sectors fueling improvements in healthcare: pharmaceuticals, biotechnology, platform technology, medical devices and information technology. As the President of Payer+Provider Syndicate, Adam C. Powell, Ph.D. contributed a chapter on health information technology to the book, complementary copies were delivered to Payer+Provider Syndicate headquarters.
While witnessing the arrival of a textbook may not be as exciting as unboxing a new iPad, this was no ordinary book delivery. As The Business of Healthcare Innovation is published by Cambridge University Press, our copies were sent straight from England.
This large sack arrived at the doorstep of Payer+Provider headquarters, and we must admit it seemed a bit creepy at first. It’s not every day that the postman drops off a plasticized burlap sack from the Swiss Post.
Upon seeing that the sack contained printed matter, we were relieved, as we realized what had arrived.
It turns out that the large burlap sack contained a small box.
At last, Dr. Adam Powell got to see his chapter on health IT in print!
Want to save 20% on The Business of Healthcare Innovation and have a large burlap sack sent from Europe to your door? Health System Review is offering a coupon for a limited time to enable you to do just that. To get it, click here.
Payer+Provider in the News – July 2012
BOSTON– August 15, 2012: July 2012 was a great media month for Payer+Provider Syndicate. The month began with an article in Becker’s ASC Review by Taryn Tawoda in which Adam C. Powell, Ph.D. was interviewed about means for reducing patient no-shows and non-compliance in surgery centers. A week later, Steff Deschenes of Healthcare Finance News interviewed Dr. Powell about the ways that telemedicine is reducing the cost of healthcare. The article got a lot of attention and was featured on mHIMSS, Healthcare IT News, and a number of blogs. Later, Kathleen Roney of Becker’s Hospital Review featured Dr. Powell in an article on managing cultural change following a hospital merger or acquisition. The month concluded with William Hudson of CNN quoting Dr. Powell in an article on health insurance rebates.
David McLain, Ph.D. joins Payer+Provider Syndicate
Dr. David McLain
BOSTON– August 8, 2012: David L. McLain, Ph.D. has joined Payer+Provider Syndicate’s panel of experts. Dr. McLain has expertise in project modeling and measurement, healthcare strategy, and decision making. Dr. McLain is an Assistant Professor of Management and Marketing at the State University of New York, and has over two decades of experience in science, engineering, and research.
