Posted by on in Payers, Providers

In our last post we introduced two potential scenarios. “Provider bastions” in which buyers of health care services select upfront the network that they will trust to deliver their care in a coordinated manner.  “Value-based deconstruction” in which buyers of healthcare choose the site-of-service for every interaction with the delivery system based on incentives built on micro level information about value – outcomes and cost.  Obviously there are factors unique to firms that will have a tremendous impact on optimal strategic choices for them. All we do here is raise some key strategic implications at a high… Read More

Posted by on in Payers, Providers

It seems like every day there’s some news outlining strategic actions that various players are taking or other developments with respect to health reform. Here’s a sample of recent news: Employer adopts a tightly limited provider network  Customers sign on to private exchange Hospital chain grows through acquisition Insurers boycott state exchange Health systems drop out of ACOs Payer collaborates with provider systems to target Medicaid population All of these represent choices or “bets” that firms are making based on a view of a healthcare world facing… Read More

Posted by on in Payers

In 2011 we commented that while the health reform law, the ACA, had several positive intended consequences, it also could spawn several perverse effects and side-effects. Now in an attempt to ward off some of those unintended consequences, the administration has delayed the employer mandate from 2014 to 2015. Reactions range from praise (from the unlikely alliance of Democrats and business groups), derision (from Republicans and right leaning think tanks) and bemusement or befuddlement (across the spectrum). Of course, perturbing a portion of a complex system has ripple effects of its own. Here’s one that we’re… Read More