Commercial · Medicare · Medicaid · Specialty
Strategy for
Payers.
We work with payers serving Commercial, Medicare, and Medicaid populations on their hardest strategic questions. These have included questions relating to employer and member segmentation, provider vertical integration, provider risk-sharing, geographic expansion, network strategy, population health and member engagement, diversification, and innovation.
FEATURED insights
- Biopharma ,
- Payers ,
- Institutional
Outcomes Based Arrangements in Biopharma
Today’s advanced therapies target devastating diseases with high unmet need. Given the urgent medical need (and pressure from patient advocates), regulators increasingly must make decisions based on early, incomplete data when it comes to durability, real-world effectiveness, and cost-effectiveness – all while bearing costs that can exceed $1 million per patient.
Policymakers globally are grappling with how health systems should manage a combination of high upfront costs and uncertain long-term value.
— Recon analysis
Why the Best AI Won’t Win in Healthcare
- By Nikhil Bhojwani
- Biopharma ,
- Payers ,
- Providers ,
- Medtech ,
- Digital
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Outcomes Based Arrangements in Biopharma
- By Lilian Zhang, Tory Wolff, and Jason Brauner
- Biopharma ,
- Payers ,
- Institutional
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AJMC: More frequent visits to primary care can save net $30-40 PMPM for top 20% highest risk commercial members
- By Jacob Wiesenthal and Tory Wolff
- Payers ,
- Providers
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featured CASE STUDIES
How we've helped our payer clients
Representative engagements, anonymized. Each pairs deep sector knowledge with rigorous, structured analysis.
- Payers, Providers
Medicare Advantage channel strategy
A personal care platform faced a payer market that was growing fast but buying in two incompatible ways and needed to know which model to build its sales approach around.
Payer partnership economics
- Payers
Payer employer segment growth strategy
A state-wide health plan was losing the mid-size employer market and needed to find the employer segments where it could develop a real edge and a strategy to convert into share.
Employer buyer segmentation and targeting
- Medtech, Early Stage
Molecular diagnostics growth strategy
A molecular diagnostics developer had more new-test opportunities than it could fund and no shared view of which it was equipped to win or whether the economics could work.
New test portfolio prioritization