Healthcare Definitions

Top 4 Consumer Wellness Benefits for Payers to Add to Health Plans

by Thomas Beaton

As payers explore innovative ways to improve beneficiary engagement and satisfaction, they may wish to consider adding enhanced consumer wellness benefits to their health plan offerings. Health plans...

Why the Generic Drug Market is a Growing Payer Opportunity

by Thomas Beaton

As payers try to ease the rising costs of prescription drugs, which account for 10 percent of national healthcare spending, they may wish to turn to the generic drug market to help curb unnecessary...

How the Medicare Advantage Market Can Offer Payer Opportunities

by Thomas Beaton

Medicare Advantage (MA) market data from A.M Best and the Kaiser Family Foundation reveals that the MA market has remained profitable and provides financial opportunity, but payers looking to enter...

Payer Strategies for Boosting Consumer Engagement, Satisfaction

by Thomas Beaton

In an increasingly competitive health insurance environment, payers that can successfully increase consumer engagement and beneficiary satisfaction will be best positioned for success. David Biel, the...

Top Commercial Payers Offering Medigap, MA, and Medicaid Plans

by Thomas Beaton

The top payers with the highest enrollment numbers for Medigap, Medicaid, and Medicare Advantage (MA) are a unique mix of some of the largest commercial payers as well as smaller to mid-size insurers,...

How to Create Balanced Risk Pools that Lower Premiums

by Thomas Beaton

Payers have been increasingly challenged to manage the high cost of healthcare while lowering the premiums their beneficiaries pay.  Creating balanced risk pools that benefit medically complex...

Beneficiary Segmentation, Spending by Healthcare Payer Type

by Thomas Beaton

Healthcare spending in the US continues to grow steadily across all beneficiary segments and healthcare payers. 2015 data from CMS, the CDC, and the Kaiser Family Foundation (KFF) indicates that...

Payer Pricing, Partnership Strategies for Population Health

by Thomas Beaton

Effective population health management and comprehensive preventive care open the door to new opportunities that maximize payer spending, raise care quality, and slow the progression of costly chronic...

Top 10 Healthcare Spending Categories in the United States

by Thomas Beaton

The upward trajectory of US healthcare spending doesn’t seem to be slowing down anytime soon, leaving payers, providers, and beneficiaries wondering how to control costs while maintaining a high...

How Pharmacy Benefit Managers Lower Prescription Drug Prices

by Thomas Beaton

Payers in both the private and public sectors require new strategies that offset the rising cost of prescription drugs. Pharmacy benefit managers (PBMs) are professionals that administer prescription...

How Preventive Healthcare Services Reduce Spending for Payers

by Thomas Beaton

Reducing healthcare spending is a multi-faceted challenge for payers that requires creative and innovative strategies like offering a wide range of preventive healthcare services in health...

How Can Health Savings Accounts Help, Hinder Patients and Payers?

by Thomas Beaton

Health savings accounts (HSAs) have been widely discussed as lawmakers consider policy reforms, at the federal level, and have become a fixture in conversations about healthcare spending among payers...

What to Look for in Health Insurance Enrollment Technology

by Thomas Beaton

Health insurance enrollment technology is designed to offer payers convenience, cost savings, and administrative ease-of-mind when it comes managing beneficiaries enrolled in health plans. Many...