National health insurers seem to be about twice as likely as other types of carriers to move beyond the traditional health insurance market, according to consultants at Boston Consulting Group Inc. (BCG).
The consultants have included data on health payers’ response to the Patient Protection and Affordable Care Act of 2010 (PPACA) in an analysis of how PPACA might change the insurance landscape.
Payers are looking at ways to cut costs, experiment with new provider reimbursement strategies and come up new ways to appeal to consumers, who may end up having much more responsibility for choosing their carriers, the consultants say.
The consultants also looked at how payers are trying to diversify revenue streams.
“Integrated models,” such as traditional health maintenance organizations, are already designed to fit into the world of PPACA, and they are planning few efforts to diversify, the BCG consultants found.
About a quarter of all other payers are trying to add new products and services, about 5% to 10% are trying to expand to new regions, and about 15% to 26% are trying to diversify beyond health insurance.
National health insurers were an outlier when it came to asking about efforts to diversify beyond health insurance: About 57% of the national health insurers are crossing outside the core health insurance market. The national health insurers’ have the capital to take on big new projects, and even to do business outside the United States, the consultants say.
When the consultants asked about efforts to expand to new regions, focused-segment plans – plans that cater to Medicaid enrollees, Medicare enrollees or individuals and families – were much more likely than other carriers to raise their hands. About 33% of the focused-segment plans said they have an interest in expanding to new regions.
- Allison Bell