Oliver Wyman March 31, 2023
Kevin Deutsch

Health plans need to define success if they are going to thrive in burgeoning government markets.

As enrollment rates decline in the large-group market and premiums rise for employers and employees alike, health plans are focusing their attention on government-sponsored markets. Ongoing and upcoming policy changes allow for continuous growth in the Affordable Care Act, Medicaid, and Medicare Advantage markets. To capitalize on the significant gains in stability and profitability, health plans must first understand what success looks like in government-sponsored markets.

Thriving in government markets was the focus of a recent Softheon Executive Advisory Council, an invitation-only think tank of senior executives from national and regional health plans. During the...

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Topics: ACA (Affordable Care Act), Insurance, Medicaid, Medicare, Medicare Advantage, Payer
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