HealthLeaders Media April 30, 2024
Marie DeFreitas

Four trends are shaping the payer landscape in 2024.

Governmental payers outweigh commercial payers: With the immense growth of government-funded programs like Medicare and Medicaid, hospitals and health systems have become too reliant on these systems. Medicaid fee-for-service physician payments are about 30% lower than Medicare payments, and commercial payments are even lower than that. Medicaid expansion has been booming lately and the program now has even more enrollees than Medicare programs.

Size & Negotiation Power: Often, a payer business is about ten times the size of its health system. Providers are fed up with the lack of negotiation power when they’re contracting with these insurance giants. When payers hold the majority of negotiation power in contracts providers’ reimbursement...

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Topics: Insurance, Payer, Survey / Study, Trends
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