24. Healthcare Trends And Their Impact On Health Plan Finances and Economics

Marc concludes his podcasts on health plan economics with a look at major healthcare trends and their impact on health plan economics and finance.

About The Podcast:

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.

Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.

Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.

Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through the Healthcare Labyrinth website and his book of the same name.

Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.

Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.

About The Episode:

On this episode, Marc looks at various trends in healthcare impacting health plans.  He discusses their impact on health plan finances and economics. There are numerous trends, including enrollment, rates, utilization, inflation, quality, regulations, price transparency, antitrust scrutiny, and drug price reforms.

Key Takeaways:  

Enrollment is surging in Medicare Advantage and the Exchanges but falling in Medicaid.

Rate hikes are problematic in Medicare Advantage, but healthier for now in Medicaid.

The entire health plan world is being challenged by higher utilization and inflation.

Quality ratings are challenging in Medicare Advantage, which impacts revenue. Medicaid will begin to see a rigorous quality regime as well.

Major regulatory mandates will challenge health plans and add to administrative costs.

Price transparency should help bring down and rationalize prices over time.  It, too, will help on bringing site-neutral payments to the fore.

The Biden Administration’s antitrust scrutiny will slow major consolidations on the payer and provider front.  This is a good thing.

Drug price reforms hold great promise for reducing spending.

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