US Health Insurance Growth Opportunities
The United States is the world’s largest healthcare market, spending over 18% of its GDP on healthcare. Therefore, it is important for healthcare stakeholders to understand how the US healthcare market functions, primarily its insurance system. The US health insurance landscape has seen significant evolution through various legislations, ranging from the 1940s laws that established the Centers for Medicare and Medicaid Services (CMS) to the Affordable Care Act of 2010. More importantly, the insurance landscape has not been immune to the far-reaching impacts of the COVID-19 pandemic on how the payer community will operate in the future. The US healthcare landscape continues to evolve, leading to the growth of telehealth, virtual care, and home care models. These changes not only affect care delivery and reimbursement models in the United States, but also bring new opportunities for various stakeholders, including payers, home health agencies, and medtech companies. This study provides an overview of the US healthcare payer landscape and the emerging trends impacting this space, resulting in a slew of opportunities for growth in this evolving landscape.
- Strategic Imperatives
- Why Is It Increasingly Difficult to Grow?
- The Strategic Imperative 8™
- The Impact of the Top Three Strategic Imperatives on the US Health Insurance Industry
- Growth Opportunities Fuel the Growth Pipeline Engine™
- US Payer Ecosystem Overview
- US Healthcare Payer Authority
- 2022 Payer Ecosystem
- Important Regulations for US Healthcare Payers
- Medicaid Expansion (ACA)
- Growth Drivers
- Growth Restraints
- Overview of Medicare
- Medicare
- Standard Medicare vs Medicare Advantage (Medicare Part C)— 2022
- Medicare-Medicaid (Medi-Medi) Beneficiaries
- Overview of Medicaid
- Medicaid Overview
- Medicaid Coverage
- Medicaid for Long-Term Care
- Overview of Commercial Health Insurance
- Commercial Health Insurance
- Trends Impacting Payers
- Broad Trends and Technology Initiatives by Payers
- Growth Opportunity Universe
- Growth Opportunity 1—New Era of Portable and Smaller Medical Devices to Address Hospital at Home Demand
- Growth Opportunity 2—Home Health Agency Business to Evolve Patient Mix and Reimbursement in Response to Virtual Care Growth and PDGM
- Growth Opportunity 3—Hospital at Home a Major Growth Avenue for Care at Home Services, Payers, Healthcare Facilities, and Physician Groups
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