Healthcare Reform

Healthcare reform is bringing major changes to the U.S. healthcare system. Care will be delivered and paid for in new and disruptive ways. Growth opportunities will shift to new segments and value chain components. White space opportunities will become increasingly important. Health plans that anticipate and proactively prepare for the post-reform marketplace will have a strategic advantage over other plans that wait to respond.

Specifically, Oliver Wyman believes health plans’ success in a post-reform world hinges on:

• Scenario planning to develop options for how to compete in the post-reform market with consideration for the most viable pathways and key strategic hedge positions
• Strategic realignment across the organization with a focus on the value proposition and competencies that will drive success
• Transition management to bring the organization through a significant transformation while maintaining legal and regulatory compliance, key stakeholder relations, and market share

 

Specific examples of our healthcare reform work include:

• Created reform strategies for multiple health plans (including local, regional and national) that included: Comprehensive analysis of reform impact on existing business; business segment portfolio analysis, operating profit analysis, and long-term scenario planning; short-term and long-term strategy prioritization for product, pricing, and distribution strategy, as well as for health management imperatives
• Conducted detailed analysis of the impact of reform on membership, risk, and cost summarized in public report for major payer association
• Shaped legislation through our participation in multiple meetings on the Hill with key decision makers and influencers