US Health Insurance Growth Opportunities

US Health Insurance Growth Opportunities

Transitional Care Delivery Models and Payer Policies Redefining Stakeholders’ Future Growth Strategies

RELEASE DATE
25-Apr-2022
REGION
North America
Research Code: K779-01-00-00-00
SKU: HC03535-NA-MT_26473
$2,450.00
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Description

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.

Author: Siddharth Shah

Table of Contents

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 Healthcare Payer Authority

2022 Payer Ecosystem

Important Regulations for US Healthcare Payers

Important Regulations for US Healthcare Payers (continued)

Medicaid Expansion (ACA)

Growth Drivers

Growth Restraints

Medicare

Standard Medicare vs Medicare Advantage (Medicare Part C)—2022

Medicare-Medicaid (Medi-Medi) Beneficiaries

Medicaid Overview

Medicaid Coverage

Medicaid for Long-Term Care

Commercial Health Insurance

Broad Trends and Technology Initiatives by Payers

Growth Opportunity 1—New Era of Portable and Smaller Medical Devices to Address Hospital at Home Demand

Growth Opportunity 1—New Era of Portable and Smaller Medical Devices to Address Hospital at Home Demand (continued)

Growth Opportunity 2—Home Health Agency Business to Evolve Patient Mix and Reimbursement in Response to Virtual Care Growth and PDGM

Growth Opportunity 2—Home Health Agency Business to Evolve Patient Mix and Reimbursement in Response to Virtual Care Growth and PDGM (continued)

Growth Opportunity 3—Hospital at Home a Major Growth Avenue for Care at Home Services, Payers, Healthcare Facilities, and Physician Groups

Growth Opportunity 3—Hospital at Home a Major Growth Avenue for Care at Home Services, Payers, Healthcare Facilities, and Physician Groups (continued)

List of Exhibits

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Related Research
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. Author: Siddharth Shah
More Information
Author Siddharth Shah
Industries Healthcare
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Is Prebook No
Podcast No
WIP Number K779-01-00-00-00