Health plan strategy

Health plans must meet growing purchaser and consumer expectations and address the accompanying challenges. Our research team works with plans of all sizes and types to provide the strategic insight and market intelligence that equips health plan executives to make smart decisions and position their organizations for future success.

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Listen to Advisory Board experts discuss the escalating tensions between health plans and providers — and what to do about it

The relationship between health plans and providers has always included an element of friction, but lately, it seems like the temperature is rising. Host Abby Burns and experts Max Hakanson and Eileen Fennell discuss what each stakeholder says they need to see from their partners in order to mend the relationship.

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Learn 5 care navigation strategies to help employers cut healthcare costs

Four new factors are dramatically increasing employer-sponsored insurance costs. We dissect these for you and offer five care navigation strategies to rein in healthcare spend and a picklist to decide which make the most sense for your organization.

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Market outlooks by health plan line of business

We’ve put together the top trends and growth outlooks for employer-sponsored insurance, the individual market, Medicaid managed care, and Medicare Advantage — all in slides you can use in your next meeting.

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Expert Insight

Congress is weighing spending cuts. How will they impact healthcare?

Congressional budget resolutions could cut billions from healthcare programs. Dive into the specifics of these cuts and their potential impact on Medicaid, Medicare, the ACA Marketplaces, and more.

Cheat Sheet

Health data: 3 strategies to effectively leverage and manage it

Understand how healthcare data is impacting our industry and three ways you can better approach data over the next year.

Expert Insight

3 ways health plans can strengthen partnerships with CBOs

Learn how health plans can improve their collaborations with community-based organizations (CBOs) through focused portfolio development, strategic contracting, and enhanced support mechanisms.

Cheat Sheet

3 strategies for sustainable health plan growth

Discover how health plans can leverage operational excellence, consumer- and purchaser-centric offerings, and diversified revenue streams to achieve sustainable growth in a challenging regulatory landscape.

Expert Insight

How employers are combating the ‘new normal’ for benefits costs with unconventional measures

Employer benefits costs are skyrocketing. Coupled with new fiduciary accountability now unfolding in the courts, employers are forced to reconsider their cost containment strategies. Most are choosing to focus on managed navigation, but a few go even further and attempt the arduous work of excluding high-price providers from their networks.

Expert Insight

4 ways health plans are approaching AI

Discover how health plans are adopting AI — and how their approach differs from health systems. Delve into the strategic advantages, adoption challenges, and internal-first approach of health plans as they embrace AI applications.

Expert Insight

The plan-provider tensions driving Medicare Advantage ‘breakups’

Medicare Advantage (MA) plans are feeling the squeeze from tighter benchmark payment rates and increased utilization, causing friction with providers. Learn why some health systems are reevaluating their contracts with certain plans, resulting in increasingly fragmented plan-provider relationships.

Expert Insight

How employers are combating the ‘new normal’ for benefits costs with unconventional measures

Case Study

St. Charles Health System’s pilot program for instant authorization in oncology

Prior authorization can be frustrating and time consuming, especially for cancer patients in need of timely care. St. Charles Health System partnered with a health plan to develop an instant authorization pilot program for cancer patients, leveraging their alignment on evidence-based guideline adherence. Learn how this program is reducing delays, improving patient satisfaction, and paving the way for streamlined authorization processes in oncology.

Research

4 health system partnership models for life sciences

Compare partnership models between life science companies and health systems to determine which model is best for your organization based on your specific needs and goals.

Case Study

How Steindler Orthopedic improved joint replacements with digital surgical technologies

Learn how Steindler Orthopedic Clinic leveraged the VELYS™ Enabling Tech portfolio and achieved more precise surgeries, improved patient outcomes, and better operational efficiency.

Cheat Sheet

Geriatric flying squads

Increased demand for emergency and inpatient care from older, complex patients is further straining limited hospital resources, including beds and staff. Geriatric flying squads, or aged care outreach services, are hospital-operated rapid response teams that provide on-site assessments and acute-level care for geriatric patients in long-term care facilities. Discover how this model is reducing ED utilization, preventing hospital admissions, and improving the overall care experience for geriatric patients.

Market Insights

The MCO's guide to 4 trends shaping the future of Medicaid RFPs

Winning bids is essential for Medicaid Managed Care Organizations (MCOs), and understanding the emerging trends in Medicaid requests for proposal (RFPs) is key to success. Four priorities are shaping the future of RFPs: health equity, behavioral health, population health, and social determinants of health (SDOH). Learn how MCOs can strategically plan and document their approaches to win RFP bids.

Market Insights

3 effects of the Medicaid unwinding on managed care plans

The expiration of the Medicaid continuous coverage protection triggered "the great unwinding," resulting in over 17 million disenrolled members. Discover three key ways this impacts managed care plans and how to apply the lessons learned.

Emerging Idea

Cost-control strategy: Digital navigation tools

Many health plans and vendors are experimenting with innovative digital navigation tools to steer members to high-quality care options that produce cost savings for plans and employers. Discover how digital navigation tools work across the patient journey, ways organizations are leveraging them to reduce costs, and what to keep in mind if you're considering them.

Quick reads

Expert Insight

Congress is weighing spending cuts. How will they impact healthcare?

Congressional budget resolutions could cut billions from healthcare programs. Dive into the specifics of these cuts and their potential impact on Medicaid, Medicare, the ACA Marketplaces, and more.

Cheat Sheet

Health data: 3 strategies to effectively leverage and manage it

Understand how healthcare data is impacting our industry and three ways you can better approach data over the next year.

Expert Insight

3 ways health plans can strengthen partnerships with CBOs

Learn how health plans can improve their collaborations with community-based organizations (CBOs) through focused portfolio development, strategic contracting, and enhanced support mechanisms.

Cheat Sheet

3 strategies for sustainable health plan growth

Implementation resources

Case Study

How UNC Health made VBC sustainable in an academic health system

Learn how University of North Carolina (UNC) Health achieved executive alignment on VBC, made VBC financial performance visible across business units, and more in an academic health system.

Case Study

How Ochsner Health grounded its VBC success in a culture of innovation

Learn how Ochsner Health's commitment to innovation propelled them to become a value-based care (VBC) powerhouse with $264 million in value-based revenue and a 27% increase in covered lives in three years.

Case Study

How Bellin Health’s VBC strategy saved employers $6.4M

Discover how Bellin Health's direct-to-employer value-based care (VBC) strategy reduced employee medical spending by 11% and saved their employer partners millions.

Case Study

Inside Advocate Health’s VBC approach that saved $136M

See how Advocate Health's operations-driven approach to value-based care (VBC) and commitment to measurable goals achieved significant savings and improved population health outcomes.

Experts

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The Advisory Board Fellowship is an immersive leadership laboratory where your leaders emerge with a fresh perspective to advance critical priorities and increase capacity for difficult decision making.

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Expert support

Bring your leadership together for a presentation where we’ll explore the top priorities for health plans today and better understand how they’re positioning for future success.

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We help leaders and future leaders in the healthcare industry work smarter and faster by providing provocative insights, actionable strategies, and practical tools to support execution.

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Health plan strategy

Listen to Advisory Board experts discuss the escalating tensions between health plans and providers — and what to do about it

Learn 5 care navigation strategies to help employers cut healthcare costs

Market outlooks by health plan line of business

Congress is weighing spending cuts. How will they impact healthcare?

Health data: 3 strategies to effectively leverage and manage it

3 ways health plans can strengthen partnerships with CBOs

3 strategies for sustainable health plan growth

How employers are combating the ‘new normal’ for benefits costs with unconventional measures

4 ways health plans are approaching AI

The plan-provider tensions driving Medicare Advantage ‘breakups’

How employers are combating the ‘new normal’ for benefits costs with unconventional measures

St. Charles Health System’s pilot program for instant authorization in oncology

4 health system partnership models for life sciences

How Steindler Orthopedic improved joint replacements with digital surgical technologies

Geriatric flying squads

The MCO's guide to 4 trends shaping the future of Medicaid RFPs

3 effects of the Medicaid unwinding on managed care plans

Cost-control strategy: Digital navigation tools

Congress is weighing spending cuts. How will they impact healthcare?

Health data: 3 strategies to effectively leverage and manage it

3 ways health plans can strengthen partnerships with CBOs

3 strategies for sustainable health plan growth

How UNC Health made VBC sustainable in an academic health system

How Ochsner Health grounded its VBC success in a culture of innovation

How Bellin Health’s VBC strategy saved employers $6.4M

Inside Advocate Health’s VBC approach that saved $136M

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