Research & Insights

Health plans

Health plans must meet growing purchaser and consumer expectations along with 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.  


Featured insights

Tackle these challenges

 

Health plans vary immensely in their size, scope, and strategic priorities. A baseline understanding of the health plan market requires a grasp on the following dynamics:

  • How plans make money: Premiums, quality bonuses, diversified assets 

  • Common “types” of health plans: National, regional, provider-sponsored, community/local

  • Key lines of business: Medicare Advantage, Medicaid Managed Care, employer market, individual market

  • Executive priorities: Strategy and growth, utilization and costs

  • Increasingly health plan executives think of growth as a health plan via two primary avenues: line of business growth and asset diversification.  

  • Plans are rapidly chasing member growth in their insurance lines of business with Medicare Advantage receiving outsized attention given profitability and growth trajectory.

  • Many health plans are expanding their offerings to include diversified health care service divisions. 

  • To grow, health plans must excel against strong existing competitors and established, yet evolving, market dynamics. 

  • Provider relations is an imprecise term used to describe the relationship between health plans and providers — most notably physicians. 

  • Collaborative providers are essential to advancing health plan strategic goals such as value-based care, behavioral health integration, and efficient specialty referrals.

  • The path forward seems clear: successful plans will relentlessly focus on physician-led, data-driven provider enablement. 

Member engagement is the process of building, nurturing, and managing relationships with members to drive behavior change.


Our latest on health plans

Explore resources health plans care about

experts

Don't miss out on the latest Advisory Board insights

Create your free account to access 2 resources each month, including the latest research and webinars.

Want access without creating an account?

   

You have 2 free members-only resources remaining this month remaining this month.

1 free members-only resources remaining this month

1 free members-only resources remaining this month

You've reached your limit of free monthly insights

Become a member to access all of Advisory Board's resources, events, and experts

Never miss out on the latest innovative health care content tailored to you.

Benefits include:

Unlimited access to research and resources
Member-only access to events and trainings
Expert-led consultation and facilitation
The latest content delivered to your inbox

You've reached your limit of free monthly insights

Become a member to access all of Advisory Board's resources, events, and experts

Never miss out on the latest innovative health care content tailored to you.

Benefits include:

Unlimited access to research and resources
Member-only access to events and trainings
Expert-led consultation and facilitation
The latest content delivered to your inbox
AB
Thank you! Your updates have been made successfully.
Oh no! There was a problem with your request.
Error in form submission. Please try again.