Health Care Plans
Legislators, regulators and customers are demanding more price transparency, fewer denials, bigger networks in the face of provider shortages, lower costs, less overhead but more program integrity, reimbursement for social factors, digitalization, interoperability, faster processing times, lower cost-sharing, more risk-bearing, real-time provider directories, fraud detection and prevention, better quality tracking. Providers are demanding higher reimbursement, gag clauses, anti-steering provisions, secret prices, and on and on. Shareholders demand higher profits quarter after quarter.
You want to work with employers to cover risk to keep patients healthy without losing your shirt.
KFT Consulting advises insurers on:
- Innovative, high-value strategies for how carriers can partner with private and public payers to lower costs, improve quality and improve clinical outcomes for patients, high-satisfaction patient experience and significant savings;
- Carrier role in ERISA fiduciary risk mitigation for employer/customers, in the context of an increasingly aggressive enforcement and litigation environment;
- Deciphering federal health policy outlook, trends, and prospects for success, including value-based models, price transparency, and drug pricing
- Patient experience and other health care consumer demand trends;
- Mitigating reputational and political risk in the health sector;
- Price transparency as an opportunity for the health care industry, rather than a threat;
- Incorporating and evaluating social determinants of health in delivery systems;
- Assembling or influencing coalitions and grassroots organizations to advance a policy agenda