Folks in the health care industry say 2012 is a “tactical year” because of the overwhelming list of priorities and the need to carefully allocate resources with which to accomplish them.
Yet, despite the challenges facing the industry—such as complying with specific provisions of the Patient Protection and Affordable Care Act and trying to anticipate what regulatory modifications may be on the horizon—survey results reveal that many payer organizations remain surprisingly optimistic about the future.
This information comes from a report based on information gathered from a survey of 61 responding health plans, from The Managed Care Executive Group and HTMS, an Emdeon company.
“One issue common among many of the survey respondents is the ‘overflowing plate’ challenge,” says Vince Ferri, vice president and chief information officer for AvMed Health Plans and Chair of MCEG. “With so many priorities related to health care, payers find it increasingly difficult to accomplish all the goals set before them in a straightforward, efficient manner. It is good to see that, despite the torrent of changes, health plans largely remain upbeat.”
The survey shows 92 percent of respondents reported that, despite a scarcity of resources and the “overflowing plate” challenge, they were, at the very least, compliant with the various provisions of reform. Twenty-three percent of this group of respondents identified themselves as “leaders” and plan to use the changes associated with healthcare reform as a strategic differentiator.
Survey results also demonstrated optimism by small and mid-size health plans—only 4 percent of respondents considered health reform and its impacts to be a threat. Comparatively, 94 percent considered reform to be either an opportunity or a “mixed bag,” offering both opportunities and threats. Additionally, the majority of respondents expected to see growth in all sectors, with only a few anticipating expansion in the large group market.
“According to our research, health plans don’t see PPACA as either all good or all bad,” says Gary Stuart, executive vice president of payer services for Emdeon. “Respondents listed multiple opportunities—such as growth in the individual market due to health insurance exchanges—as well as hurdles, including the potential impact of uncertainties related to the Supreme Court’s upcoming decision on the PPACA mandate that individuals must purchase health insurance and the outcome of the 2012 presidential race.”