The US has no shortage of plans for establishing universal healthcare. While most proposals focus on expanding access to care through private coverage and government programs, a half dozen federal and state plans would expand government programs to cover everyone.
Most proposals would expand coverage using existing public and private frameworks.
Most new growth has come in this area, as can be seen through the ongoing expansion of Medicare Advantage. This continuing shift creates opportunities for payers. Under new models, payers would likely maintain their presence in network and claims management, though they could expect to see administrative savings, increased regulatory burdens and greater compliance requirements. Remaining flexible, reducing redundant processes and capitalizing on opportunities for savings under new regulations are key.
Payers that focus on developing supplemental products, investing in retail capabilities and expanding core competencies like fraud prevention will find themselves positioned to continue adding value even in the face of systemic change.