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These McKinsey white papers were developed for healthcare executives. To receive a copy of one of them, please fill out and submit this form.

8 tests before midnight: Assessing reform readiness with less than 11 months to open enrollment

November 2012

Open enrollment on the new health insurance exchanges is not far away. To succeed in this new environment, payor organizations—all segments and all functions—need to be in the advanced stages of their most crucial reform preparations. This report describes 8 tests payors can use to assess their current progress.

Health insurance distribution in a consumer-driven world

July 2012

Of all the disruptions that will result from the health insurance industry becoming a consumer-driven business, the greatest is likely to be in distribution, where the real shift from wholesale to retail is taking place. This report outlines how the distribution landscape will change for payors and what moves these organizations should consider in response.

Post-reform Medicare market—how attractive is it?

July 2012

Despite the tremendous expansion of the individual and Medicaid markets expected as a result of healthcare reform, the seniors segment—Medicare Advantage (MA), Medigap, and dual eligibles—is likely to be the largest revenue and profit opportunity for payors in the next few years. This white paper describes the challenges and uncertainties surrounding the opportunity, and it outlines four key actions payors should take to prepare themselves.

Winning on the individual exchanges: Driving high consumer participation

June 2012

Implementation of the Affordable Care Act will lead to the creation of state and federal health insurance exchanges, establishing a new marketplace for consumers as well as a significant growth opportunity for health insurers. This report discusses what payors can do to drive high participation rates on the exchanges and ensure a well-functioning market.

Implications of final Medicare accountable care organization rules

November 2011

This report focuses on the strategic implications of the final ACO rules for physicians, health systems and commercial health plans. It also highlights key changes between Medicare’s preliminary rules and its final rules.

Implications of CMMI bundling proposal

September 2011

This report briefly reviews the Center for Medicare and Medicaid Innovation’s Bundled Payments for Care Improvement initiative and then outlines the impact it is likely to have on US health systems, physicians, and commercial health plans.

Medicare ACO rules—strategic and economic implications

August 2011

This analysis gives US providers a deeper understanding of the impact of the Centers for Medicare & Medicaid Service (CMS)’s proposed rules for the shared savings program.

Supplemental products—no longer just a side dish

July 2011

Supplemental health insurance products range from traditional plans (e.g., dental and vision coverage) to completely new offerings. This report forecasts the likelihood of growth in the US market for these products and provides recommendations for how players can capture the opportunities.

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