Helping payer organizations drive sustainable growth and deliver an enhanced value proposition to customers through distinctive data- and advanced-analytics-driven insights
Payers in the individual and employer-sponsored health-insurance markets are looking for new ways to improve performance and drive growth. We help clients identify product-innovation, pricing-excellence, sales-force- effectiveness, and ancillary growth levers that can drive sustainable growth, ensuring payers bring improved experience, outcomes, and savings to employers and members.
Over the past two years, we have served a breadth of national and regional carriers, delivering more than $2 billion in earnings growth through our unique data, advanced analytics, and deep expertise-based approaches.
What we do
Pricing sophistication
We embed industry-best practices, unique data sources, advanced analytics, and years of actuarial experience in our next-generation pricing models for self- and fully insured employers to provide actionable, validated, and impactful strategies for payers to effectively articulate and price the value created for members.
Sales-force effectiveness
We use proprietary data, predictive analytics, and consultative selling capabilities to help payers drive sales-force effectiveness and seamlessly manage the last mile to brokers, employers, and ultimately - members.
Product innovation
We leverage cutting-edge broker, consumer, and employer insights (for example, annual survey of 1,000 employers) to design customer-backed commercial offerings to improve experience, affordability, and minimize abrasion.
Ancillary growth
We help payers develop unique, whole-health-focused value propositions across medical and nonmedical lines of business through our deep expertise in stop-loss, dental, vision, life, and disability insurance.
Featured capabilities
We invest heavily in developing proprietary tools, databases, and methods, including:
Comprehensive commercial-transformation diagnostic: We use a holistic, integrated review of more than 50 commercial-growth levers across a payer to identify the product, pricing, sales, and ancillary-growth opportunities.
Payer-growth and -retention tool: Our one-of-kind, granular view of US employer-benefit trends, built on a synthesis of proprietary data, market intelligence, and machine learning, enables higher group conversion and renewal rates through data-driven sales decision making.
Administration-services-only pricing-sophistication tool: We apply a library of best-in-class administration-services-only pricing tactics to identify and size growth opportunities rapidly.
Examples of our work
Comprehensive commercial diagnostic
When a regional payer faced increasing competitive pressure, we launched a comprehensive diagnostic to identify priorities for reigniting growth across pricing, product, sales, and ancillary levers, identifying more than $400 million in EBITDA growth opportunities.
Pricing sophistication
A regional payer with high market share and low profitability in its self-insured business was looking to improve its margin performance while delivering more value to customers. We helped deploy more than 20 best-in-class self-insured product price architecture practices to significantly boost margin performance and simultaneously improve the customer value proposition.
Sales transformation
A large payer facing declining renewal rates and stagnating new sales was looking to transform their sales process to enable delivery of innovative, more effectively priced benefits to current and new employers. We provided support across the board, from industry insight to analytics, and from account prioritization to the design of a consultative sales model. These efforts helped identify opportunities for one-million-plus membership growth and more than $300 million in growth in earnings before interest, taxes, depreciation, and amortization.
Ancillary growth
When a payer wanted to deliver a value proposition for enhanced medical plus ancillary services, we aggregated internal-group-level data across business lines and connected them to proprietary data to prioritize prospects that could benefit from the combined value proposition. Together, we charted a path to double carve-in rates across key ancillary lines.
Featured experts
Elena Bhamidipati
New York
Serves insurance clients on sales operations and sales effectiveness, corporate strategy, diligences, and M&A
Patrick Finn
Detroit
Global leader of McKinsey’s healthcare work, counseling healthcare leaders on strategic planning, holistic performance...
Aditya Gupta
Boston
Counsels healthcare organizations—particularly commercial payers—on corporate strategy, board agendas, M&A, business building,...
Akshay Kapur
Chicago
Serves leading healthcare organizations on strategy, growth, M&A, and performance transformations
Boris Körs
Munich
Serves clients across the healthcare, health-insurance, pharmaceutical, medtech-manufacturing, and logistics industries
Shubham Singhal
Detroit
Chair of McKinsey Global Institute; Global co-leader of McKinsey's strategic priority on geopolitics; counselor to healthcare...