Another gold rush in the ACA marketplace: Can newer entrants beat out long-standing incumbents?
When evaluating growth opportunities, companies can consider expanding their geographic footprint, entering new segments, or launching differentiated products or services.
Mature, heavily regulated markets create the need for companies to drive growth through innovative offerings.
Relatively immature markets that are facing a great deal of expansion due to increased consumer growth or demand.
Long-standing markets with entrenched competitors and stabilised consumer demand.
Companies are looking to M&A to expand their market share and grow delivery and technology capabilities. Significant planning and alignment around M&A strategy, acquisition criteria, and realistic synergies is essential to driving a successful transaction and integration.
We help clients with market scanning and pre- and post-integration planning (we do not perform due diligence or transaction management services)
Companies are always examining how to create a sustainable delivery method that enables leading class outcomes for consumers.
Competitive markets requires companies to understand how they can optimize for the best dollar against competitors based on predictions of what they might do.
Examples in Healthcare:
Transparency in Coverage: Stakeholders in healthcare can leverage cost transparency to their advantage in different ways. Health plans can utilize this information to achieve lower rates. Providers can utilize this information to increase their rates.
Network: Health plans must carefully design networks to steer membership towards providers in which they have discounted rates.
Provider: Assessing different reimbursement models and care structures between providers and alternative sites of care can improve overall spend.
Care Management: Care management services can be used to steer patients towards time saving, cost-efficient resources that may lower overall spend and improve health outcomes.
Rx: Pharmacy utilization management and pharmacy unit cost levers can be used to reduce Rx spend.
SUBJECT MATTER EXPERTS