In the United States health insurance is one of the most contentious issues currently being debated among voters and constituents. The healthcare industry is a booming one, but it’s also changing extremely quickly. These changes will not only affect patients and consumers, but will also have an impact on healthcare payers and providers. Below we’ll address a number of issues currently threatening healthcare payers within the healthcare payer space with the help of expert Himachal Mukhopadhyay.
Ensuring Costs Don’t Spiral Out of Control
“Keeping costs under control is a challenge for any business – established or fledgling – and the healthcare industry is no different.” Himachal Mukhopadhyay says. Private insurers often don’t have the purchasing power that governments have, and because of that they’re beholden to price hikes of drug companies and hospitals. Keeping the costs of these products and services under control is key to ensuring that healthcare payers can continue to offer affordable services.
Retaining Current Number of Members
According to Himachal Mukhopadhyay, retaining members within the healthcare payer space is critical for ensuring that overheads are consistently met. As private insurers move towards value-based-care, they will work harder and offer incentives to keep patients healthy; this in turn will reduce the amount of money the insurer will have to spend to keep that patient healthy during their lifetime. If patients choose to switch to another insurer, they take with them all the benefits afforded to them by their current healthcare payer, thus wasting money.
The 2017 Tax Cuts and Jobs Act will start to have an increased effect in 2019, according to Himachal Mukhopadhyay. This reform will affect payers and providers in different ways, and for profit companies will be able to repatriate foreign cash at a favorable rate. Most payers and providers don’t have foreign companies or services and so won’t be able to benefit from this repatriation. There were also other aspects of the Act which could negatively affect both payers and providers.
Higher Administrative Costs
As the call volume increases in healthcare so do administrative costs. A greater network of providers is needed to assist with determining patient liability amounts in advance. This will ultimately increase the volume of calls across the board as patients enquire about provider invoices and other costs.