Health Systems Advised to Tread Carefully When Considering Provider-led Health Plans

By Claire Thayer, April 18, 2016

McKinsey & Co released an in-depth paper that explores both growth and evolution of provider-led health plans and offers key questions health systems should think about when evaluating their current plans or considering offering stepping into to provider-led plan market space. Here are some of the highlights gleaned from this paper.

The authors point out that overall, the growth in enrollment of provider led plans has increased 6% since 2010, growing from 12.4 million in enrollment to 15.3 million in 2014. While during this same time period, growth in the number of provider-led health plans was modest, increasing just 3% from 94 plans in 2010 to 106 in 2014. The enrollment growth was most pronounced in the Medicaid, Medicare Advantage and Individual Markets

The authors point to 4 important questions that are critical for health systems to consider when evaluating provider-led health plan (PLHP) offerings:

• How can consumerism benefit a PLHP
• When is growth through a PLHP most likely
• Is an alternative type of administrative infrastructure possible?
• What can be gained through granular analytics?

For further reading:

Article Summary: The market evolution of provider-led health plans [McKinsey & Company]

Full Article: The market evolution of provider-led health plans [McKinsey & Company]