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Business Strategy: Business Lines of the Future — Emerging Opportunities and Key Considerations for Medicare and Medicaid Plan Management

Business Strategy: Business Lines of the Future — Emerging Opportunities and Key Considerations for Medicare and Medicaid Plan Management

This IDC Health Insights report examines emerging opportunities and key considerations for payers participating in the Medicare and Medicaid programs and the related IT vendors.

"Innovations in Medicare and Medicaid, particularly as funded and mandated by the Affordable Care Act (ACA), are continuing to shape the marketplace for payers and the IT vendors supporting them. CMS' CMMI continues to implement pilot programs and/or issue regulations regarding innovative payment and care delivery models, both of which are changing business models for payers, providers, and vendors. Successful payers need to stay abreast of findings and rules coming out of the U.S. Department of Health and Human Services (HHS) regarding Affordable Care Act–related pilots and programs, including the State Innovation Models (SIM) for Medicaid and the Independence at Home Demonstration program for Medicare, and other programs as they evolve. It has become clear that a true population health management approach for both of these programs will continue to grow in the future, which has significant implications for all industry stakeholders." — Lynne A. Dunbrack, research vice president, IDC Health Insights

Please Note: Extended description available upon request.


IDC Health Insights Opinion
In This Study
Situation Overview
Recent Trends
The Potential Benefits and Challenges of Medicaid Expansion
Medicare and Chronic Conditions
The Approach
Key Strategic Elements
Medicaid
Medicare
Future Outlook
Essential Guidance
Actions to Consider
Medicaid
Medicare
Learn More
Related Research
Synopsis
Figure: Access to Healthcare for Men and Women by Age

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