2021: Winning in a busy year for payers and providers

Most payers and providers have completed their review of 2020 and are moving forward in 2021. Of course, 2020 was a very challenging year managing through a variety of challenges and opportunities created by the COVID-19 pandemic.

Executing on the 2021 plan, including positioning for 2022, is underway. Although we are hopefully getting a handle on the pandemic, this year isn’t going to be normal. For example:

• Vaccinations and testing
• American Recue Plan Act of 2021 (ACA expansion and increased subsidies)
• Evolving healthcare policy
• Catching up on care (preventive and surgeries)
• Acceleration of market change (value-based care, payer-provider alliances, telehealth adoption, investments in innovation)
• Another uber-competitive open-enrollment cycle

 So, who wins in this environment?

Forward-looking companies that are positioned to execute bold strategies fast are the ones likely to win. Generally, this approach is central for newer, investor-backed companies and more challenging for mature legacy companies. The keys to success clearly vary by company and market, but there are several common themes:

• Health consumerism—understanding and meeting unique needs by segment (Hispanic segments, individuals with chronic conditions, the underserved)
• Alignment and process integration with ecosystem partners (payers and providers)
• Advancing value-based care strategies (lowering costs and improving health outcomes)
• Advancing capabilities (data management, analytics, consumer engagement)

These themes are certainly not new. They’ve been included in industry talk for years. The key is “walking the talk.” It’s an exciting time to be in this industry and it will be interesting to see who wins.