Whitepaper

Medicare Lines of Business and the Challenges Payers Face

There are significant market forces impacting Medicare, both today and in the future. The rise of value-based reimbursement models along with innovative pilot demos is forcing a different awareness for providers and a changed reality for payers. Regulatory reform continues to provide a layer of uncertainty that directly impacts the ability for payers to plan ahead.

Read this white paper to learn:

  • Why regulatory changes drive requirements for flexibility on the part of payers
  • How the rise of ACO’s has brought focus to quality metrics tied to outcomes
  • Details of the complexity brought on with Dual eligible members who belong to Medicare and Medicaid

Medicare is the government program being driven to change the most by CMS. In many ways it is the leader in healthcare reform as well as the move to ultimately lower costs in our system. This paper outlines important trends that payers should be tuned into for continued success.