With several final rulings on ACA mandates, numerous takeovers and acquisitions, 2011 has proved to be a sprightly year. The U.S. healthcare landscape is marked for change again in 2012, as the Supreme Court announces its ruling on ACA’s constitutionality, thousands of baby boomers become eligible for Medicare and more insurers, physicians and providers enter into collaborative partnerships.

Here are some of the top healthcare trends that we believe, will affect change in 2012.

Increased enrollment in Medicare plans

The Medicare Advantage plan segment is expected to observe explosive enrollment figures in 2012. The very first baby boomers turned 65 on January 1, 2011. Over the next year, every day, thousands of baby boomers will reach the age of 65 and become eligible for Medicare plans. With hundreds of thousands of projected enrollments in 2012, the Medicare sector will see a significant boom.

Leading U.S. healthcare giants such as United Health that operate in the Medicare markets have been busy striking mergers to fortify their infrastructure and have released their projected Medicare enrollees’ figures for 2012. Cigna announced its plans to acquire HealthSpring – a Medicare Advantage plan, to expand its Medicare market outreach. Two other leading health plans operating in the Medicare sector joined hands to prepare for the projected upsurge in Medicare enrollments.

Boost in Medicaid plan registrations

Under the latest health reforms, beginning 2014, all the U.S. states have been decreed to provide at least the minimum basic health coverage to all residents who have incomes up to 133 percent of the poverty level. This mandate will add an estimated 17 million un-insured Americans to Medicaid rolls.

Mounting U.S. states debts and rising Medicaid costs, together with ACA’s Medicaid regulations, are pushing more States to consider Medicaid Managed care programs. As Medicaid enrollment is expected to increase by 30% over the next year, the huge potential has captured the interest of health insurers planning to penetrate the Medicaid markets. Healthcare insurance players already operative in the Medicaid segment have a great opportunity to expand their Medicaid Managed care client pool.

Improved collaboration among Insurers and Providers

In 2012, U.S. will witness increased investments in health informatics and business intelligence tools and consequent data-sharing partnerships between insurers and hospital operators.

Last year health insurers spent more than $2 billion on partnering or acquiring hospitals and clinics as per a PricewaterhouseCoopers (PwC) report. Increased engagement among population health providers, health plans, healthcare systems and individual providers can be expected to achieve common goals such as improved security, reduced costs, improved customer satisfaction etc.

Continued Healthcare players’ mergers and acquisitions

The year 2011 witnessed huge takeovers of health plans, physician groups and health information systems, by leading healthcare insurance companies. Aetna entered into a number of collaborative partnerships with physician groups, health networks and completed acquisitions of Payflex, an account-based health plan administrator and Genworth Financial’s Medicare Supplement business. Humana announced its agreement to acquire SeniorBridge, a New York based in-home care provider to senior citizens.  Wellpoint also completed its acquisition of CareMore, a Medicare Advantage health plan.

The acquisition trend is expected to continue in 2012 as health plans are looking for companies that can help them reduce administrative costs and fetch larger client pool and increased profits. Aetna has already announced its plans to acquire and repurchase stock options in 2012 to expand its business outreach.

hCentive is all set to welcome this new wave of Medicare baby boomers with its fully scalable and user-friendly WebInsure Medicare solution, that has been specifically designed to equip hCentive’s clients to service their customers better.

Leave a Reply

You must be logged in to post a comment.