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In the News: November 16

Insurer Consolidations Equal Shrinking Competition

An annual review of the insurance market by the American Medical Association (AMA) reveals continued shrinkage of market competition despite recent failed mergers. The AMA reports 69% of commercial markets are highly concentrated, and 43% of markets have an insurer with a majority of the market share.

While market concentration trends have led to increased scrutiny in insurance company mergers, insurers point to hospital and health care mergers as contributing factors to limited competition and increased prices.

There are risks and advantages to entering new partnerships. Read the Sg2 Letter: Leadership Priorities and Market Realities to learn more about assuming risk and how to make partnerships work more effectively.


Minimal Decrease in Low-Value Care Despite Early Support

Launched in 2012, the Choosing Wisely campaign challenges providers to lead the charge against overuse of medical services by adhering to a set of recommendations for care. The campaign targets the significant amount of “low-value” care provided every year, accounting for nearly $200 billion in spending in 2011. While health care systems and providers responded positively to the campaign, a new Health Affairs analysis indicates only small decreases in low-value services have been observed. The authors suggest this may be attributed to entrenched provider beliefs and patient expectations for care.

Amidst rising pressures from private and public payers, health care systems will be challenged to drive down wasteful, duplicative care. To learn more about how your organization can successfully reduce unnecessary care, read the Sg2 report: Elements of Care Redesign: Unnecessary Care Reduction.


Health Care Industry to Account for One-Third of New Jobs

The Bureau of Labor Statistics (BLS) recently released their employment projections for 2016–2026, with the health care and social assistance sectors projected to add approximately 4 million jobs by 2026, or about one-third of all new jobs. Specifically, home health aides, personal care aides, medical assistants, nursing assistants and registered nurses are expected to account for almost one-fifth of all new jobs. The BLS stated that demand for health care services will be driven by an aging population, longer life expectancy and increasing rates of chronic conditions.

With an increasingly frail, aging and medically complex patient mix in the inpatient setting, Sg2 believes that both hospital quality and financial sustainability will be at risk without increased attention to hospital workforce planning. To learn more about confronting the mounting hospital workforce challenges, read the Sg2 report: Inpatient Workforce Planning.

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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