Report Summary
The 2024 Trends Shaping the Health Economy Report: Micro Edition is an interactive report, exclusively available to Compass+ Enterprise subscribers. The Micro Edition equips stakeholders with the tools to develop actionable strategies in response to evolving health economy trends.
The U.S. health economy is the most expensive health system in the world, underwritten by the Federal government, state Medicaid programs and employers. Healthcare providers depend on commercial reimbursement rates from employer-sponsored plans to cross-subsidize inadequate payments from Medicare and Medicaid. For years, all stakeholders in the health economy have concentrated on maximizing the value that they can extract from employer-sponsored health plans, whether fully or self-funded, instead of delivering value for money.
This reality is unsustainable. Health economy stakeholders who shift their focus from value maximization for themselves to value optimization for their customers will gain a significant competitive advantage. The future of the health economy belongs to those who prioritize optimizing value for their customers by considering price, quality, safety and convenience.
In this newest installment in the Trends Shaping the Health Economy Report Series, we go beyond our foundational conclusions from the Macro Edition to expand upon how the national health economy trends impact their sector, local markets and patient populations.
Key Questions
- How do national findings vary by region and CBSA?
- Are certain patients disproportionately affected?
- How do trends in the commercially insured population compare to all payers, public and private?
- What changes will your organization have to make to deliver more value for money relative to your current and future competitors?
- What trends have you not considered, and how will they impact the markets that your organization serves?
Methodology
A variety of data sources were leveraged as part of this research, with most insights gleaned from Trilliant Health’s proprietary datasets with visibility into patients and providers across the country. Trilliant Health’s national all-payer claims database combines commercial, Medicare Advantage, traditional Medicare and Medicaid claims, providing a nationally representative sample on a deidentified basis. Claims-based data analyses use data through Q4 2023.
Trilliant Health’s Provider Directory enables a direct view into providers and their practice patterns. Trilliant Health’s health plan price transparency dataset is comprised of health plan machine-readable files that have been parsed. Trilliant Health leverages its Provider Directory and claims data against the health plan price transparency dataset to reveal the negotiated reimbursement rate between any health plan and any provider for any service rendered at any location.
Additional data were obtained from a variety of publicly available sources (and are noted in respective source notes), including individual health system, health plan and company financial statements, Census Bureau, KFF, the Congressional Budget Office, American Hospital Association, American Medical Association, Centers for Disease Control and Prevention, Healthcare Cost Report Information System and the Bureau of Labor Statistics.
This research does not include data from self-pay encounters or encounters provided at no cost through commercial insurers.
Most data are presented with a national view, while some were exclusively focused on counties or the largest markets – defined as the core-based statistical areas (CBSAs) – to illustrate local variation.
About the Author
