Presented by: Product Challenges

The Act spawns new types of healthcare organizations that create opportunities – and challenges – for insurers in developing new products.

It’s fraught with opportunity but, boy, it’s going to be some troubled waters in the short term as we figure it out.

Jim Kennedy, Carlton Fields

Regional health insurance exchanges, ACOs and provider service networks are among the new types of healthcare organizations emerging from the Act. Insurers and producers have a great opportunity to introduce new products that address the risks of these organizations. The challenge for carriers is to first understand how these organizations will bear risk, manage it, and insure it.

For example, the Act puts a great emphasis on paying providers based on quality and safety – and taking money back when healthcare organizations produce bad outcomes. Insurers will have to figure out how to value that risk, especially for highly integrated organizations whose commitments are contractual.

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