Private insurers, who represent some of the primary stakeholders affected by legislative proposals, have spent considerable time and resources attempting to shape and influence the debate. At the same time, many insurers have felt severely constrained, even paralyzed, by the uncertainty the reform debate has created, and by the potential disruption to the insurance industry.

As reform legislation comes closer to critical votes, insurers should start refining their long-term strategies to take advantage of potential opportunities and to mitigate potential risks and challenges in a post-reform world. Under any plausible scenario, the reforms will create a new set of winners and losers. Some insurers may already be better situated than others to win, given their current market position and book of business. But success will accrue to those insurers that can quickly seize the moment, mobilizing their resources and building the necessary capabilities to not only survive but succeed in post-reform healthcare.

Looking ahead, many insurers will find that post-reform success entails a reorientation of their business and a focus on four core strategic imperatives: refine “individual segment” strategies to target an expanded individual market; refresh strategies for dealing with government segments at both the federal level and the state level; strengthen administrative capabilities to serve and retain the new member base; and drive and demonstrate healthcare value by helping to reduce costs and enhance quality as long-term delivery system reform unfolds.

Download "Winning in Post-Reform Healthcare: What Insurers Can Do Today".

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