Good news for payers in a consumer-focused industry


Consumerization is in full swing throughout the entire healthcare industry. And as the transition from fee-for-service to value-based payment continues, high deductible plans slam providers with a negative credit outlook.

But for payers, the credit outlook is a bit more stable, despite some added risk, reports Healthcare Payer News.

"Credit quality is strong for the U.S. health insurance sector and is likely to remain so through the next 12 months as insurers continue to adapt to reform-driven change in the marketplace," notes Standard and Poor's analyst, Mariola Borysiak, according to Healthcare Payer News.

One of the main "reform-driven changes" the industry is learning to adapt to is the increase in health insurance retail stores. Part of the allure of the brick-and-mortar stores is their convenience--not only are they located in local shopping centers across the country, but the stores offer experience and guidance to consumers who are shopping for plans, FierceHealthPayer previously reported.

And now pharmacy retail stores are going above and beyond by expanding their businesses to offer primary care, diagnostics and chronic condition management, notes Healthcare Payer News.

For instance, last year, Walgreens teamed up with physician groups in three accountable care organizations to focus on consumers and ultimately lower costs while boosting quality of care.

This new industry trend bodes well for payers. If places like CVS Health and Walgreens offer diagnostics at a low cost, payers can help their members locate such services, as to avoid potentially hefty out-of-pocket fees, reports the article.

While diagnostics are part of the new boom in consumerization, costly spending on speciality drugs will most likely cause these retail pharmacies to capitalize on this opportunity as well, suggests Borysiak.

What's more, this change is slowly making headlines. Last year, fifteen insurers in the state of New York urged their members to start buying speciality drugs at retail pharmacies, FierceHealthPayer previously reported.

For more:
- here's the Healthcare Payer News article

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