Abstract : The health insurance sector is continually navigating through a dynamic environment, contending with the impact of external market forces that challenge its stability. In the current landscape of the United States, the health insurance market relies on investments and mergers to sustain and implement growth strategies. The feasibility of a merger is contingent upon investors perceiving robust financial returns. Simultaneously, consumers are acutely aware of the significant influence of financial factors such as out-of-pocket (OOP) costs, which have emerged as pivotal criteria for choosing a health plan [1]. Therefore, conducting a thorough financial evaluation and analysis of a company's business operations provides a comprehensive overview of its performance and future prospects. This information benefits three key stakeholders: the company itself, potential and existing investors, and the end consumer. The examination of the 2012 Medicaid Managed Care Health Plans Financial Performance study delved into the underlying factors contributing to lower medical costs by employing ratio analysis and scrutinizing the financial data of the selected product lines. The study provided valuable insights into spending patterns, profit generation potential, resource utilization, and opportunities for business process improvement through thorough analysis of financial data. Additionally, a 2015 survey conducted by Deloitte focused on Value-Based Care (VBC) strategies, market conditions, and influencing factors among 15 health plans. Survey respondents expressed their belief in payment innovations, collaborations with providers, and strategies for engaging patients as key drivers for adopting and transitioning to VBC. Executives emphasized that a shift towards a model where providers assume responsibility for cost and quality is crucial for future profitability and sustainability [2,3].
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Humana’s 2019 Medicare Health Plans Emphasize Choice, Affordability and Convenience to Care for the Whole Person | Humana Healthcare [Internet]. Press.humana.com. 2019 [cited 9 May 2019].
Aetna Announces Personalized Well Being Experience that Combines Health History with Apple Watch Information.2019.
