Is the 20th century model still viable in the 21st century’s new economy? The 20th century’s health insurance business model based on risk pooling no longer reflects the social, technical, economic, and political realities of the 21st century. The new reality and long-term trend suggest that health insurance in the US will evolve into a third-party administrator (TPA) of value-based claims processing on behalf of government entities, where the lowest cost provider of services will win in the marketplace.

SSA & Company’s national bench marking study on the economics of 174 payers, combined with scenario based planning techniques, yields insights about which payers are well positioned for the coming sector disruption, and what steps need to be taken now that will set payers on a path for longer-term success. Read the complete op-ed that further delineates our insights and conclusions here.

Wayne Dix  serves as Vice President at SSA & Company