Publications
Publications
- January 2019 (Revised June 2019)
- HBS Case Collection
U.S. Commercial Health Insurance Industry
By: Susanna Gallani, Mary Witkowski and Harry B. Wolberg
Abstract
This note describes the role of commercial payers in the U.S. healthcare industry. We begin with a review of the historical evolution of commercial payers and their role in the market, from the beginning to the Affordable Care Act and beyond. Every wave of reforms in the healthcare industry has impacted commercial payers and forced them to adapt and evolve. The note then provides a quick overview of the main service lines where commercial payers have traditionally operated. An overview of the main players in 2017–2018 follows and describes the main strategic frameworks applied by these organizations. The note concludes with a detailed section on the new trends and challenges that threat the very existence of commercial payers in the future and provides insights into potential future strategic choices that will likely affect once again how commercial payers adapt and operate in the future.
Keywords
Health Care and Treatment; Insurance; Governing Rules, Regulations, and Reforms; Organizational Change and Adaptation; Health Industry; Insurance Industry; United States
Citation
Gallani, Susanna, Mary Witkowski, and Harry B. Wolberg. "U.S. Commercial Health Insurance Industry." Harvard Business School Technical Note 119-064, January 2019. (Revised June 2019.)