Summary
On earnings calls this quarter, with Oscar as a notable exception, payers largely communicated that they don’t want to be the lowest-priced option in their markets, instead seeking to control growth and aim for profitability given the tumultuous policy backdrop.
Payer pricing strategy gets even more fascinating as you zoom in on specific markets—and even counties—to understand who is trying to grow where, who might have mispriced and is in for some unexpected growth, and where member shopping will make a big difference. We dug into those dynamics with Rebecca Stob, Principal Consultant at Evensun Health.
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What we covered:
00:00 Introductions
00:09 Challenges in the Individual Market
00:50 Factors Influencing Pricing and Product Offerings
02:43 Strategic Decisions by Major Payers
04:02 Complexities of Pricing and Member Retention
09:06 Regional Market Dynamics
16:06 State-Based vs. Federal Exchanges
22:36 Renewals and Member Retention Strategies
26:59 Conclusion and Contact Information