246: Plans have trust and cost problems. Here's how to manage both. episode artwork

EPISODE · Apr 8, 2025 · 35 MIN

246: Plans have trust and cost problems. Here's how to manage both.

from Radio Advisory · host Advisory Board

Every stakeholder in healthcare is getting squeezed by mounting financial pressures, and health plans are no exception. Higher utilization and rising treatment costs are hitting plans hard. At the same time, plans are facing heightened public scrutiny. It may seem like the wrong time for plans to focus on cost management, but the combination of market and public pressures is exactly why it is so important for plans to get a handle on their clinical costs. If not, they risk passing those costs on to employers or members. The good news is, health plans already have a comprehensive playbook for managing their clinical costs. The bad news is, these strategies don’t often take a targeted approach. This week, host Rachel (Rae) Woods invites Advisory Board experts Chelsea Needham, Morghen Philippi, and Rhea Jain to unpack how plans should think about tailoring their approach to cost management, how leaders can deploy their tools with greater precision, and why plans’ actions in this space will impact healthcare stakeholders across the board. Stay tuned to the end of the episode, where co-host Abby Burns provides an update on the recent layoffs and restructuring of HHS, and the near and long-term impacts of the shakeup. Let us know what you think about today’s discussion, or share your ideas for future episode topics by leaving us a voice message or emailing us. Links: 5 care navigation strategies to help employers cut healthcare costs 3 strategies for sustainable health plan growth Health plan utilization management Learn more about the key features and benefits of Optum Integrity One™, and how it can transform your revenue cycle Q&A with iRhythm Technologies: The importance of arrhythmia detection A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

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246: Plans have trust and cost problems. Here's how to manage both.

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