Boston | Massachusetts | 2023 | Market Overview

The COVID-19 pandemic has not impacted the dynamic shift in power from two major industry mergers shaking up the landscape for the first time in decades. A landmark health system merger creating Beth Israel Lahey Health already has pushed BILH to a slim statistical lead and the approved merger between two nonprofit insurers will give market leader Blue Cross Blue Shield of Massachusetts new competition it has never experienced. Payment reform initiatives are well established and extensive in Boston. The market embraces value-based care and accountable care organization models, boasts a healthy population and some of the highest-quality care in the nation, but it also has high prices and above-average hospital utilization and readmissions rates. A new telemedicine law brings much needed reimbursement parity, even if it is for specific conditions. Look for the competition within the industry to drive down prices, increase collaboration and partnerships, and improve access to care where patients live. Expect the industry to slowly recover from the pandemic through partnerships, increased value-based contracts, and improved access.

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