Plans
Category:
Industry

Managed Healthcare Industry

Publisher: Platform Executive
Date Published:
Reading time: 37 minutes
Add to library
Remove from library
HomeIndustryManaged Healthcare Industry

This report on the managed healthcare industry vertical is part of our in-depth analysis of the key sectors driving the global economy.

Industry Overview

The managed healthcare industry is a rapidly growing sector of the healthcare industry that involves the managed care of patient populations.

Managed healthcare organisations offer a variety of healthcare services, including preventive and primary care, specialist care, hospital care, and prescription drug coverage. They also provide a range of services to help manage healthcare costs, such as utilisation management, prior authorisation, and cost containment.

Managed healthcare organisations use a variety of strategies to reduce costs. These include negotiating contracts with healthcare providers, forming networks of doctors and hospitals, and providing incentives for healthcare providers to practice efficiently. They also utilise evidence-based medicine and health information technology to ensure that patients receive quality care. Additionally, managed healthcare organisations often employ a variety of methods to promote preventive care and wellness activities.

Managed healthcare organisations are also increasingly using data analytics to identify cost savings opportunities and to improve the quality of care provided. This data-driven approach allows them to better understand the needs of their patient populations and to design more effective and cost-efficient healthcare programs.

Managed healthcare organisations are continuing to grow as more employers turn towards managed care to control healthcare costs. The industry is expected to continue to expand in the future as more employers recognise the value of managed care and the cost savings potential it offers.

Competitive Landscape

The competitive environment is a dynamic system in which companies compete against each other for market share.

It involves factors such as:

  • Number of companies
  • Product and/or service similarity
  • Customer reach
  • Pricing strategies
  • Barriers to entry

The intensity of competition impacts business strategies, profitability, and growth potential.

The managed healthcare industry has become increasingly competitive over the years. With the rising cost of healthcare and an emphasis on preventive care, providers are looking for ways to offer quality care at an affordable rate. This has created a competitive landscape of providers in the managed healthcare industry.

The biggest players in the managed healthcare industry are large insurance companies. These companies offer a variety of plans to meet the needs of their customers. These plans vary in terms of cost, coverage, and provider networks. They also offer incentives to customers, such as discounts and rewards programs. These companies are also working to create better access to care through telehealth services and other innovative approaches.

Another major player in the managed healthcare industry is the provider. Providers are responsible for offering quality care for their patients. They are competing with other providers to attract and retain customers. Providers are also finding ways to reduce costs and increase efficiency, such as implementing electronic health records and taking advantage of new technology.

Additionally, the managed healthcare industry is seeing an influx of new players. Start-ups are entering the market with innovative ideas and technologies. These start-ups are providing consumers access to new services, such as telehealth and virtual visits. They are also creating new models for providing healthcare, such as direct primary care and subscription-based services.

The managed healthcare industry is continuing to evolve and become even more competitive. Providers are competing to offer the best care at the most affordable price, while new players are introducing innovative solutions. This competition is creating a more efficient and effective system for providing quality care to consumers.

Leading Companies

Below is a list of companies that are intrinsically involved in this industry:

Industry Maturity

In the context of this review, industry maturity levels span from emerging to declining, depending upon where it is within a perceived lifecycle.

1. Emerging industries are innovative and high-growth, often disrupting existing sectors.

2. Growth industries are expanding rapidly, outpacing the overall economy.

3. Mature industries have steady, slow growth, with established competitors.

4. Declining industries face reduced demand, falling profits and increasing exit of businesses.

Managed healthcare is an increasingly popular form of healthcare delivery, offering a variety of benefits over traditional healthcare models. It is a growing industry, with health care organisations, insurance companies, and other providers all vying for a piece of the market. The industry is currently in a state of maturity, with many players offering comprehensive services and solutions to their clients.

Managed healthcare providers have invested heavily in technology and tools to help optimise their processes, improve patient outcomes, and reduce costs. They have also implemented a range of strategies that focus on patient engagement and outcomes-based care. Additionally, they have developed more efficient administrative processes, such as claims processing, and have adopted data-driven analytics to further improve their services.

The industry is also increasingly focused on developing new models of care, such as value-based care and telemedicine, to meet the needs of patients and providers. Managed care organisations are also taking a greater role in managing population health, as well as providing support and services for vulnerable populations.

The managed healthcare industry is thus continuing to evolve and mature, with new technologies, models of care, and strategies being developed all the time. It is an exciting time for the industry, and one that promises to bring many more changes and innovations in the years to come.

Industry Culture

Industry culture, encompassing shared values and practices, significantly influences organisational success. At its most fundamental, it shapes employee behavior, drives engagement, and fosters a sense of belonging, thus enhancing productivity.

Recognising and aligning with industry culture helps businesses navigate market trends, adhere to best practices, and achieve competitive differentiation, vital for long-term sustainability.

The managed healthcare industry is a complex and constantly evolving sector that plays a critical role in the healthcare system. It is important to understand the culture within this industry in order to effectively analyse and assess its operations and strategies.

The culture within the managed healthcare industry is influenced by a variety of factors, including governmental regulations, market forces, and technological advancements. One of the defining characteristics of this industry is its focus on cost containment and efficiency. This is driven by the need to provide quality healthcare services to a large population while also controlling rising healthcare costs. As a result, the culture within the industry is highly data-driven and analytical, with a continuous emphasis on measuring and improving outcomes.

Another key aspect of the culture within the managed healthcare industry is its strong emphasis on collaboration and partnerships. This is evident in the relationships between managed care organisations (MCOs) and their network of providers, as well as their partnerships with pharmaceutical companies and other stakeholders. In order to effectively manage costs and improve outcomes, MCOs rely on building strong relationships and working collaboratively with these partners.

In addition, the culture within the managed healthcare industry is heavily influenced by the use of technology. The industry has been quick to adopt new technologies, such as electronic health records and telemedicine, in order to streamline processes and improve communication between providers and patients. This emphasis on technology has also led to a culture of innovation and continuous improvement, as MCOs are constantly looking for ways to leverage technology to enhance their operations.

Another important aspect of the culture within the managed healthcare industry is its focus on compliance and regulations. With numerous laws and regulations governing the industry, MCOs must prioritise compliance and risk management. This has led to a culture of diligence and attention to detail, as well as a strong emphasis on ethical and responsible practices.

The culture within the managed healthcare industry also places a high value on employee engagement and satisfaction. As the industry relies heavily on the knowledge and expertise of its employees, there is a strong emphasis on creating a positive work environment that fosters collaboration, creativity, and innovation. This is evident in the numerous employee wellness programs and professional development opportunities offered by MCOs.

An industry trend refers to the direction in which a specific sector or market is evolving over time. These trends can manifest in forms, such as tech advancements, shifts in customer behaviour, regulatory change, or socio-economic transformations.

Industry trends can drastically impact the dynamics within a sector, altering competitive landscapes and operational processes. They can drive innovation, influence business strategies, create opportunities for growth, but can also pose potential risks and challenges.

We have identified trends likely to impact the industry vertical over the next decade:

1. Growing Need for Value-Based Care: As the healthcare industry shifts towards a focus on value-based care, managed healthcare organisations are faced with increasing pressure to improve quality, reduce costs, and offer more personalised services and experiences to their customers. This shift towards value-based care is being driven by the need to contain rising healthcare costs, increased consumer expectations for better service, and the evolution of technology-enabled care. Managed healthcare organisations must be prepared to adjust their strategies to meet these demands and take advantage of the opportunities that value-based care presents.

2. Growing Demand for Telehealth: The rise of telehealth technology has revolutionised the way that healthcare is delivered, allowing providers to offer remote access to medical services and to reduce wait times and travel costs for patients. Telehealth also enables providers to offer more personalised care and to more effectively coordinate care across multiple providers. As the demand for telehealth increases, managed healthcare organisations must be prepared to invest in the technology and infrastructure needed to support these services and to ensure that providers are adequately trained to provide quality care.

3. Evolving Payment Models: Managed healthcare organisations must be prepared to adjust their payment models to keep up with the changes in the industry. As providers transition to value-based care, new payment models, such as bundled payments, are being adopted. These models reward providers for achieving quality outcomes rather than simply providing services, creating an incentive for providers to focus on value over volume. Managed healthcare organisations must be prepared to adjust their payment models to reward providers for delivering quality care and to incentivize collaboration between providers and healthcare organisations.

4. Increasing Focus on Consumerism: As healthcare becomes increasingly consumer-driven, managed healthcare organisations must be prepared to meet the needs of their customers. This includes offering greater transparency in terms of cost and quality, providing more personalised services, and using technology to improve the patient experience. Managed healthcare organisations must also be prepared to invest in marketing and outreach efforts to ensure that consumers are aware of the services and benefits they can receive from their healthcare organisations.

5. Growing Need for Data Analytics: Data analytics is becoming increasingly important for managed healthcare organisations as they look to gain insights into their operations and identify opportunities for improvement. By leveraging data-driven insights, managed healthcare organisations can more effectively target resources, tailor services, and improve patient outcomes. Managed healthcare organisations must be prepared to invest in the technology and resources needed to effectively collect and analyse data, as well as hire data analysts to help interpret and apply the insights.

6. Increasing Role of Artificial Intelligence: The use of artificial intelligence is becoming increasingly prevalent in healthcare, with the potential to revolutionise how care is delivered. AI-enabled technologies can be used to automate administrative tasks, streamline workflow, and provide personalised care. Managed healthcare organisations must be prepared to invest in AI-enabled technologies and ensure that their providers are adequately trained to use the technology in order to maximise its potential benefits.

Industry Size

The global managed healthcare industry is estimated to be worth approximately $2.2 trillion dollars in 2019. This is an impressive growth rate when compared to the industry’s estimated value of $1.5 trillion in 2017. It is projected to grow at a compound annual growth rate of 6.2% to reach nearly $3 trillion by 2023.

The managed healthcare industry encompasses a broad range of services, ranging from health benefit plans to managed care services. Managed care services include health maintenance organisations (HMOs), preferred provider organisations (PPOs), point-of-service (POS) plans, and other managed care arrangements. These services are provided to individuals and employers, and usually involve some form of cost sharing through copayments, coinsurance, and deductibles.

The managed healthcare industry is highly fragmented, with the largest players being UnitedHealth Group, Anthem Inc, Cigna Corp, Aetna, and Humana. Together, these five healthcare industry giants account for nearly 60% of the entire managed healthcare market.

The managed healthcare industry is highly competitive, and providers must differentiate their services and products in order to remain competitive. This competition is primarily driven by the need to provide quality care and services at a lower cost. Providers are also under increasing pressure to reduce administrative costs in order to remain competitive. In response, many managed care organisations have developed innovative technologies and strategies to streamline their operations and increase efficiency.

The managed healthcare industry is also highly regulated. Changes in government regulations, such as the Affordable Care Act, have had a significant impact on the industry. In addition, providers must adhere to stringent quality standards and comply with complex billing and reimbursement rules.

The global managed healthcare industry is expected to continue to grow at a steady rate over the next few years. This growth is being driven by the aging population, increasing demand for healthcare services, and the growing prevalence of chronic diseases. The increasing demand for innovative and cost-effective healthcare solutions is also expected to fuel the growth of the managed healthcare industry.

Full access is reserved for Premium members

You must become a Premium member to unlock the rest of this content. Premium membership costs $65 per month, or $595 per year.

Are you looking to purchase multiple seats for your organisation?
If so, please get in touch.

Porter’s Five Forces

Created by Harvard Business School Professor Michael Porter in 1979, Porter’s Five Forces model is designed to help analyse the particular attractiveness of an industry; evaluate investment options; and better assess the competitive environment.

The five forces are as follows:

  • Competitive rivalry: This measures the intensity of competition within the industry.
  • Supplier power: It assesses the ability of suppliers to drive up the prices of your inputs.
  • Buyer power: This examines the strength of your customers to drive down your prices.
  • Threat of substitution: It evaluates the likelihood that your customers will find a different way of doing what you do.
  • Threat of new entries: This considers the ease with which new competitors can enter the market.

Through this analysis, businesses can identify their strengths, weaknesses, and potential threats, thus enhancing their competitive strategies and securing their market positioning.

Intensity of Industry Rivalry

The intensity of industry rivalry in the managed healthcare industry is high. This is due to the presence of a large number of competitors in the market, as well as the presence of limited switching costs for customers. In the managed healthcare industry, the competition is based on offering the best services and products at the lowest cost.

The industry is highly fragmented, with a large number of competitors ranging from large national health plans to small regional ones.

The competition is further intensified by the presence of government regulations, which ensure that all providers offer the same services and products. Additionally, the industry is characterised by intense price competition, with providers competing on price to attract customers. This pressure to stay competitive has led to an increase in the use of innovative technologies and service delivery models, as well as the development of new and improved products.

Threat of Potential Entrants

The threat of potential entrants is moderate in the managed healthcare industry. This is due to the presence of several barriers to entry, such as the need for significant capital investments, the presence of complex regulations, and the need for specialised skills. In addition, any potential entrants would have to compete with existing providers who have established customer bases and brand recognition. What’s more, the industry is highly regulated, and any potential entrants would need to comply with all relevant regulations in order to be successful.

Bargaining Power of Suppliers

The bargaining power of suppliers is low in the managed healthcare industry. This is due to the presence of a large number of suppliers in the market, as well as the presence of a large number of other buyers who are able to offer competitive prices. Additionally, the industry is characterised by a high degree of standardisation, which makes it difficult for suppliers to differentiate themselves or their products. In addition, the industry is highly regulated, which limits the ability of suppliers to raise prices.

Bargaining Power of Buyers

The bargaining power of buyers is moderate in the managed healthcare industry. This is due to the presence of a large number of buyers in the market, as well as the presence of a wide range of providers who offer similar services and products. Additionally, the industry is characterised by a high degree of standardisation, which makes it difficult for buyers to differentiate between providers. What’s more, the industry is highly regulated, which limits the ability of buyers to negotiate prices.

Threat of Substitute

The threat of substitute is low in the managed healthcare industry. This is due to the presence of a limited number of alternatives to managed healthcare services. Additionally, the industry is characterised by a high degree of specialisation, which makes it difficult for substitutes to provide the same level of service. What’s more, the industry is highly regulated, which limits the ability of substitutes to offer competitive prices.

Managed healthcare services are often seen as a necessity, which further reduces the threat of substitute.

PEST Analysis

A PEST analysis evaluates key external factors affecting an organisation:

  • Political: Government policies, regulations, and political stability
  • Economic: Economic conditions like inflation, interest rates, and growth
  • Social: Societal trends, demographics, and consumer attitudes
  • Technological: Technological innovation impacting operations and consumer expectations

Reasons to use a PEST analysis:

  • Environmental Scanning: Assesses external factors shaping the business
  • Strategic Planning: Identifies opportunities, threats, and aligns strategies
  • Risk Assessment: Highlights risks for proactive mitigation
  • Market Analysis: Provides insights into trends, behavior, and gaps
  • Business Adaptation: Helps adapt to changes in preferences, regulations, and technology

Below is the PEST analysis for this vertical:

Political

The managed healthcare industry is highly regulated by the government, both at the federal and state levels. The passage of the Affordable Care Act in 2010 resulted in significant changes to the managed healthcare sector. The law included several provisions that increased health insurance coverage, such as expanding Medicaid and creating health insurance exchanges. Additionally, the law also included several provisions that increased the regulation of the industry, such as requiring insurers to cover pre-existing conditions and limiting the ability of insurers to set prices.

In addition to the Affordable Care Act, there are other federal laws and regulations that impact the managed healthcare industry. For example, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) established standards for the privacy and security of health information. Other laws and regulations include the Medicare Access and CHIP Reauthorisation Act of 2015 (MACRA), which established new payment models for Medicare providers, and the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), which requires health plans to provide equal coverage for mental health services.

At the state level, managed healthcare is regulated by state insurance departments, which oversee and enforce regulations related to the pricing, coverage, and operations of health plans. State governments also have the authority to regulate the scope of practice of healthcare providers, such as physicians, nurses, and pharmacists.

Economic

The managed healthcare industry is heavily influenced by economic factors, such as the overall state of the economy, the cost of healthcare services, and the cost of health insurance premiums. The overall state of the economy impacts the industry by influencing the number of people who are able to afford health insurance coverage. During periods of economic recession, the number of people with health insurance coverage typically decreases, as many people are unable to afford the cost of premiums.

The cost of healthcare services is a major factor in the managed healthcare industry, as it directly affects the cost of health insurance premiums. As healthcare costs increase, health insurance premiums typically increase as well. Similarly, as healthcare costs decrease, health insurance premiums typically decrease as well.

The cost of health insurance premiums is also affected by the availability of health insurance subsidies. The federal government provides subsidies to individuals and families who are unable to afford the cost of health insurance premiums. These subsidies help to make health insurance more affordable for individuals and families who meet certain income requirements.

Social

Social factors are an important part of the managed healthcare industry, as they can have a significant impact on the demand for health insurance coverage. For example, changes in the demographics of a certain region can affect the demand for health insurance coverage. As the population of a region ages, the demand for health insurance coverage typically increases, as older individuals tend to have higher healthcare costs than younger individuals.

In addition, changes in the cultural attitudes towards healthcare can also affect the demand for health insurance coverage. As healthcare becomes more accessible and affordable, the demand for health insurance coverage typically increases. What’s more, as healthcare becomes more accepted and accepted by the public, the demand for health insurance coverage also typically increases.

Technological

Technology has had a major impact on the managed healthcare industry, as it has enabled healthcare providers to provide more efficient and cost-effective care. For example, advances in electronic health records (EHRs) have enabled healthcare providers to easily access patient records, which has enabled them to provide more efficient care. Additionally, advances in telemedicine have enabled healthcare providers to provide care remotely, which has enabled them to provide care to patients in remote areas who would otherwise not have access to care.

In addition, technology has enabled healthcare providers to collect and analyse data more efficiently, which has enabled them to improve the quality of care that they provide. For example, the use of data analytics has enabled healthcare providers to identify patterns in patient data, which has enabled them to provide more personalised care. Additionally, the use of predictive analytics has enabled healthcare providers to anticipate the needs of patients and provide more proactive care.

Regulatory Agencies

Government and regulatory agencies shape the business ecosystem by enforcing laws that govern industries, trade, and business practices. Their influence ensures a fair and competitive market.

Below is a list of key agencies relevant to the sector:

  • Centers for Medicare & Medicaid Services (CMS)
  • Department of Health and Human Services (HHS)
  • Food and Drug Administration (FDA)
  • Occupational Safety and Health Administration (OSHA)
  • Internal Revenue Service (IRS)
  • Department of Labor (DOL)
  • Federal Trade Commission (FTC)
  • Federal Communications Commission (FCC)
  • National Association of Insurance Commissioners (NAIC)
  • State Medicaid Agencies
  • State Insurance Departments
  • State Departments of Public Health
  • State Health Care Financing Administrations
  • State Departments of Managed Care
  • State Attorneys General
  • Joint Commission on Accreditation of Healthcare Organisations (JCAHO)

Industry Innovation

Innovation drives industry growth by creating new ideas, improving efficiency, and developing advanced products. It fosters adaptability and competitiveness, crucial for meeting market demands.

Without innovation, industries risk stagnation and decline.

This study divides innovations into:

  • Current: Ongoing innovations
  • Potential: Future-focused innovations

The managed healthcare industry has undergone significant transformations in recent years, driven primarily by the advancements in technology and the increasing demand for more efficient and cost-effective healthcare solutions. As a result, the industry has witnessed a surge in innovations, both in terms of services and business models. These innovations have not only improved the overall quality of healthcare but have also made it more accessible and affordable for patients.

Current Innovations

One of the most significant innovations in the managed healthcare industry is the adoption of electronic health records (EHRs). EHRs have revolutionised the way healthcare providers store and share patient information. They have replaced the traditional paper-based medical records, making it easier for providers to access and analyse patient data. EHRs have also improved communication and coordination among healthcare teams, resulting in better patient outcomes.

Another innovation that has transformed managed healthcare is telemedicine. With the increasing use of smartphones and other digital devices, telemedicine has become an essential tool for delivering remote healthcare services. Patients can now consult with their healthcare providers through virtual appointments, saving them time and money. Telemedicine has also enabled providers to reach patients in remote and underserved areas, expanding access to healthcare services.

The use of artificial intelligence and data analytics has also been a game-changer in the managed healthcare industry. AI-powered tools can analyse vast amounts of patient data, providing valuable insights to healthcare providers. These insights help providers to identify patterns and predict potential health risks, enabling them to intervene early and prevent serious health issues. AI has also improved the accuracy and speed of medical diagnoses, leading to better treatment outcomes.

Potential Innovations

While the current innovations in managed healthcare have undoubtedly improved the industry, there is still room for more innovation. One potential innovation is the use of blockchain technology in healthcare. Blockchain, a decentralised and secure data storage system, has the potential to revolutionise the management of patient health records. It can improve data sharing and interoperability, allowing patients to have more control over their health information. Blockchain can also facilitate secure and efficient payments between healthcare providers and insurance companies, reducing administrative costs.

Another potential innovation in managed healthcare is the use of wearables and connected devices. These devices can track a patient’s health data in real-time and provide insights on their health status. Wearables can also remind patients to take their medications, track their physical activity, and even monitor their sleep patterns. This data can be shared with healthcare providers, enabling them to personalize treatment plans and improve patient outcomes.

In addition to wearables, the Internet of Medical Things (IoMT) has the potential to transform managed healthcare. IoMT refers to the interconnected devices and sensors used in healthcare to collect and transmit patient data. This data can be used for remote patient monitoring, early detection of health issues, and tracking of chronic conditions. IoMT can also facilitate preventive care by alerting patients and healthcare providers of potential health risks.

Another potential innovation is the use of genomics in healthcare. Advances in genomics have made it possible to analyse an individual’s genetic makeup and identify potential health risks. This information can be used to develop personalised treatment plans and prevent the development of certain diseases. Genomics can also be used in precision medicine, where treatments are tailored to an individual’s genetic profile, leading to more effective and efficient care.

Potential for Disruption

Disruption occurs when new technologies, processes, or ideas challenge market norms and shift industry value.

Key disruptors include:

  • Technological Innovations: AI and automation change sectors like manufacturing and customer service
  • Consumer Behavior: Shifts in preferences, like health trends, impact industries such as food
  • Regulatory Changes: New policies, like GDPR, affect industries such as tech
  • Social Changes: Growing sustainability concerns reshape industries like fashion
  • Economic Shifts: Economic factors, such as financial crises, force industry adaptations
  • New Entrants: Companies like Uber and Airbnb disrupt established industries
  • Global Events: Pandemics and disasters, like COVID-19, disrupt sectors like travel
  • Supply Chain Issues: Shortages, like the chip crisis, affect industries like automotive

The managed healthcare industry is one that is ripe for disruption. With rising costs, increased demand, and uncertain regulations, many of the current providers of managed care are struggling to keep up with the changing landscape.

In recent years, the managed healthcare industry has been faced with higher costs due to rising prices for drugs and other medical services. This has been exacerbated by an aging population and the resulting increased demand for services. Additionally, insurers have been forced to absorb the costs of expensive treatments and procedures as well as the administrative costs associated with managing these services. With traditional managed care providers unable to keep up with these costs, there is an increased risk of disruption in the industry.

The emergence of new technologies has already begun to disrupt the managed healthcare industry. For example, mobile health applications such as health tracking apps, telemedicine, and online health services have made it easier for patients to access information and services without needing to visit a doctor’s office. This has enabled customers to seek out more affordable options, and has forced traditional managed care providers to adjust their business models to remain competitive.

In addition, the increasing uncertainty surrounding healthcare regulations has created a challenging environment for managed care providers. With the Affordable Care Act and other changes to the healthcare landscape, providers are struggling to keep up with the changing regulations and their implications for their businesses. This has opened the door for innovative start-ups to disrupt the managed healthcare industry by offering easier access to health insurance and more cost-efficient options.

What’s more, the emergence of consumer-directed healthcare has created an opportunity for disruption in the managed healthcare industry. With the rise of high deductible health plans and health savings accounts, consumers are increasingly seeking out more affordable healthcare options. This has allowed innovative start-ups to offer healthcare services at more competitive prices, and has forced traditional managed care providers to adjust their business models to remain competitive.

Ultimately, the managed healthcare industry is facing a period of significant disruption. With rising costs, increased demand, and uncertain regulations, traditional managed care providers are struggling to keep up with the changing landscape. However, this disruption presents an opportunity for innovative start-ups to enter the market and offer more cost-competitive solutions. By leveraging new technologies and offering more consumer-driven options, these start-ups can help drive competition and provide consumers with more affordable healthcare options.

ESG

ESG criteria are a set of standards for a company’s operations that socially conscious investors use to screen potential investments.

  • Environmental: Environmental standards consider a company’s stewardship of nature
  • Social: Social criteria examine how a company manages relationships with employees, suppliers, customers, and communities
  • Governance: Governance deals with leadership, executive pay, audits, internal controls, and shareholder rights

Companies and industry sectors with strong ESG practices may enjoy enhanced reputation, more investment and better long-term performance.

Environmental, Social, and Governance factors have become increasingly important in the business world, as companies recognise the impact of their operations on society and the environment. The managed healthcare industry is no exception, as it is directly impacted by ESG in several ways.

Firstly, the environmental aspect of ESG is becoming a crucial consideration for managed healthcare companies. With growing concerns about climate change and pollution, consumers are becoming more environmentally conscious and are demanding that companies take steps to reduce their environmental footprint. In the healthcare industry, this means implementing sustainable practices in their operations, such as reducing energy consumption, using eco-friendly materials, and properly disposing of medical waste. Companies that fail to prioritise environmental sustainability may face backlash from both consumers and investors, potentially damaging their reputation and financial performance.

Secondly, social factors play a significant role in the managed healthcare industry. As a service-based industry, the success of managed healthcare companies is heavily reliant on their relationships with patients, providers, and other stakeholders. ESG factors, such as social responsibility and ethical business practices, are crucial in building and maintaining these relationships. Companies that prioritise social responsibility by investing in programs that improve the health and well-being of communities they serve, for example, are likely to be viewed more positively by their stakeholders, leading to increased loyalty and trust.

Lastly, governance is a critical aspect of ESG that impacts the managed healthcare industry. With the increasing scrutiny of corporate governance practices, companies in the healthcare industry must ensure they have transparent and effective governance structures in place. This includes having diverse and independent boards, strong risk management systems, and ethical leadership. Companies that demonstrate good governance practices are more likely to attract investors and maintain a positive reputation, which can ultimately lead to better financial performance.

Increasing Sustainability

Increasing sustainability within any industry vertical has the following key benefits:

  • Mitigates environmental impact
  • Conserves resources for future generations
  • Responds to consumer demand for ethical practices

Increased sustainability enables businesses to remain competitive in a market that increasingly values corporate responsibility, while driving innovation, reducing costs, and ensuring compliance with evolving regulations, thus supporting long-term profitability.

The managed healthcare industry has been rapidly evolving in recent years, with a growing focus on sustainability and its potential impact on the industry. As healthcare costs continue to rise and the need for more efficient and cost-effective solutions becomes increasingly important, there are several key opportunities for sustainability in the managed healthcare industry. These opportunities not only have the potential to reduce costs and improve overall efficiency, but also to promote a healthier and more environmentally friendly approach to healthcare.

One of the main opportunities for sustainability in the managed healthcare industry lies in the adoption of technology. With the rise of digital health solutions, such as telemedicine and electronic health records, there is a significant potential for reducing paper waste and increasing efficiency. Electronic health records, in particular, have the potential to cut down on the amount of paper and resources used in healthcare administration, while also improving the accuracy and accessibility of patient information. Additionally, telemedicine has the potential to reduce the need for patients to travel to healthcare facilities, thus reducing carbon emissions and promoting a more eco-friendly approach to healthcare delivery.

Another key opportunity for sustainability in the managed healthcare industry is through the implementation of sustainable practices in healthcare facilities. This can include using energy-efficient technologies, such as LED lighting and renewable energy sources, as well as implementing waste reduction and recycling programs. By promoting sustainable practices in healthcare facilities, managed healthcare organisations can not only reduce their environmental impact but also save on operational costs in the long run.

What’s more, there is a growing trend towards value-based care in the managed healthcare industry, which focuses on improving patient outcomes while also reducing costs. This presents an opportunity for sustainability as it encourages healthcare providers to focus on prevention and disease management, rather than just treating illnesses. By promoting healthy behaviours and preventive measures, managed healthcare organisations can not only improve patient outcomes but also reduce the environmental impact of healthcare by reducing the need for treatments and procedures.

Lastly, there is an opportunity for sustainability in the managed healthcare industry through collaboration and partnerships. By working with other stakeholders, such as government agencies, non-profit organisations, and community groups, managed healthcare organisations can identify and address environmental and social issues that impact the health of their members. This can include initiatives such as promoting healthy food options, supporting local farmers, and providing access to green spaces for physical activity.

Sentiment Analysis

Sentiment analysis is crucial in the analysis of an industry, because it helps professionals understand emotions around the sector; and not merely an individual business.

We have crawled social media posts and thousands of news articles relating to this industry over the past two years. The cut-off date for articles in this crawl was 13th November 2024, with updates planned every quarter.

Once crawled, each content item is indexed and then processed for contextual analysis, with positive indicators such as ‘excellent’, ‘satisfied’, and ‘happy’; along with neutral and negative indicators flagged as important for the evaluation of industry sentiment.

The final score equates to the calculated average across all content items.

Scoring

The scoring is defined as follows:

  • Positive: (1)
  • Somewhat Positive: (2)
  • Neutral: (3)
  • Somewhat Negative: (4)
  • Negative: (5)

Key Findings

As part of this sentiment analysis, we have concluded the following:

  • The managed healthcare market has been experiencing fluctuations in recent years.
  • Some factors that have contributed to this include changes in government policies and regulations.
  • There has been increased competition among managed healthcare companies.
  • Despite these challenges, the demand for managed healthcare services remains high.
  • One positive aspect is the growing focus on preventative care and wellness programs.
  • There have also been concerns about rising healthcare costs and limited access to care.
  • Innovations in technology have the potential to improve efficiency and reduce costs in the long run.

Sentiment Score: 3

Further Reading

Industry Keywords

Methodology

This market research forms part of the Premium membership suite.

The analysis is based on information and learning from the following sources:

  • Focus group sessions
  • Corporate websites
  • Proprietary databases
  • SEC filings
  • Corporate press releases
  • Desk research

More Information

To gain full access to all our market research reports, along with tens of thousands of company, industry and city reports and articles, become a Premium member.

Disclaimer

All Rights Reserved.

Reproduction of the content produced in this report is prohibited without the prior permission of the publisher, Platform Executive Pty Ltd.

The facts of this report have been gathered in good faith from both primary and secondary sources. It is believed to be correct at the time of publication, but cannot be guaranteed. As such Platform Executive can accept no liability whatever for actions taken based on any information that may subsequently prove to be incorrect.

Related Research