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While Originally Intended for Consumers, Health Plan Price Transparency Will Ultimately Promote Value-Based Competition-1
Life Science Investments Signal a Continued Focus on Oncology and Immunology
2022 Trends Shaping the Health Economy Report
Health Plan Price Transparency

Healthcare’s Negative-Sum Game Impacts Every Stakeholder in the Health Economy

For decades, the U.S. health economy has operated as if the fundamental rules of economics – demand, supply and yield – do not apply.
The U.S. healthcare system is what game theorists call a “negative-sum game,” and the rules of that game are immutable.

5,000 babies are born covered by commercial insurance each day, while 10,000 people become Medicare eligible each day.

The commercially insured population is shrinking, as ~10,000 Americans become Medicare-eligible each day, while almost half of the ~10,000 daily births are covered by Medicaid.

Supply of providers now includes Amazon, Optum, Teladoc, Walgreens, Walmart, CVS and VillageMD.

Patients have an increasing number of providers from which to choose, with new entrants offering services to compete with traditional providers at lower prices.

Impact of Reduced Yield by Stakeholder: Highly positive impact for payers; highly negative impact for hospitals, health systems & physicians.

As the number of Americans with government-sponsored health insurance increases, the impact of inadequate reimbursement from Medicare and Medicaid is amplified.

Network Performance Determines the Winners and Losers in Healthcare's Negative-Sum Game

The measure of network performance is different for different stakeholders in the health economy, but the variables
are the same for every stakeholder: the series, and sequence, of provider and patient decisions.

Map of Markets Most Similar and Dissimilar to Austin, TX Based On Aggregate Similarity

Are you in the right markets?
Market quality is the most important variable in the performance of a network, and understanding market quality is essential to selecting the markets in which to compete.

How does your network perform in the markets you serve?
Every market has a total addressable market (TAM) of goods and services. Network performance measures how well an organization maximizes its performance within the TAM as compared to other competitors. Do you know the TAM and “share of care” in every market you serve?

Share of Care for Patients Who Had At Least One Encounter at the Cedars-Sinai Medical Center Campus in 2021, In-System vs Out-of-System
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How can you improve network performance?
To win healthcare’s negative-sum game, health economy stakeholders must understand the economic principles underpinning changing industry dynamics and then design targeted, competitive strategies in every market to maximize network performance.

Provider Referral Decisions and Consumer Options Impact the Patient Journey

How do provider decisions impact your network performance?
Everything in healthcare begins with a provider decision.
The only way to improve network performance for providers, payers, employers or life science companies is to have a detailed understanding of the locations of, practice patterns of and value (cost + quality) provided by the more than 2.7M providers in the United States.

How do consumer decisions impact your network performance?
Patients are people, and whether a patient adheres to a particular network depends on many factors, including access, affordability, consumer psychology and benefit design. 

Healthcare Analytics for Every Stakeholder

Provider Solutions
Health Plans Solutions
Life Sciences Solutions

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Data-driven Insights on the Health Economy

The health economy creates more data than any other part of the U.S. economy. Trilliant Health’s research and reports examine the organization, financing and delivery of healthcare from the lens of demand, supply and yield.

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The Compass
A weekly research publication led by Chief Research Officer, Sanjula Jain, Ph.D., The Compass explores data-driven trends as a guide to the increasingly complex health economy.

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2022 Trends Shaping the Health Economy

2022 Trends Shaping the Health Economy
Our second annual Trends Shaping the Health Economy report sheds light on the past, contextualizes the present and predicts the future of the $4.3T health economy.

Download the Full Report >


Trends Shaping the Health Economy | Behavioral Health
Our Trends Shaping the Health Economy: Behavioral Health report highlights eight macro trends to explore how the pandemic altered behavioral health diagnosis and treatment in America through the lens of supply, demand and yield.

Read the Full Report >