Services

Provider-health plan integration

Using health care financing as the catalyst for innovation

​Many health care providers are weighing a move into the health plan space. Already, there are more than 220 provider-sponsored plans in the US—and they represent less than 10 percent of the market, so many more are likely to follow. However, few of these pioneers are leveraging the full potential of the new model.

How we can help

​Our end-to-end solution can empower a health care provider to stand up an operational, licensed health plan that can advance new reimbursement models and a differentiated patient experience. For many provider organizations, this transformation presents a path to sustained profitability.

Our services include:

  • Value-based care, network strategy, and bundled payments financial strategy
  • M&A strategy-white label options
  • Health plan synergy models
  • Market attractiveness-prioritization
  • Product design and pricing
  • Licensing
  • Core administration platform strategy and implementation
  • Staffing models
  • Tax strategy
  • Change management
  • Patient and consumer experience
  • Sales and distribution strategy
  • Risk and compliance
  • Fraud analytics
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Key Potential Benefits

  • ​Develop and implement provider-health plan integration reimbursement models
  • Capitalize on the economic benefits of a transition to a risk-based business model
  • Generate enhanced margins to finance consumer-centric care transformation
  • Access to accelerators, methodologies, and capabilities instead of building from scratch
  • Reduce the execution risk and cost of transition to a providerhealth plan integration model
  • Unlearn the volume habit and generate greater margin through a change in service mix

Meet the leaders

Bill Copeland

Bill Copeland

US Life Sciences & Health Care Industry Leader

Bill, vice chairman of Deloitte LLP, is a 30-year Deloitte veteran and leads the US Life Sciences & Health Care practice. Bill is also Deloitte’s Corporate Citizenship champion for RightStep, Deloitte... More

Jim Whisler

Jim Whisler

Principal | Life Sciences & Health Care

Jim is the national leader of Deloitte Consulting LLP’s health actuarial practice. With more than 20 years experience, he specializes in managed care, including accountable care (opportunity identific... More

Ollie McCoy

Ollie McCoy

Principal | Life Sciences & Health Care

Ollie is the US M&A Practice leader, managed Health Care for Deloitte Consulting LLP. He led the industry’s largest multi-year health plan restructuring effort, and several other large-scale M&A trans... More