HCEG Top 10

The Top 10 has been a pillar of HCEG for over 10 years, providing extensive insight into the industry, based on HCEG member input and sponsor research.

Through the development of the Top 10, HCEG encourages continuous and evolving dialog on the main issues and concerns facing member organizations.

The list, compiled directly from HCEG member surveys and Forum initiated-input, is the keystone for industry wide analysis, and subsequent research: The Industry Pulse, an annual survey initiative, conducted over the past five years in partnership with HTMS.

The survey is designed to gather input on priorities and challenges for payers across the country and then share the findings with the industry and the public at large.

The Industry Pulse provides stakeholders across the healthcare spectrum direct insight into obstacles and opportunities, as voted on by a significant representation of the market at HCEG.

2017 HCEG Top 10

Click on a Top 10 item for more information

  1. Value-based Payments: targeting specific medical conditions to manage cost and quality of care
  2. Total Consumer Health: improving member’s overall well-being – medical, social, financial, and environmental
  3. Clinical and Data Analytics: leveraging big data with clinical evidence to segment populations, manage health and drive decisions
  4. Cybersecurity: protecting the privacy and security of consumer information
  5. Cost Transparency: growing legislation and consumer demand
  6. Harnessing Mobile Health Technology: improving disease management, member engagement, and data collection/distribution
  7. Addressing Pharmacy Costs: implementing strategies to address growth of pharma costs versus benefits to quality of care and total medical costs
  8. Care Redesign: leveraging team-based care models, focusing on behavioral health and social needs
  9. Accessible Points of Care: telehealth, retail clinics and micro-hospitals vs. large, integrated systems
  10. Next Generation ACOs: additional programs in bundled payment, episodes of care-shared savings, and growing participant base

2016 HCEG Top 10

  1. The Consumer Experience: omnichannel business, mHealth, HIX, social media and telehealth.
  2. Payment reform: ACOs, P4P, value-based care and value-based reimbursement
  3. Population health: managing total health, including social and environmental determinants
  4. Provider/Plan integration: combining functions of care delivery and financing in a single organization.
  5. Transparency: triple aim price, quality and service measures to support customer decisions
  6. Retail health care: established consumer companies disrupt traditional care providers (TIED)
  7. Pharmacy: cost, compliance, convenience & specialty health (TIED)
  8. Big data and advanced analytics: identifying patterns, opportunities in vastly detailed data sets
  9. Cybersecurity: protecting the privacy and security of customer information
  10. Genomics: customizing prevention and treatment to individual DNA

2015 HCEG Top 10

  1. Payment reform, ACOs, value-based care and value-based reimbursement
  2. ACA implementation (3Rs, MLR, etc.) and adapting to evolving regulations and requirements
  3. Price, quality and access transparency to support the consumer experience
  4. Bend the cost curve in both medical and administrative expenses
  5. Medicare, Medicaid expansion, dual eligibles and other government programs
  6. Member management/strategy, portals, engagement, education and communication
  7. Big Data and the race to advanced analytics and informatics
  8. Consumerism initiative driving health care
  9. Mobile/Digital devices, telemedicine, mHealth and social media
  10. Personal health monitoring, population

2014 HCEG Top 10

  1. Mobile/Digital Devices, Telemedicine, and mHealth
  2. Payment Reform, ACOs, Value-Based Care and Reimbursement
  3. Price, Quality and Access Transparency to support the Consumer Experience
  4. ACA Implementation (3Rs, MLR, etc.) and Adapting to Evolving Regulations
  5. Member Management and Strategy, Portals, Engagement, Education and Communications
  6. Consumerism Initiatives Driving Health Care
  7. Medicare, Medicaid Expansion, Duel Eligible and other Government Programs
  8. Big Data and Race to Advanced Analytics
  9. Personal Health Monitoring, Population Health and Wellness, Incentives and Rewards
  10. Bending the Cost Curve in both Medical and Administrative Expenses

2013 HCEG Top 10

  1. Health Insurance Exchanges (HIXs)
  2. Reform, Regulation and Market Uncertainties
  3. Consumerism Driving Health Care
  4. Care Management, Data Analytics, and Informatics to Improve Outcomes
  5. Medicare, Medicaid and Other Government Programs
  6. New Provider Payment Models & Delivery Systems
  7. Operational Overload and Competing Priorities
  8. Social Media, Mobility, BYOD, and Digital Health
  9. Innovation and Collaboration of Business and IT for Competitive Advantage
  10. Hiring, Engaging and Empowering staff for the 21st Century Workplace

2012 HCEG Top 10

  1. Bend the Cost Trend in both Medical and Administrative Expenses
  2. Care Management, Data Analytics, and Informatics to Improve Outcomes
  3. New Provider Payment Models & Delivery Systems (ACOs, PCMHs)
  4. Medicare, Medicaid and Other Government Programs
  5. Health Information Exchanges (HIEs)
  6. Big Data, Warehousing and Analytical Capability Expansion
  7. Payer/Provider Interoperability
  8. Administrative Simplification, Mandates and Efficiency (HIPAA 5010, ICD-10, MLR)
  9. Health Insurance Exchanges (HIXs)
  10. PHI Privacy and Security

2011 HCEG Top 10

  1. Administrative Mandates (Compliance HIPAA 5010, ICD-10, etc.)
  2. Care Management, Data Analytics, and Informatics.
  3. Health Insurance Exchanges and Individual Markets.
  4. New Provider Payment & Delivery Systems (ACOs, PCMHs, etc.).
  5. Bend the Cost Trend.
  6. Medicare and Medicaid.
  7. Health Information Exchanges and EMRs.
  8. Consumer’s Role in the Modernization of Healthcare.
  9. Reform Uncertainties.
  10. Payer / Provider Interoperability.