The health insurance landscape continues to rapidly evolve, presenting new regulations, challenges and opportunities. One of the areas many health plans are continuing to refine is their approach to risk adjustment. While risk adjustment is commonly viewed from the perspective of compliance and cost savings, a well-defined strategy, fine-tuned structure and function-specific expertise can evolve it into a revenue generating area within your organization.

The 2020 healthcare open enrollment period is nearly here, slated to run from Nov. 1 to Dec. 15, 2019, with Medicare open enrollment from Oct. 15 to Dec. 7. As you know, with this seasonal spike in enrollment comes a much heavier workload. How can you best prepare for the influx to avoid staff burnout and increase productivity during this peak period?

Written by Joanne Turner, Assistant Vice President, and Blake Grimm, Client Development Manager

The future of healthcare is upon us and it’s offering a chance for payers to lead the industry through innovation and expansion. Global healthcare spending is projected to reach $8.7 trillion by 2020. Organizations are continuously finding smarter and more innovative ways to deliver efficient and effective patient care. The unprecedented growth commands additional job opportunities. According to the Bureau of Labor Statistics, the healthcare industry is expected to add four million new jobs and account for approximately a third of total job growth by 2026.

Healthcare professionals and their patients are retiring at an alarming rate. In fact, there will be more than one million openings for registered nurses by 2024 - twice the rate seen in previous shortages. Meanwhile, there will be a 55 percent increase in number of Americans aged 65 and older who seek additional care over the next two years. However, nursing school enrollment is not increasing fast enough to meet this projected demand and lack of nursing school faculty is preventing larger program enrollments.

No longer just an ominous warning for the future, the long-predicted war for talent is here. The insurance industry—in particular—has been hard hit by the emerging talent crunch and insurers are now faced with more openings than potential professionals. The result is a candidate’s market.