Health care insurance companies determined more than 20 years ago, that the key to success in the individual and small business health care insurance business was based on two cornerstones: health care underwriting and market share.
In the large employer third party administered health insurance business, the key was market share, cost efficient claims management, claims payment delay and avoidance, and utilization management. So the insurance companies set out to excel in these areas in order to succeed.
I will examine each of these success factors over the next week in my successive blogs to provide you insights into the behavior of health insurance companies. In addition, I will attempt to lay out recommended regulation and legislation, that could restore effective competition to the health care insurance industry.