Managed Care Outlook 2024

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In the ever-evolving landscape of health care, where policy changes, technological advancements and societal shifts play pivotal roles, staying ahead of the curve is not just a strategy; it’s a necessity. As legal professionals and business leaders in managed care organizations (MCOs), your role is more crucial than ever in shaping the industry’s future while ensuring compliance and navigating complex regulatory frameworks.

Authors: Martin J. Bishop

Welcome to the 2024 edition of the Managed Care Outlook, your compass in the dynamic sea of health care management. In this comprehensive series of articles, we aim to provide an insightful preview of the hot topics and emerging trends that will define the managed care industry in 2024. Our goal is to equip legal departments and their business partners with the knowledge and foresight needed to proactively address challenges and capitalize on opportunities, fostering a resilient and forward-thinking approach.

With so much development in the law, regulation and politics surrounding health care and MCOs, it is nearly impossible to reduce the landscape down to all-encompassing categories or themes. Complexity notwithstanding, there are three key themes that our practice will be focused on in 2024, all of which permeate this edition of the Managed Care Outlook:

Regulatory reshaping: Adapting to policy winds

The winds of policy change are ever shifting, and 2024 promises no reprieve. From politically charged developments in the regulation of abortion and gender-affirming care for minors, to potential updates to telehealth regulations, to the continuous debate over drug pricing, the Managed Care Outlook delves into the regulatory landscape. We dissect how legislative developments may impact managed care organizations, offering strategic guidance on compliance and potential shifts in operational paradigms.

Technology and telehealth: Digital revolutions in health care

As the digital revolution sweeps across industries, health care stands at the forefront of transformation. The adoption of telehealth services, artificial intelligence (AI) and data analytics presents both opportunities and challenges. How can legal departments navigate the intricate web of privacy laws while embracing innovative technologies? And how will MCOs embrace AI’s potential while avoiding the developing legal and regulatory risks? Join us as we explore the legal implications of the digital age in managed care and strategies to harness its potential.

Key takeaways
  • State abortion and gender-affirming care prohibitions could spill liability onto health plans
  • Digital advancement brings concerns about security of health data, and about AI’s impacts on medical decision-making
  • The times call for providers and payors to find new ways of cooperating on network payment issues
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