For over a decade, healthcare insurers have grappled with a trio of challenges: soaring medical costs, complex administrative processes, and workforce limitations. These issues have spurred the evolution of population health management, along with efforts to improve care management (CM), utilization management (UM), and data integration. 

This concise yet comprehensive report delves into the significant challenges health plans face, which also impact employers and government health initiatives. It evaluates the effectiveness of existing tools and strategies in CM, UM, and population health, as assessed by industry leaders.

This research, commissioned by Medecision, gathers perspectives from more than 50 C-Suite leaders, offering invaluable insights for those seeking to make a significant impact in the healthcare sector.

A crucial finding is the importance of 'contextual understanding' of the member. By integrating various data sources, health plans can achieve a more comprehensive understanding of individual needs, leading to better health outcomes.