A number of long-term challenges for the industry are identified and discussed in the paper.
- Continued movement to looser products and models
- Survival of the traditional HMO largely as a niche-product
- Technology challenges on both clinical and technology fronts
- Major purchaser preference shifts to direct contracting with providers or defined contributions for employees/beneficiaries
- On-going consequences of efforts at provider organization
- A continuing legitimacy deficit for the managed care industry