麦肯锡：2023年及以后美国医疗保健展望报告（英文版）（10页）.pdf

1、Healthcare PracticeWhat to expect in US healthcare in 2023 and beyondRecent developments have complicated the outlook for industry profit pools.By Neha Patel and Shubham SinghalJanuary 2023 Raken/Getty ImagesGoing forward,a number of factors will likely influence shifts in profit pools.These include

2、:Change in payer mix:A substantial shift toward Medicare will continue,led by growth in the over-65 population of 3 percent per year projected over the next five years and continued popularity of Medicare Advantage among seniors,as reflected in the latest Centers for Medicare&Medicaid Services(CMS)e

3、nrollment data.3 However,based on our models,Medicaid enrollment could decline by about ten million lives over five years given recent legislation that will allow states to begin eligibility redeterminations,which were paused during the federal public health emergency that was declared at the start

4、of the COVID-19 pandemic.4 Commercial segment margins in 2021 were about 200 basis points lower than 2019 levels,resulting from the return of deferred care.We expect profit pools in this segment to rebound and grow at a 15 percent CAGR as EBITDA margins will likely return to historical averages by 2

5、026.The growth will be partially offset by enrollment changes in the segment,prompted by a shift from fully-insured to self-insured businesses that could accelerate as employers facing recessionary pressure seek to cut costs.Endemic COVID-19:Since the publication of our last article,COVID-19 has mov

6、ed more and more toward an endemic stage.Based on our estimates,endemic COVID-19 could result in healthcare costs of about$200 billion annually in the United States.The majority of these costs would be When we last looked at the trajectory of the US healthcare industry in our July 2022 article,“The