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      Industry

      Healthcare Payers

      Healthcare Payers

      Manage costs and catalyze growth as you enhance service levels

      Our Experience

      180+
      projects completed across strategy, analytics and other services
      200+
      dedicated and experienced global partners

      Health plans compete in a particularly dynamic—and challenging—industry. We can help you improve share in flat-growth markets; build and buy into new, high-growth markets; improve your Medical Loss Ratio; deploy analytics to derive powerful insights from your data; improve member experiences; and turbo-charge automation.

      Our health insurance consulting teams collaborate with you to address:

      • Value chain re-alignment triggered by M&A
      • Renewed competition for core processes, from providers and privately funded third parties
      • Increased competition in the most attractive and shifting membership profit pools
      • Increased activity with direct-to-employer offerings
      • Data and analytics as critical drivers of growth

      We work alongside you to develop a robust yet flexible strategy, deploy an operating model that maximizes performance, harness data and analytics to reinvent your business, and enhance other essential business functions so you can catalyze growth and create a sustainable, winning position. We understand the many complexities and nuances of the industry, and tailor our solutions across geographies to account for the significant differences in public participation regarding the provision and reimbursement of healthcare.  

      Our expertise in healthcare payers consulting spans strategy, digital transformation, customer sales and marketing, organizational effectiveness and every facet of performance and operations. We can help you achieve significant medical cost improvements, adopt an agile operating model, expand your value chain, and implement optimum forms of automation. We are also the leading M&A advisor to the healthcare industry, with deep experience in M&A, including merger integration and post-close strategy.

      Read more Read less

      Global Healthcare Private Equity Report 2026

      Record highs, renewed momentum, ready for more

      Read more

      AI for Healthcare Payers

      We support healthcare payers with developing, piloting, and scaling AI-driven solutions that are designed to:

      • Enhance operational efficiency and member experience
      • Personalize customer engagement
      • Manage costs and utilization

      Our work addresses today’s operational inefficiencies and prepares organizations for tomorrow’s value-based, member-centric care, including national insurers and regional Medicare Advantage providers.

      Learn how AI is powering new discoveries in healthcare

      Real Outcomes

      Learn how we’re working with companies to use AI to drive smarter decisions, more streamlined operations, and results that stick.
      See how we’re helping global industry leaders win with AI

      How We Help

      We help payers build bold, AI-powered futures, from refining go-to-market strategies and simplifying service operations to developing data ecosystems and enabling next-generation care models.
      Learn more about our AI approach

      Our Client Results

      Case study

      A Health Insurance Company Creates a Digital Factory to Propel Its Transformation
      Facing increased competition, an aging employee population and other challenges, a large European public health insurer needed to develop and implement a holistic digital transformation, including the creation of a "digital factory" that could quickly execute high-quality projects.

      Case study

      A healthcare payer sets its own long-term health strategy
      Bain developed a long-term growth strategy for an integrated healthcare payer based on its analysis of the company's core business and adjacent opportunities; account share improved in less than one year.
      See more

      Our Health Insurance Consultants

      Headshot of Jeremy Marlow

      Jeremy Marlow Partner London

      Headshot of Kalyan Jonnalagadda

      Kalyan Jonnalagadda Partner New York

      Headshot of Michael Brookshire

      Michael Brookshire Partner Dallas

      Headshot of Joshua Weisbrod

      Joshua Weisbrod Partner New York

      Headshot of Phyllis Yale

      Phyllis Yale Advisory Partner Boston

      Headshot of Dale Stafford

      Dale Stafford Partner New York

      Headshot of Lori Sherer

      Lori Sherer Advisory Partner San Francisco

      See more

      Our Health Insurance Insights

      A New Prescription for US Pharmacy
      As drug store retail chains rightsize, mass merchants and grocers are best positioned to pick up the scripts.
      Brief
      The Healthcare AI Adoption Index
      A survey of more than 400 healthcare buyers reveals what’s fueling their AI experimentation and pinpoints opportunities for innovation partners.
      Article
      Healthcare & Life Sciences M&A
      Why companies that adapt to the new realities will come out ahead.
      M&A Report
      The Future of Primary Care: Traditional and Nontraditional Models Continue to Evolve
      Changes in the primary care landscape over the past two years have led to important shifts in our 2030 market share forecast.
      Brief
      See more

      How We Can Help

      Agile Enterprise

      Agile Enterprise

      Become faster, more flexible, and intensely customer-focused

      Read more

      Organizational Design and Operating Model

      Organizational Design and Operating Model

      This is how you make your strategy happen

      Read more

      Data and Analytics Transformation

      Data and Analytics Transformation

      As data explodes in quantity and complexity companies find it increasingly difficult to unlock its full potential. We take a comprehensive approach to your data challenges, helping you conquer obstacles and become an analytics leader.

      Read more

      M&A

      M&A

      Achieve consistently higher returns with a systematic and repeatable approach to mergers and acquisitions

      Read more

      Strategy

      Strategy

      Breakthrough strategies for sustained value creation

      Read more

      Customer Experience

      Customer Experience

      Deliver a triple play of results: happier customers, employees and shareholders

      Read more

      Performance Improvement

      Performance Improvement

      In today’s markets, businesses face pressure from customers, investors, and competitors. We help you grow earnings, outperform peers, and win consistently. 

      Read more

      Sales Compensation

      Sales Compensation

      The right sales compensation plan can spur performance like nothing else, yet few leaders believe their plans are truly effective. Sales Compensation Booster analyzes the key issues that affect compensation so you can design an exceptional plan.

      Read more
      See more
      View All Consulting Services

      Explore Our Healthcare & Life Sciences Sector Expertise

      Explore Our Healthcare & Life Sciences Sector Expertise

      • Healthcare Payers

      • Healthcare Providers and Services

      • Medical Technology

      • Pharmaceuticals

      • Healthcare & Life Sciences

      Ready to talk?

      We work with ambitious leaders who want to define the future, not hide from it. Together, we achieve extraordinary outcomes.

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