Environment

  • GHG Emissions
  • Air Quality
  • Energy Management
  • Water & Wastewater Management
  • Waste & Hazardous Materials Management
  • Ecological Impacts

Social Capital

Human Capital

  • Labor Practices
  • Employee Health & Safety
  • Employee Engagement, Diversity & Inclusion

Leadership & Governance

  • Business Ethics
  • Competitive Behavior
  • Management of the Legal & Regulatory Environment
  • Critical Incident Risk Management
  • Systemic Risk Management
General Issue Category
(industry agnostic)

Disclosure Topics (industry specific) for:
Managed Care

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Data Security

Customer Privacy & Technology Standards

Regulations, such as the Health Insurance Portability and Accountability Act (HIPAA) in the U.S., may require health insurance plans to comply with various requirements relating to the use, disclosure, storage, and transmission of patient health information. Companies in this industry are required to develop policies and technical safeguards to protect patient health information. A failure to comply with these evolving standards, which in the U.S. include provisions established under the Health Information Technology for Economic and Clinical Health (HITECH) Act, can lead to significant civil and criminal penalties. These risks are intensified by an increase in cyberattacks that target managed care companies.

Access & Affordability

Access to Coverage

Although the Patient Protection and Affordable Care Act in the U.S. reduced the number of uninsured, more than 10 percent of adults in the United States remain uninsured. The percentage of uninsured is significantly higher for people near or at the federal poverty level. Managed care companies can play a role in providing additional access by limiting plan costs and rate increases. Companies must also comply with regulations intended to control plan costs, including medical loss rations, while also ensuring coverage for all applicants regardless of health status, gender, or pre-existing conditions. Increased regulatory focus on health care costs and the need to comply with evolving regulations continue to present challenges for the industry.

Product Quality & Safety

Plan Performance

Managed care companies manage performance in areas such as responsiveness, complaints, voluntary disenrollment, and customer service in order to maintain competitiveness. Under the Five-Star Quality Rating System for Medicare Advantage Plans in the U.S., performance on key metrics are factored into federal reimbursement rates and bonus payments for Medicare Advantage carriers. Disclosure on key indicators related to plan performance may allow shareholders to understand how managed care companies are able to protect corporate value.

Customer Welfare

Improved Outcomes

Managed care companies can play a critical role in maintaining and improving the health of enrollees. In addition, legislation continues to emphasize improved outcomes through provisions, including those that require health plans to provide coverage for preventive services without cost to members. The development of the Five-Star Quality Rating System for Medicare Advantage Plans in the U.S., for example, further strengthens the relationship between enrollee health and value by linking reimbursement rates and bonus payments to performance in five domains, including specific outcome-based measures. Companies that are able to improve the health of enrollees may be better positioned to protect shareholder value.

Physical Impacts of Climate Change

Climate Change Impacts on Human Health

An increase in extreme weather events associated with climate change could have significant health impacts. These events, coupled with the potential spread of infectious diseases and food and water scarcity, are likely to present material implications for the Managed Care industry through an increase in encounters with the health care system. Companies that are able to address the risks posed by extreme weather events and potential changes in the incidence, morbidity, and mortality of illnesses and diseases may be better positioned to protect shareholder value.

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