Health Insurance Exchange Displays 2 Consumer Engagement Tools
Along with Simple Choice plans, the federal health insurance exchange is also implementing a quality ratings system.
By - The health insurance exchange under the Affordable Care Act is undergoing some renovations over the next year, reports Kevin Counihan, CEO of HealthCare.gov and Dr. Patrick Conway, Principal Deputy Administrator of CMS. In The CMS Blog, Conway and Counihan discussed two new innovations that will be taking place within the federal health insurance exchange.
The federal government is looking to improve the enrollment process for consumers and create greater engagement when purchasing and utilizing health plans through the health insurance exchange.
Simple Choice Plans
Out of the two new innovations taking place within the exchange, Simple Choice Plans is one different strategy that will include the same set of features across all offerings allowing consumers to compare and contrast monthly premiums and benefits.
Simple Choice Plans will be a feature available under the Plan Compare subset. This should improve the enrollment process over the coming year as well as allow consumers to make the best decisions for their own medical care and, thereby, lead to healthier populations.
The Simple Choice Plans will be available for comparing in a quick and easy manner, said Counihan and Conway. These type of plans we'll have a maximum out-of-pocket spending limit along with a fixed deductible amount. The co-payments for Simple Choice Plans will be defined under a metal tier tier such as gold, bronze, or silver.
Each of these plans will have the same cost when it comes to visiting with the primary care physician. Currently, the federal health insurance exchange is surveying consumers regarding the type of displays for these health plans that are best suited to meet the needs of the consumer base.
These new innovations along with tools such as the drug prescription lookup will allow consumers to improve their decision-making when it comes to choosing which health plans fit their lifestyle best.
Quality ratings
Along with Simple Choice plans, the federal health insurance exchange is also implementing a quality ratings system. The quality rating system will allow consumers to compare and contrast the actual experience and healthcare services of those enrolled within the particular health plans they're interested in.
Healthcare quality experts provided their input when designing the quality rating system. Consumers will be able to see how well physicians within the provider network coordinate their care multiple medical facilities and healthcare professionals.
Starting in 2017 during the open enrollment period, the federal health insurance exchange will include a five-star rating system that allows consumers to decide which health plans are best for their needs.
In addition, the federal government will be working with state-based exchanges to enable them to display quality ratings for their health plans. Another issue that the federal government has been working to address is the higher number of enrollment that could be putting a strain on the database that runs the health insurance exchange.
MarkLogic database platform
Luckily, the health insurance exchange runs on the MarkLogic database platform, Which is capable of scaling out instead of upwards, explained Bill Fox, Vice President of Healthcare and Life Sciences at MarkLogic.
“The technology was always developed from its inception 14 years ago to be an enterprise product, so there’s a number of pieces to that answer. One – the technology, unlike traditional relational technology, scales out and not up,” Fox told HealthPayerIntelligence.com. “That means as demand rises and volumes rise, you don’t have to buy a new, bigger, better box – you just add more capacity with affordable commodity hardware and keep building it out. It’s very easy to scale to demand.”
In addition to utilizing superb technology to handle massive volumes of enrollment data, it is vital for health insurance plans to incorporate consumer engagement with in the selection process. This is why the health insurance exchange has implemented new innovations like the quality rating system and the Simple Choice plans.
Utilizing consumer engagement
Neil Kennish, Associate Vice President of Marketing and Sales at Memorial Hermann Health Solution, explained how his company addressed consumer engagement during the enrollment process.
“We tried to do a lot of things to change the way we approached consumer engagement for 2016,” Kennish told HealthPayerIntelligence.com. “Historically, our health plan had been geared towards brokers as well as employers. Then the changes that accompanied the Affordable Care Act really put an emphasis more on the individuals and targeting consumers.”
“There are going to be a lot of challenges associated with understanding health insurance and how it works regardless of what segment you’re in - whether it’s individual, Medicare Advantage, commercial, or group insurance.”
“We tried to take an approach where we either did focus groups or did surveys of our existing customers to get a better sense of what critical benefits that they need to make sure are covered without them having to be concerned. What are benefits that need to be explained in detail so that people understand the difference between copays and coinsurance rates? We try to take away some of the questions and uncertainty around health insurance so that it is an easier decision for them.”
Due to the new innovations taking place at the health insurance exchange, consumers will now be able to compare and contrast health plans more effectively in order to make the best decision for their medical care needs. As technology continues to advance, consumer engagement tools are likely to proliferate throughout the health insurance industry.
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