Insurance Coverage Grows as Consumers Explore Payer Options
By Sara Heath
- Attitudes toward healthcare coverage and healthcare reform have been reshaped in recent years. New avenues of healthcare coverage have come to light, and they are opening more options for how consumers may receive their coverage. Between the options made available via the Affordable Care Act (ACA), health insurance exchanges, and new and emerging payers, consumers seem to be exploring alternatives for health insurance coverage. A recent survey by Valence Health provides insights into the changing relationship between health insurers and consumers.
The study, which was first conducted in 2013 and again in June 2015 in order to measure changes over time, highlights the way in which consumers obtain their health insurance. While employee benefits are still the leading sources of healthcare coverage in 2015 with 38 percent of respondents identifying with that category, this is a notable drop from 59 percent in 2013. This indicates that through the emergence of the ACA, health insurance exchanges, and the expansion of Medicaid in many states, consumers are now exploring new and perhaps more cost-effective options for healthcare coverage.
The study also noted a 12 percent increase in Medicare enrollees, a potential indicator of more retirees, and showed the emergence of a Healthcare.gov or state exchange option, which garnered 4 percent of the 524 randomly selected respondents.
Consumers are beginning to leave their employer-sponsored healthcare plans and seek out different options, as made evident by the survey results. One such option the report discussed was a provider-sponsored health plan (PSHP). As defined by Valence Health, a PSHP is “an organization of individual practitioners, ancillary service providers and/or hospitals that come together to design and run their own health plan.” In essence, the providers are also the payers, and therefore are liable for all of the costs associate with a patient’s care. According to Valence Health, PSHPs often report better population health management and coordinated care.
While 21 percent of respondents said they would consider enrolling in a PSHP, a majority of them reported that they were unsure of the benefits such a plan would provide them. Valence Health states that in order to remedy that, more education needs to be provided for the consumer to make an informed decision.
Other non-traditional healthcare coverage options include Consumer Operated and Oriented Plans (Co-Ops), non-profit organizations which solely focus on patient well-being rather than on the profit to be gained. Valence Health reports that nearly one fourth (28 percent) of respondents state they are at least somewhat likely to enroll in a Co-Op, showing a potential transition from corporate payers to smaller, more patient-centric payers.
This increased variety of coverage options may indicate an overall increase in healthcare coverage. The survey reports that the number of respondents going without health insurance was cut in half between 2013 and 2015, with seven percent in 2013 and three percent in 2015. As more non-traditional health insurers emerge, Valence Health suggests there will be an increase in healthcare coverage, closing the gap between the insured and uninsured and helping to achieve the ideal that all persons can get access to healthcare.
