Private Payers News

Slavitt: Health Insurance Marketplace Boosts Patient Engagement

The health insurance marketplace has undergone a variety of changes and improvements that have benefited the consumers.

By Vera Gruessner

The federal government has taken a wide variety of steps to strengthen patient care and healthcare revenue systems throughout the country. Specifically, the Centers for Medicare & Medicaid Services (CMS) and the health insurance marketplace have played a role in ensuring American citizens obtain healthcare coverage even when their yearly income is low. Through the Affordable Care Act, the federal government has worked to ensure that healthcare is a right in this country.

Health Insurance Exchange

Whether it is through the health insurance marketplace where tax subsidies are offered to those unable to afford high premiums or through the Medicare and Medicaid programs where the elderly and disabled are ensured healthcare access, the federal government has worked tirelessly to provide a system in which medicine can be accessed by the general American population.

CMS Acting Administrator Andy Slavitt spoke at the at the Marketplace Innovation Conference and offered his viewpoints on the success of the health insurance marketplace, according to The CMS Blog. First, he discussed the success of the Medicare program, which has been much more than a medical coverage benefit of late. It has moved into preventive medicine, pharmacy benefits, and coordinated care improvements.

The health insurance marketplace has also undergone a variety of changes and improvements that have benefited the consumers, Slavitt mentions. During its first five years, the marketplace is meant to be tested and experimented upon before best practices can be integrated.

The health insurance exchange is also meant to stimulate the business to consumer market and provide a chance for payers to utilize competitive strategies to meet consumer demands. The health insurance marketplace has led to an increase in patient or consumer engagement when it comes to plan selection, according to Slavitt.

“Marketplace consumers are much more engaged and increasingly educated about what they purchase particularly compared to other health care consumers. 70 percent of renewing consumers on the Federal exchange  came back to the exchange to proactively choose a plan instead of opting automatic enrollment. That creates millions of opportunities for consumers to find the right offering at every open enrollment,” Slavitt said at the Marketplace Innovation Conference.

Most importantly, Slavitt emphasized how the health insurance marketplace and the Affordable Care Act has led to a significant drop in the number of uninsured individuals across the nation. Today, an additional 20 million people have health insurance thanks to the exchanges. Healthcare is slowly becoming a right in this country as people are obtaining access to medical services regardless of pre-existing conditions or their income.

In the state of Texas, for instance, research from the Episcopal Health Foundation and Rice University’s Baker Institute for Public Policy shows that the uninsured rate dropped by a total of 30 percent ever since the Affordable Care Act was implemented. Additionally, among lower income Texans making a salary between $16,000 and $47,000, the uninsured rate declined 42 percent.

More than 90 percent of the customers signing up on the exchanges last year had three payers on average and 50 health plans to choose from, said Slavitt. About 67 percent of all consumers purchasing plans on the exchange have premiums of $75 or less with the help of tax subsidies.

The results are also showing that patients are now able to afford primary care and prescription drugs that was out of their reach before due to higher out-of-pocket costs. For instance, the costs of preventive services including diagnosis tests and immunizations are now required to be covered completely by insurers due to ACA provisions.

Additionally, while employer-sponsored healthcare coverage has remained steady in numbers, employees are secured health insurance and access if they lose their job. As the health insurance marketplace maintains a stage of testing plans and benefits, payers and providers are bringing greater focus to consumer engagement and attempting to meet the needs of the people they serve.

In an exclusive interview, Neil Kennish, Associate Vice President of Marketing and Sales at Memorial Hermann Health Solutions, spoke about how his company has improved consumer engagement in 2016.

“We tried to do a lot of things to change the way we approached consumer engagement for 2016,” Kennish mentioned. “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. Specifically, for 2016, I can speak to both sales and marketing because I oversee both these functions here at the health plan.”

“We made a lot of changes to really make sure that we were communicating and approaching individuals on a direct level. Our marketing materials allowed the individual consumer to get a better sense of what is health insurance. What does it cost them? And to try to get away from the vagaries around copays and deductibles. Simplify it for them as much as possible.”

“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,” he concluded.

The future of the health insurance marketplace depends upon the work of payers and providers as well as the federal government in moving forward affordable medical care access and keeping consumers engaged with their health.

 

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