Top 3 Predictions for Health Insurance Industry News in August
The health insurance industry may see more consumers in the month of August as more incoming students sign up for student health plans.
By - The future of the health insurance industry changes depending upon the regulatory challenges happening at a particular time as well as consumer interests and provider needs transforming the healthcare landscape in today’s transitioning climate. Over the next month, while many may be taking summer breaks, the health insurance industry will not be resting but pushing full steam ahead. Below we outline the top three predictions describing where the health insurance industry will move this August.
Mergers may hit the market despite current DOJ decisions
Even though the Department of Justice has moved forward with filing lawsuits against the top two health insurance mergers taking place right now between Anthem-Cigna and Aetna-Humana, the market is likely to continue to see mergers and acquisitions among health payers.
With the Affordable Care Act impacting the finances of health payers today and leading to significant losses, payers are searching for ways to consolidate their losses and scale their organizations instead of having to drop out of the exchanges or lose more business. Additionally, the strive toward population health management and value-based care is also pushing forward more restructuring within the health insurance industry and greater innovation along with acquisitions among payers.
High-deductible health plans continue to infiltrate employer-sponsored coverage
Employers will seek new ways to work with their health plans to ensure that healthcare costs are lowered and both employers and employees have lower spending rates. This may mean some employers will bring more focus toward preventive care and the use of telemedicine tools before having employees access more expensive services. It also means that high-deductible health plans are likely to continue spreading among employer-sponsored coverage.
Data from the Kaiser Family Foundation’s 2015 Employer Health Benefits Survey illustrates that the number of deductibles in employer-sponsored coverage has risen from 70 percent in 2010 to 81 percent last year. This is an 11 percent rise in only five years, which shows how payers and employers have been working toward reducing their end of healthcare spending.
“In addition to any required premium contributions, most covered workers face cost sharing for the medical services they use. Cost sharing for medical services can take a variety of forms, including deductibles (an amount that must be paid before most services are covered by the plan), copayments (fixed dollar amounts), and/or coinsurance (a percentage of the charge for services),” the report stated.
“The share of covered workers in plans with a general annual deductible has increased significantly over time: from 55 percent in 2006, to 70 percent in 2010, to 81 percent in 2015, as have the average deductible amounts for covered workers in plans with deductibles: from $584 in 2006, to $917 in 2010, to $1,318 in 2015.”
With more employers looking to reduce their side of healthcare spending, more employees are left to cover the costs of high-deductible plans and out-of-pocket spending. To meet the needs of consumers, payers will need to further innovate strategies to cut costs.
Open enrollment period hits colleges
Anybody who is self-employed or doesn’t qualify for employer-sponsored healthcare coverage may qualifies for public health plans. While the open enrollment period through HealthCare.gov doesn’t begin until November 1, 2016, there are special circumstances that may allow a consumer to purchase a health plan. These are called qualifying events and often include situations such as a birth, a marriage or divorce, change in employment, a new job, or a move to another state.
Additionally, those who need health insurance and are starting either their undergraduate or graduate career at a university are eligible to sign up for student insurance over the coming weeks before their semester begins. Payers are likely to see more consumers in the coming weeks as incoming students begin the school year.
Dig Deeper:
52% of Employers Offer High-Deductible Health Insurance Plans
DOJ May File Lawsuits against Health Insurance Acquisitions
