Assessing The Impact Of Healthcare Enrollment Numbers On Insurance Exchanges

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The U.S. Department of Health and Human Services (HHS) recently gave conditional

approval to several U.S. states for their state Exchange plan implementations. These health insurance exchanges are estimated to receive millions of health care enrollments requests from both individuals and small businesses. The PPACA also mandates employers with more than 200 full-time employees to automatically enroll employees in the health plans in 2014.

The virtual marketplaces popularly hailed as health insurance exchanges are expected to provide health insurance to more than 30 million individuals. To ensure that the health insurance exchanges witness maximum health care enrollments, exchange administrators would need to develop a strong and effective information outreach and health care enrollment assistance system.

As with most product or information releases, timing would play a crucial role in successfully implementing the outreach program. To sensitize individuals and businesses about open enrollment periods, the outreach specialists would need to make sure that all the information related to healthcare enrollments are dispensed at a predefined time to drive maximum product enrollments. An information drive, initiated too much in advance or too late in time to actual healthcare enrollment commencement period, may not be as effective as one that begins a few days before the actual healthcare enrollment open period.

Health exchange navigators would play an equally important role as outreach specialists in ensuring a smooth healthcare enrollment experience for exchange consumers who may be unfamiliar with the enrollment process in the new exchange marketplaces. Businesses and individuals that have long relied on the services of a broker or a brokerage firm are likely to feel more comfortable in the presence of a trusted advisor while applying for health insurance at the health insurance exchanges. Navigator teams may consist of community workers, brokers, agents, etc., and if individuals and businesses have access to a familiar and well-known navigator during health care enrollment, it can not only help simplify but also speed up the health care enrollments for exchange consumers.
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The success of the health insurance exchanges largely depends on the number of enrollment requests that health exchanges receive in a year. A large number of health care enrollments would help generate interests among the payer community to sell insurance at subsidized rate to millions of consumers. If the exchanges charge an exchange participation user fee from the insurers or consumers, high number of health care enrollments would help spread the impact of the charger fees among consumers or payers without adversely impacting the health exchange model. A high number of health care enrollments would also help spread the risks among a larger pool, which in turn would help reduce the premium rates usually charged by the employees.

With health exchanges expected to arrive on the U.S. healthcare space soon, state and federal exchange administrators would need to quickly identify strategies for ensuring high healthcare enrollments in the exchanges.

by: shandra

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