The Evolution Of A Two-Tier Health Insurance Exchange System

TweetNote: In addition to Rosemarie Day, this post is also coauthored by Pamela Nadash and Angelique Hrycko. Health reform has been a catalyst for change. It has fostered the creation of public health insurance exchanges and accelerated existing trends in health insurance coverage for employees. Many employers are reevaluating their coverage offerings, some employers are no longer providing insurance coverage, and, among those who continue to offer it, high deductible plans with restricted networks are becoming the norm. In addition, employers are increasingly outsourcing health insurance benefits management by moving employees to private health insurance exchanges – often in combination with a shift toward a defined contribution approach. Estimates vary, but surveys show that anywhere from 9 to 45 percent of employers plan to implement private exchanges in the future. Accenture (see Figure 1) has predicted that by 2018, private exchange enrollment will outpace public exchange enrollment. Figure 1 Consulting firms and benefits consultancies are positioning themselves to grab this market, and are generating interest by publicizing upbeat projections of conversions to private exchanges. This publicity means that attention is focused on these firms and the large employers they target. However, another, less visible movement is taking place among small to mid-size employers, whose employees may not be so well served by private exchanges. Not only do small employers lack the...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: All Categories Business of Health Care Coverage Employer-Sponsored Insurance Policy Source Type: blogs