1 / 8

Improving the Odds of Success for Insurance Exchange(s)

Improving the Odds of Success for Insurance Exchange(s). Jon Kingsdale, Ph.D. Executive Director, Mass. Health Connector For the NHPF & AHR January 8, 2010. Focus on the Feasible. Extremely challenging implementation Cost control harder than coverage expansion Most exchanges have failed

lacey
Télécharger la présentation

Improving the Odds of Success for Insurance Exchange(s)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Improving the Odds of Success for Insurance Exchange(s) Jon Kingsdale, Ph.D. Executive Director, Mass. Health Connector For the NHPF & AHR January 8, 2010

  2. Focus on the Feasible • Extremely challenging implementation • Cost control harder than coverage expansion • Most exchanges have failed • Personal bias, as an executive

  3. How to Improve the Odds of Success for Exchange(s) • Define realistically a limited set of objectives for exchange(s) • Acknowledge & compensate for weaknesses in the two bills • Resource exchange(s) adequately and provide for their evolution

  4. Realistic Objectives • Reduce the administrative costs of buying insurance • Improve the consumer’s insurance shopping/buying experience • Add price resistance to premium-setting and insurers’ negotiations with providers

  5. Industry Resistance: Adverse Selection: Cost Control Tools: Excl. channel for Non-Group Evolutionary for other market segments Local flexibility/options Option to rate N-G separately Claims-based risk adjustment across each entire rating pool Forego large-group Bid for plan selection Standardize benefits over time Automate Weaknesses in Both Bills

  6. Market Sensitivity Regulator vs. Retailer Customer Experience Focus on non-group Delegate & de-centralize Emphasize customer experience Establish few, clear goals Encourage semi-independent agencies & self-funding Minimize ‘policing’ role Regulate carriers thru DoI Flexibility in plans/benefits Phase-in offerings by segment Run group premiums thru Exch. Don’t prescribe transparency Encourage pilots, research Weaknesses in House Exchange

  7. Scale Economies Geographic Portability Consistent Performance Exclusive channel for N-G Develop national “utility” resources e.g.: website, risk-adjustment tools National health plans Recipricity of regional plans Federal inter-operability standards for states Federal oversight, based on cost & customer service Sharing best practices Weaknesses in Senate Bill

  8. How to Resource/Evolve Exchange(s) • Semi-independent exchange(s), funded by surcharging transactions • Clear objectives, flexible means • Drive to electronic transactions and audit trails • Rigorous evaluation over time

More Related