Contributor: Jenny Kerr
Topic: Health insurance exchanges
The National Committee for Quality Assurance held a conference call recently to provide education on health insurance exchanges—except that because these exchanges are still in their infancy, the talk was short on state details and focused on advocating best practices for states.
Leaders from the NCQA, National Business Group on Health and the Consumer-Purchase Disclosure Project told listeners that exchanges should allow consumers to compare the quality and cost of each plan online side by side, and have a chief value officer in charge of controlling costs. Exchanges should be high-touch, using social media and technology like smart phones to reach consumers to tell them about this new way they can purchase health insurance. They want those in charge of exchanges to be skilled in choosing high-value plans as part of the exchange, especially those that offer value-based insurance design that promotes primary care.
If consumers are shopping for a high-deductible health plan, the NCQA and others want consumers to have an online portal to calculate their yearly cost based on their average use of healthcare services and clearly list what will and won’t be covered under that deductible. Finally, they suggest choosing exchange board members who are not politically motivated. This is probably key to the proper function of an exchange, as political battles over accepting Innovator Award money to help develop the exchanges have erupted in states like Oklahoma; newly elected Republican Gov. Mary Fallin accepted the money, then turned it down after it created a firestorm from conservatives in the state.
The conference call showed how really game-changing these exchanges will be, emphasizing that COBRA will basically be eliminated because of its high cost and that part-time and seasonal employees will finally have a way to buy health insurance. The speakers want businesses, large and small, to be able to purchase insurance in exchanges.
All these ideas make it clear that states have a long way to go in setting up how their exchanges will work, and ultimately be implemented. Keeping consumer choice and value in mind at every turn and keeping politics out of the equation are probably keys to making these entities work at their best. Now, we just have to see how states actually use these recommendations when setting up their exchanges.