The Truven Health Blog

The latest healthcare topics from a trusted, proven, and unbiased source.

 

Rate Setting by Insurance and Exchanges

By Truven Staff
Anita Nair-Hartman imageAs the October 2013 open enrollment date for insurance marketplaces approaches, more information is emerging on how states are managing the premium rates set by health insurers. Maryland is an example. As a recent noted, this state is working diligently to ensure affordability for consumers in its market.

Questions remain: How easily does the open enrollment work for consumers? And are states or the federal government able to support consumers as they navigate the healthcare maze and try to understand their out-of-pocket costs and assess the best plans for their situation? Consumer understanding of plan design options and their associated costs, as well as their subsidies, will be the ultimate test of the work states and federal government did to keep rates low. We’ll know in October whether consumers were adequately supported
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Anita Nair-Hartman
Vice President Market Planning and Strategy

Health Plan Support of the Newly Insured

By Truven Staff
Anita Nair-Hartman imageA recent discusses the premiums consumers will face in the new public exchanges. There has been much market focus and press on the rates that consumers will be charged and the potential impact to enrollment. Although this is an important topic, equal attention should be focused how we will manage these newly-insured consumers. From research that Truven Health completed earlier this year titled, , we know that there is limited information in the market on this subset of consumers.

Our research indicates that these newly insured will be less healthy, currently use services at a lower rate, and have gone long periods without coverage due to insurance cost. All of this research suggests that the newly insured will most likely have service needs that they have deferred and will present challenges for the health plans who cover them. It will be critical that health plans support these new consumers with tools and services to help them understand and navigate their new health care coverage. As we have noted in the past, consumers who have more information are able to make wiser decisions about their healthcare choices. And this leads to improved quality, lower costs, and higher satisfaction with their health plan and exchange.

Anita Nair-Hartman
Vice President, Market Planning and Strategy

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