“There are lessons we can learn from Part D,” she said. She will be instructing her clients on “how (consumers) make decisions, need support and education, and how to engage them.”
Insurers, who have historically dealt with large groups, employee benefit managers and human resource staffs, now will need to interact directly with new members as individuals. The first point of interaction will be the new health insurance exchanges that will open for business Oct. 1, according to John Fiacco, CEO of Chicago-based ConnectedHealth, which offers a benefits platform to employers that provides greater health care transparency to employees.
The big problem for payers, Fiacco said, is that “they don't know how to talk to consumers” very well.
However, it does present payers with a new opportunity to build client loyalty, something not usually present when employees receive their health plans choices through an employer. “It's kind of like when a person opens an account at a bank,” he said. Payers “can now make lifelong relationship with an individual,” not only in providing them with coverage, but with getting them more involved in wellness programs and living more healthfully.
“People won't want to switch (during renewals) just to save a few bucks if they have a positive experience in the first year,” he said.
Insurers are already responding to new members becoming more savvy healthcare consumers by offering transparency tools that will allow consumers to compare provider rates for specific procedures in their service area when they get sick. This will be especially important to new members who select high-deductible health plans, also known as consumer-driven health plans, since they will have deductibles of $2,000 or more before a an insurer will begin paying claims.
For instance, Portland, Ore.-based HealthSparq, a wholly owned-subsidiary of carrier Cambia Health Solutions, developed a price comparison tool for 17 of its health plans, HealthSparq President Scott Decker said. A member who needs an MRI can compare facility costs for the procedure as well as view rating of providers to make a more informed decision on where to go. It's “kind of like Amazon.com,” he said. “Consumers do care to shop around, especially people on HDHPs. Young people already expect this.”
The comparison services HealthSparq offers are online-based. However, the company hasn't forgotten that many of the new individuals who will gain coverage in 2014 aren't tech-savvy. Decker said that if a member needs help, they can call a customer service number and have a representative do the comparisons.
Follow Jonathan Block on Twitter: @MHjblock