HealthCare.gov opened for business Sunday night, for window-shopping at least, and experts think the website is mostly improved.
The website now includes the ability to check insurance plans before open enrollment starts Nov. 15. That change to the site is obvious immediately on its home page.
Last year's website required several windows to input information before actually getting to plans. This year, however, requires the input of only a few pieces of information: ZIP code, household income information, age, and some health and familial status such as smoking, pregnancy, or parenthood.
“The shopping function is quite consumer friendly,” Ferris Taylor, the chief strategy officer of Utah co-op Arches Health Plan, said. “Last year, (consumers) had to do a full enrollment to see the information they can see in this year's shopping function,” he said, and that resulted in many accidental double-enrollments that he suspects will be avoided this year.
Also, he thinks that opening up HealthCare.gov early for shopping might reduce the strain on the website—people might visit less often before finding plans they want to purchase, and they might spend less time on the site making their decisions. That, in turn, might reduce the risk for site downtime brought on by times of massive consumer usage.
“The Web page is much improved but still a work in progress that will require substantial improvement to achieve what consumers have come to expect from consumer websites,” said Joel Ario, managing director at consultancy Manatt Health Solutions and one of the architects of the exchange. Ario has frequently called for better information available to consumers about networks and formularies when they go shopping for insurance.
Dan Schuyler, the senior director of exchange technology at consultancy Leavitt Partners, felt that the website was improved but that there were still problems. Like Taylor, he approved of the ability to browse plans before enrolling, calling it a vast improvement.
But while the website allows users to compare plans, it forces the user to toggle between plans, meaning that only one plan's characteristics can be seen at a time. Schuyler would prefer side-by-side comparison instead.
And Schuyler thought the glossary function, which explains health insurance terms, was not intuitive and difficult to find. Instead, he would prefer a mouse-over ability, where a user could hover over a specific term, with the site providing an appropriate explanation.
But Schuyler appreciated the translation ability on the website—a user can click a button labeled “Espanol,” which automatically translates the page into Spanish while retaining previously inputted information.
One area that has received attention is the adequacy of information provided to consumers regarding the provider networks serving each plan. A June survey conducted for the Commonwealth Fund found that 25% of adults who selected a plan on the exchange were unaware of whether their network was narrow, and 39% didn't know which doctors were on their plan.
The new HealthCare.gov prominently displays a provider directory near each plan, but the function wasn't perfect Monday. For example, after searching for plans for a 25-year-old male in Nashville, Tenn., the top result is a bronze plan from Community Health Alliance, a Tennessee co-op. Clicking Provider Directory takes the user to the main page of the insurer's website, but doesn't direct one to where a provider directory can be found.
A user clicking Summary of Benefits, however, will be directed to a website with information regarding formularies and provider directories. Some of that information is not helpful either; for example, the link to the “Plan Brochure” is broken.
Paul Ginsburg, a professor of medicine and public policy at the University of Southern California, window-shopped himself in Arlington, Va., and found the plan directory clunky there as well, relying on a trip to the insurer's website and the need to remember the name of the insurance plan.
“An improvement would be what Consumer Checkbook does for federal employees, where the user lists a number of physicians and the tool tells the user for each plan which of those physicians are included in the network,” Ginsburg said.
Schuyler thinks that the reliance on plan directories is probably appropriate for now. “Keeping a third part provider directory up to date is very difficult and I feel [the website] is taking the best approach by sending the consumer to the carrier's web site to see the provider list. While a little 'clunky' it does provide the consumer with the most current provider information,” he said.
Sometimes the information provided by the website can be difficult to parse for the consumer. Take a Humana HMO plan offered to a 25-year-old male in Miami. The section describing the details of the plan on HealthCare.gov says that laboratory outpatient and X-ray and diagnostic imaging has “no charge(s) after deductible.”
But the summary of benefits and coverage provided by Humana tells a different story. Imaging and diagnostic tests are each “no charge” if in network, and “not covered” if out-of-network. It also specifies that pre-authorization is necessary, and that “cost share may vary based on where service is performed.”
Follow Darius Tahir on Twitter: @dariustahir