Exclusive article by Dennis Hung at EMRIndustry.com
The Patient Protection and Affordable Care Act, now entering its second year in effect, has created dramatic changes in the way everyday customers deal with health insurance, and healthcare providers. Even though consumers who are switching healthcare providers are doing so for most of the same reasons they always have, some of the provisions of the Affordable Care Act have made those reasons more prevalent. Moving forward, the average consumer will be more deeply involved in the process of acquiring health care coverage than ever before. One of the primary results of that involvement is that we’ll the average consumers feeling more empowered to switch healthcare providers when they don’t like what’s being served. So let’s take a brief look at some of the motives behind switching healthcare providers.
Obamacare: Just because you like your insurance policy doesn’t mean you get to keep it
President Obama’s famous line, “If you like your current policy, you can keep it,” came back to haunt him in 2013 when, according to Urban Institute researchers, 2.6 million insureds received cancellation notices from their providers ahead of Obamacare’s open enrollment period. Even though Obamacare created a net reduction in uninsureds in the U.S.—down to 36 million from 45.6 million five years earlier—and even though the 2.6 million people tallied in the cancellation column likely found insurance elsewhere, that counts as a major migration. All ideological arguments aside, there’s no debating that Obamacare has been the biggest contributor to healthcare switching in recent years.
Employment Change
Because the Affordable Care Act took effect in 2015 nearly one third of customers returning the HealthCare.gov, switched to a new plan. That rate of plan switching is far higher than other years, when the typical motive behind switching is changes in employment. Once the new Obamacare system stabilizes the rates of consumers looking to switch plans may level off. However, for now, the federal government continues to spread the message, “It pays to shop,”
Insurance plan was dropped
In the wake of Obamacare, many insurance providers have restructured, not only their coverage plans, but also the pricing indexes. In some instances consumers have been forced to switch their healthcare coverage because existing plans were cancelled. In other instances employers themselves are dropping group insurance coverage and instead paying employees a stipend to negotiate their own policies through HealthCare.gov, effectively externalizing human resource costs onto workers.
Market competition
It will be some time before the dust settles and we can see clear picture of how insurers how restructured health plans for 2016. And while the federal government is promoting its message of, “it pays to shop,” Caroline Pearson from the private market analysis firm, Avalere Health says the real message should sound something more like, “be a smart shopper.” Of course smart shoppers always factor price, but relying on price alone oftens leaves healthcare customers with the short end of the stick if they do get sick. It’s a basic cost–benefit scenario.
Quality of service
You might consider quality of service to be one of the elements of market competition, which it is. But, it’s the counterpoint to price shopping so it deserves it’s own entry. It’s mostly coincidental that sweeping changes in the health insurance industry are happening at the same time technological advancements are improving healthcare across the board. Cloud computing, big data, mobile technology, and all other technological innovations that are changing both business as well as everyday life, are instituting changes in healthcare industries. Healthcare providers who invest in early-adoption of innovations like radiology information system right now is going to reap the benefits in the long term.
Health care providers that build cost-effective, service-oriented workflow systems using the latest technology stand to create customer experiences that are less labor-intensive, and easier to access. In other words, their services will become more valuable across the board. As some of the bugs in the Affordable Care Act and HealthCare.gov are ironed out, we should see the consumer health insurance market stabilize. Companies that offer valuable products and services will thrive. The ones that don’t will most likely cease to exist.
