Insurers can enhance the affordability, stability and accessibility of healthcare by lowering premiums, providing better guidelines for transition periods and boosting transparency, according to a report from America's Health Insurance Plans, released Wednesday.
Coinciding with AHIP's annual meeting in Seattle, the report suggests several ways to improve consumer experience and patient care under the Affordable Care Act and healthcare exchanges. For example:
1. Create a new, lower-premium catastrophic plan
In order to bring more families into the marketplace, AHIP proposes developing a plan that would offer an actuarial value (AV) just below the current minimum requirement. Because many plans offered on the marketplace are based on their AV standard, this change could lower premiums while continuing to cover essential health benefits. Lower premiums may help reach the goal of affordability, AHIP says--this way, families eligible for subsidies can purchase a new plan.
2. Provide continuity of care during transition periods
When consumers shift from one plan to the next while continuing a treatment, AHIP says, continuity of care is important. A consumer should have access to the same doctor while still paying in-network costs. Currently, health plans continue care for thirty days while individuals undergo treatment for complex care, as well as for mothers in their second or third trimesters of pregnancy. To improve that transition period, insurers want providers to stop charging consumers costs that are outside of their in-network plans, and also notify consumers that their out-of-network rates will apply after the transition period.
3. Improve transparency
Given the variety of plan options, networks and costs must be easier for consumers to understand, according to AHIP, so they can make a sound decision when choosing a plan. Insurers should notify consumers of their out-of-network status and what they'll pay for this care. Moreover, price transparency efforts must include clear, readily accessible information that enables consumers to make meaningful comparisons among providers. Pricing information should be easy to use and communicate, FierceHealthPayer previously reported.