Feds turn focus to preventing customer churn on ACA exchanges

cms

Now that the Affordable Care Act's third open enrollment period has come to a close, Obama administration officials have turned their attention to ensuring that as few customers as possible drop their coverage.

While some consumers will drop their ACA plans when they qualify for other types of insurance, the Centers for Medicare & Medicaid Services (CMS) wants to ensure that its own processes don't end up contributing to customer churn, Healthcare.gov CEO Kevin Counihan writes in a recent blog post. Therefore, CMS has taken steps to make it simpler for consumers to stay enrolled.

Consumers who don't pay their first bill face termination of their coverage, but Counihan says CMS is "working closely with insurance companies" to reinstate consumers who had trouble with the payment process. It also is stepping up its outreach efforts to remind consumers earlier, more often and in a clearer way that their first payments are due.

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Others can lose coverage because of data-matching issues--when CMS is unable to verify their eligibility given the information they've provided. Such paperwork issues have led hundreds of thousands to lose coverage or have their financial assistance adjusted, FierceHealthPayer has reported.

To help prevent these problems from happening in the first place, CMS has tweaked functions of the online coverage application to encourage enrollees to fix issues in real-time and ensure they don't re-make a mistake they've previously resolved. In 2017, CMS also plans to establish more appropriate income verification thresholds for consumers, Counihan notes.

Should data-matching problems still occur, CMS says it will clarify the language in the notices it sends to consumers which explain what documents they need to submit to resolve the issue. With additional funding from the 2017 budget, CMS will also expand its outreach efforts to help consumers resolve documentation issues.

Already, Counihan notes, the agency is starting to see fewer data-matching issues as a result of its efforts. However, an August report from the Office of Inspector General pointed out that not all of Healthcare.gov's internal controls were effective at accurately determining customers' eligibility for coverage.

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