Health exchanges: Where should payers invest time and money?

Since the reform law passed in 2010, health insurance exchanges have remained one of the most talked about and critical issues for insurers. They will dramatically change how insurers do business, shifting the industry toward a more consumer-oriented market where the individual, not the employer, is king. The practicalities of this change are wide in scope, and America's Health Insurance Plans (AHIP) plans to address them head on with a special one-day pre-conference program.

AHIP's Exchange Conference kicks off Wednesday morning with a few networking breakfasts that will discuss health exchanges such as consumer behavior, payers' approaches to preparing their plan portfolio and how to best engage consumers.

Leading the general session will be Timothy Hill, deputy director of the Center for Consumer Information and Insurance Oversight under the Centers for Medicare & Medicaid Services, talking about exchange regulations and updates. Next up are folks from Deloitte discussing how payers can prepare for exchanges, including what steps insurers can take right now to get ready for the 2014 implementation date.

Two sessions also highlight meeting quality health plan requirements. Folks from the Utilization Review Accreditation Commission and the National Committee for Quality Assurance will discuss the quality improvement requirements, whether states are developing stricter standards and how payers should prepare for the data collection challenges associated with these quality rankings. Then, state health insurance regulators from Arizona and North Carolina will break down the quality health plan requirement, including how states will determine the certification process and define essential health benefits.

Among the concurrent sessions is "Practical Steps for Exchange Preparation," in which Humana executive Jeff Layman and Robert & Nolan Healthcare Practice Director Mary Hood will provide insight into practical issues, including key organizational areas payers should focus on, processes that pose the greatest challenges and in which areas payers should invest while preparing for exchanges.

Last, but certainly not least, is a session addressing how the U.S. Supreme Court's reform decision will impact exchanges. Experts from NFP Health, hCentive and Venable will share their opinions, including whether the ruling will speed up or slow down exchange activity.

But if you can't make it out to Salt Lake City early to the pre-conference this year, AHIP has included several exchange-related sessions throughout its full conference. You can check out, for example, Thursday's session, "Changing Channels: Positioning for Health Benefit Exchanges, the Expansion of Retail Insurance Markets and Direct to Consumer Sales," to learn about strategies and technologies to accommodate an exchange-based, consumer-oriented market. Friday morning's breakfast session also addresses exchanges and consumers with OptumInsight folks discussing how to creatively adjust benefit design and network features and create an interactive online client experience. 

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