Horizon, SelectHealth share lessons learned from ACA marketplaces


Representatives from insurers including Horizon Blue Cross Blue Shield of New Jersey and SelectHealth discussed how they have overcome the challenges of operating in the still-maturing Affordable Care Act marketplaces during a panel hosted by the Department of Health and Human Services.

Since the first ACA open enrollment, 20 million U.S. citizens acquired health insurance, HHS Secretary Sylvia Burwell said in opening remarks at the panel Thursday. That's a large population entering the market, she noted, and "some participants are adapting faster than others."

Burwell added that when it comes to their health insurance consumers primarily want affordable prices, a system that's easy to navigate and a high-quality care experience. With that in mind, insurers that have done well in the marketplaces described their strategies for attempting to satisfy these three consumer needs.

Ed Lara, vice president of marketing and product development at Horizon, said that the company anticipated a loss of market share when open enrollment began, yet still experienced a 6 percent growth in membership during the first year. "This is not a land grab. This is about building a sustainable business," he added.

Horizon launched five products during the first year of the ACA, and found the most success with its gold and silver tiered options--which replaced its previously most popular basic health plans. The next year, the company added two more offerings, and still found that consumers were attracted to the tiered options.

Yet strategies for thriving in an open marketplace shouldn't just be focused on new enrollees, but maintaining existing membership, said Michael Considine, vice president of consumer and small group markets at Horizon. He says since the ACA, Horizon has seen an uptick in member retention due to increased engagement, and it sends monthly newsletters to members to "highlight products and services so consumers are constantly reminded" of what Horizon is doing.

Utah- and Idaho-based insurer SelectHealth, meanwhile, meets consumers where they are, according to Compliance Manager Rachel Reimann. She says SelectHealth knew that consumers needed the basics due to the questions they were asking such as, "What are deductibles?"

This is why SelectHealth hosted "healthcare coverage ABCs" events where the company's representatives met with consumers and answered questions about coverage. Reimann says the company found success with hosting events at community centers and providing simplified communication tailored to specific audiences--for example, digital communications for millennials versus paper communications.

According to Russ Elbel, Medicaid program director at SelectHealth, this approach not only helped the company gain new enrollment but allowed it to retain 80 percent of its existing membership.