New programs compare standardized exchange plans based on price, quality

cms

The Centers for Medicare & Medicaid Services (CMS) has detailed two new changes to Healthcare.gov for the 2017 open enrollment period designed to simplify the process of choosing a health plan on the federal exchange, according to a CMS blog post.  

For the first time, Healthcare.gov will feature "Simple Choice plans," allowing consumers to shop based on monthly premiums and provider networks. These designated plans, which will be prominently displayed on the site, have the same deductible, out of pocket limits and co-payments within each metal tier. The new program is designed to help consumers make "apples-to-apples cost-sharing comparisons" by separating plans based on particular features, CMS officials write in the post.

However, in a letter addressed to CMS Acting Administrator Andy Slavitt, 34 House lawmakers argued that standardizing exchange plans would limit consumer choice by "propping up plans that meet arbitrary requirements, instead of preserving choice and encouraging consumes to select plans that best meet their unique needs." The lawmakers called on CMS to explain how the agency developed standardized plan benchmarks and how plans will be displayed on Healthcare.gov.

Free Daily Newsletter

Like this story? Subscribe to FierceHealthcare!

The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

Beginning this year, CMS also will pilot a new five-star rating display in five states that have a large number of health plans. Ratings are based on care coordination, healthcare quality and physician ratings. Consumer feedback will help shape the way CMS displays five-star ratings during future open enrollment periods.

CMS's proposal to establish standardized exchange plans was met with pushback from lawmakers and insurers who said the change would "hamper innovation" and limit plan flexibility. On the other hand, cost and quality information, along with decision support tools, have been key factors in influencing consumer choice, and some experts have advocated for simpler plan choices that are easy to differentiate.

For more:
- read the CMS blog post
- here's the letter from congressional leaders

Read more on

Suggested Articles

To reduce readmissions and create greater operational and cost efficiencies for providers and payers, we must rethink how we deliver and manage care.

Outpatient specialty drugs can be a lucrative income source for not-for-profit hospitals, but Washington presents some risks, Moody's says.

The growing role of data in our lives raises important questions about data access and ownership. Who rightfully owns the data?