Now that the open enrollment period for health insurance exchanges has ended, insurers need to take certain steps in the next few weeks, including determining which type of consumers signed up and assessing what new consumers think of their coverage, USA Today reported.
Here's a summary of three of the five next steps the publication described:
1. Identify new customers
Many insurers have reported an increase in young members--considered a key demographic for insurer success in the post-reform market--throughout the open enrollment period. The U.S. Department of Health & Human Services said young adults comprised only 24 percent of the 2 million people who had signed up for coverage through state and federal exchanges as of January.
WellPoint Chief Medical Officer Sam Nussbaum said his company has seen a boost in young consumers and 80 percent of new members appear to be previously uninsured, he told USA Today. Meanwhile, marketplace enrollment as of Feb. 1 consisted of 55 percent women, who generally incur as much as 20 percent higher healthcare costs than men.
2. Set 2015 rates
Determining the characteristics of new members is key to insurers setting their 2015 rates, which are due in about two months.
"The plans are almost immediately going to have to set rates for next year," Dan Mendelson, CEO of Avalere Health, told USA Today. "It needs to be based on the populations they see."
In particular, insurers should review their new enrollees' health status. But some insurers like WellPoint already have declared they will seek "double-digit plus" rate hikes. And one health industry official has said his company plans to triple rates next year for plans sold on the exchanges.
3. Assess how new members use coverage
Insurers and industry analysts will likely observe how new enrollees actually use their coverage, including whether they take advantage of preventive services, shop for lower prices in high-deductible plans and see primary care doctors instead of using the emergency room. Such healthcare utilization patterns will drive future rate setting. For example, insured consumers are more apt to get preventive care to cut their risk of illness.
To learn more:
- read the USA Today article