Shopping for Health Insurance. What else should we know about the health plans? (part 2 of 3)
In its final report—“Health Insurance Marketplace: Summary Enrollment Report for the Initial Annual Open Enrollment Period” (May 2014)—HHS ASPE reported that 65 percent of the newly insured selected a Silver Plan. Given the nature of financial assistance, the result is no surprise. But what else should we know about the health plans?
The following assumes that 1) consumers had access to online decision support tools to evaluate plan options and make informed choices and 2) the marketplaces saved, aggregated and merged the data with demographic and purchasing data to analyze buying behavior. If so, then we would know:
- How often health plans were purchased. While the report segments enrollment across metal plans by demographics (age, gender, etc.), HHS has NOT reported enrollment at the state or national level by health plan. Some carriers have publicized this information, but HHS should be the one doing so for it to be credible.
- How much the health plans truly cost. By aggregating projected medical utilization and total costs (out-of-pocket expense and premium) across enrollees and applying them to health plans, the marketplaces would be able to tell us the projected total health care cost by health plan.
- How well the health plans met consumers’ needs. Assuming users identified those attributes or features of a health plan that were important to them—a specific provider, benefit coverage, satisfaction level, total cost, etc.—we would know which health plans best met their needs.
The information would be helpful to insurance marketplaces, health plans and individual consumers. Insurance marketplaces could better evaluate plans based on their performance. Health plans could make better decisions about their participation in and offerings for the 2015 plan year. And the individual consumer could make better purchasing decisions. Read Part 3 of this series to learn “What else should we know about buying behavior?”