5 Trends We ve seen in Healthcare Reform:

Transcription

1 5 Trends We ve seen in Healthcare Reform: Views from Employers, Brokers, and Consumers A presentation for the 2014 SIR Annual Conference By Zeldis Research Associates

2 Audiences Size/Scope Methodologies Zeldis Research Associates Our learnings are based on over a dozen studies in the past few years Employers Mostly small and mid-size companies, but also some national Brokers Work with companies of various sizes/industries Consumers Insured & Uninsured Over 500 qualitative discussions 300 Employers 100 Brokers 150 Consumers Many quantitative interviews Focus groups/ Dyads In-depth interviews InterVu Online bulletin board discussions Quantitative online surveys 2

3 First, we have the professionals 3

4 And, equally as important, the consumers I m Mike. I m single, with no children. I m 30 years old and I bought health insurance on my own through the exchange. I m Bert. I m married, with one child. My health insurance is through my employer. I ve had no change to my plan in the past year. I m Anthony. I m single, with no children. I am covered through work and we switched health insurance carriers last year. 4

5 Employers, Brokers, and Consumers Helped Us Establish General Lack of Knowledge and Understanding The Wait and See Approach 5 TRENDS Exchange Confusion We ve Seen in Healthcare Reform Stemming the Cost Alternative Thinking 5

6 General Lack of Knowledge and Understanding EMPLOYERS BROKERS Healthcare is one of many roles Most rely heavily on their broker for knowledge and info. Work hard to stay knowledgeable Understand clients rely on them for info. Although they understand HCR well, they are frustrated by all the changes. CONSUMERS Limited knowledge Many know by name only and may believe HCR will have a negative impact. Keep Brokers in the loop; educate and provide resources for employers and consumers where possible. 6

7 EMPLOYERS Few have made changes Other than what is needed for compliance, they plan to wait-and-see. Employers rely on brokers to dictate next steps according to the legislation. Keep clients informed So they can remain compliant; notify them when action is needed. The Wait and See Approach BROKERS Most have not given any thought to how HCR affects them. Want to maintain what they have. CONSUMERS Maintain strong Broker relationships and offer consumers a variety of plan alternatives. 8

8 EMPLOYERS BROKERS EBMs want to continue offering the same benefits But cost has put pressure on them. Realize their role is changing Consult with clients to control costs and get competitive plans. May focus more on voluntary products. Stemming the Cost CONSUMERS Trying to balance cost and health Focus on living a healthier lifestyle, preventive care. Offer flexibility so EBMs can provide choices to meet varied EE needs. Show detailed cost comparison. 12

9 Exchange Confusion EMPLOYERS BROKERS Aware of the concept of exchanges But little else. Express concerns about employees ability to navigate. A few are considering defined contribution, but have limited understanding. Feel exchanges could be good option Employers need to feel comfortable. Feel consumers will be able to follow with appropriate assistance. Wonder if the support will be there. CONSUMERS Limited understanding of exchanges Will need support if/when they go there. Very little brand loyalty, cost-driven. Provide support to employees and offer comparison tools (cost, network, carrier rating) and competitive options. 10

10 Alternative Thinking EMPLOYERS BROKERS Little awareness of alternatives Need brokers to educate them and help keep them up-to-date with trends. Need to be shown successes. Recommend alternative solutions See several trends for the future ACOs, Narrow Networks, Defined Contribution, Telemedicine. CONSUMERS Given cost sensitivity, consumers are open to less expensive alternatives Market in simpler, easy to understand language. Continue to be creative in designing plan options and offer employees and consumers as much variety in cost and coverage options as possible. 14

11 SUMMARY IMPLICATION Knowledge of the specific details of health care reform is limited. Most are adopting a waitand-see approach. Few understand the details of how an exchange works. Keep Brokers in the loop and provide education/resources for employers and consumers where possible. Maintain strong Broker relationships and offer consumers a variety of plan options. Provide support to employees, offer comparison tools and competitive options. Still evaluating steps to ameliorate anticipated cost impact of HCR. Alternative approaches are being considered. Offer flexibility so EBMs can provide choices to meet varied EE needs; show detailed cost comparison. Continue to be creative in designing plan options and offer employees and consumers as much variety in cost and coverage options. 16

12 FINAL THOUGHTS Zeldis Research Associates EMPLOYERS It s being educated on the mandates, fees, fines, and hours, and where it s going, and how it falls out. I think ACA is here to stay. As a business owner, we re going to have to make the best choice for our employees and ourselves. Become super-educated and make sure whoever our broker is, we get information so we can make the right choices. I think there is going to be a market at some point as exchanges continue to have a strong foundation and footing to help individuals navigate them, there might be a whole other market for brokers that may be focused on smaller groups that can help navigate individuals through these processes as well. BROKERS The exchange is something that people need to worry about today. But I think a lot of what healthcare reform really means hasn't played out but will in the future. CONSUMERS 17

13 Any Questions? Christine DiMeola 18