Healthcare reform: A 'long, hard slog' ahead

Panelists at national health insurance exchange summit share successes, lessons learned
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There's "a long, hard slog" ahead for exchanges and their carriers, Joel Ario, former director of the HHS Office of Health Insurance Exchanges, said yesterday at the second national health insurance exchange summit in the District of Columbia.

Ario and leaders from the Rhode Island and Connecticut exchanges agreed healthcare reform implementation is a marathon, not a sprint, and offered advice for success--as well as lessons learned from missteps--during the panel discussion. 

The first open enrollment period is over, but exchange officials and insurance leaders can't sit back and relax until next November, the panelists said. The new online marketplaces involve a continuous open enrollment process, leaving a lot of work to do between now and next fall and in years to come.

Access Health CT CEO Kevin J. Counihan said his goal for the first year was to survive it. His exchange has done well so far, bringing in twice as many enrollees as expectated and achieving 92 percent overall customer satisfaction.

For continued success, the primary focus should be on retention, said Christine Ferguson, director of the Rhode Island Health Benefits Exchange.

And those retention efforts should include helping people understand how to use deductibles and coinsurance, how to choose providers and how to use health insurance, for example.

The panelists also highlighted a few missteps their organizations have made. For example, the Connecticut exchange didn't always use outreach channels effectively. Counihan said they made a mistake in using doctors' offices as a source of information. The exchange assumed doctors were well-versed in the exchanges when, in fact, they didn't understand much at all.

The panelists also cited ongoing collaboration with carriers as essential to surviving the exchange implementation marathon. "The systems are only a little part of the equation, it's really the partnerships and relationships with the carriers that matter," Ferguson said.

From the start, the Rhode Island exchange talked with carriers about issues and still holds weekly meetings with carrier representatives. Similarly, Connecticut has a carrier council that meets every two weeks and Counihan calls health plan CEOs once a week to touch base.

"We don't have a perfect relationship always but every day you just work ahead," Counihan said.

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