[Editor’s note: this
article was contributed by Mike Baker, senior vice president and GM of
commercial products, and Maydad Cohen, senior vice president and GM of government
solutions, at hCentive (www.hcentive.com).]
Now that the annual open enrollment period is in the rearview
mirror, what are the key takeaways from 2016? Here are five lessons learned:
1. ACA health
insurance marketplaces aren’t going away.
Exchanges successfully connected people to health insurance in both the
public and private marketplaces. More than 12 million people enrolled in the
federal and state marketplaces during open enrollment 2016, and 7 in 10
consumers returned to HealthCare.gov this year. At the same time, new enrollees
increased 42%. This demonstrates need for the marketplaces as well as its
2. The tech hurdle
has been cleared.
Thanks to more mature technology delivered via off-the-shelf software, states
are learning that custom-built systems aren’t necessary. As a result, they’ve
shifted focus to providing a better customer experience and adding new benefits
products, including dental. With smarter decision tools (like provider and
prescription medication lookup), private exchange-inspired innovations and more
effective contact center support, states are now able to enroll more members
and turn their attention to eliminate waste and fraud.
3. Marketplaces are
The recent open enrollment period prompted many states to actively explore
private sector technology options to HealthCare.gov or the federally facilitated
marketplace, which is a one-size-fits-all solution that is expected to cost
more to states with looming federal fees. As states seek more control, they’ll
explore proven, financially sustainable alternatives that cost less and have
the flexibility to manage state specific policies and complexities.
4. Private health
insurance exchanges are growing rapidly.
Public marketplaces got the most media attention, but private exchanges are growing
quickly with 6 million enrollees in 2015 and a growth rate of 100% annually,
according to Accenture. Employers value private exchanges for their superior
cost management, benefits choice and user experience. Brokers are also using
some private exchange “web broker” platforms to more efficiently enroll
5. Small and
mid-sized companies are looking for new alternatives.
As they seek benefits to attract and retain the best and brightest, small and
mid-sized employers are taking a fresh look at private exchanges. These
employers are looking for ways to expand choices, simplify administration and
make costs more predictable. Brokers who recognize the market potential are
adopting technology platforms that allow them to serve this underserved but
The health insurance marketplaces still have plenty of room
for improvement, particularly on the cost and convenience side. But the
recently concluded enrollment season revealed that exchanges are here to stay
and that opportunities abound as the marketplaces evolve.