Open enrollment for the Affordable Care Act, or ACA (but better known as Obamacare), will kick off for its second year in only three weeks from now. Of course, things will be a lot different this time around. Insurers and the federal health exchange, Healthcare.gov, have a year of experience under their belts, so the expectation is they’ll be better equipped to handle an influx of enrollees. In addition, the enrollment period itself is a lot shorter, lasting just three months this year, compared to six months last year.
Also, the penalty for violating the individual mandate and not purchasing health insurance has gone up, with an individual responsible for paying the greater of $325 or 2% of your annual income. The $325 minimum penalty is a full 242% higher than in 2014, and will act as an extra incentive to get procrastinators enrolled.
But, in some ways a lot of things have stayed the same. The approach to purchasing health insurance will remain the same, with individuals being able to compare plans side by side in a transparent manner. The number of health plan participants is also expected to rise in a number of states, with companies like UnitedHealth Group , which sat out much of 2014 in many states, announcing its entry into a number of markets. In other words, consumers may find even more plans to choose from in 2015 compared to last year.
The classic conundrum of how health providers can achieve higher quality while lowering costs and delivering customer value will be explored Nov. 6 at the sixth annual Crain’s Health Care Leadership Summit.
CEOs from six organizations will talk about changes in health care, and how they impact employers, providers and insurance companies.
In a panel discussion, CEOs Nancy Schlichting of Henry Ford Health System, Gene Michalski of Beaumont Health, Joe Mullany of Detroit Medical Center and Rob Casalou of St. Joseph Mercy Ann Arbor and Livingston hospitals will give their views on how health care business consolidation and clinical integration with physicians and other providers are improving quality and lowering costs for their organizations.
Keynote speaker Joe Flower, an author and health care futurist, will begin the day at the Shriners Silver Garden Events Center in Southfield. He will speak about how the forces of change began years before legislative health care reforms came through the Patient Protection and Affordable Care Act of 2010.
Driven by decades of double-digit medical inflation and ever-higher prices to employers and patients, the health care delivery and insurance financing system is ultimately moving toward greater consumer shopping with assistance by price and quality transparency, Flower argues.
The Affordable Care Act has increased the pace of delivery change and radically cut the uninsured rate, but longer-range forces already underway are changing how patients purchase health care services and how providers compete for business, he says.
“If we change the way we pay for health care so that providers compete for our business on price and quality like other businesses do, prices will drop to well below today’s median price,” says Flower, author of Healthcare Beyond Reform: Doing it Right for Half the Cost.
After his 25-minute keynote, Flower will moderate a panel that will react to the changing health care system trends and regulations promulgated by the Affordable Care Act.
Analysts are curious to see how insurers are going to further educate the public about the Affordable Care Act. Senior vice president of Radius GMR, Kathleen Relias, noted that “[o]verall satisfaction was stronger among those enrollees who reported receiving adequate explanation of ACA coverage,” and that “[o]nly 44% of Americans feel they are well informed.” We’ve already seen WellPoint taking the initiative in the culturally diverse state of California and advertising on TV, the web, and in print in multiple languages. The question is will other insurers in different states follow suit with unique ways of reaching currently uninsured consumers?