PWC Report on What Employers Want from Health Insurers

Price Waterhouse Coopers released a survey last week of what large and small group insurers want from health insurers which is available on their website. In short employers value technology and wellness but want better ways to engage employees and manage costs. Satisfaction from large employers dropped 5% from 2008 while satisfaction from small employers (surprisingly) held steady. Key recommendations include:

• Look beyond the provider discount strategy.
• Assist in the coordination of care.
• Educate the employer and employee about their health coverage.

In short, employers are looking for health insurers to take a much more active role in controlling costs. One way to show this would be to actively approach providers regarding episode based payment pilots. Episode based payments raise an incredible amount of issues but just sitting on the sidelines I don't think is an option. Health plans who have strong relationships with the provider community have an edge on this development because it will take an incredible amount of trust to successfully implement.

What Do Health Insurers Do Now?

No matter what happens in the next few weeks to health care reform, health insurers will still need to focus on controlling costs and engaging members. The increasing cost for health insurance will continue to squeeze employers so those health insurers who show they can manage care not just cost will be successful.

Being a Successful Health Insurer

With the impending passing of health care reform, it is now apparent that future health care plans will need a new set of skills to be successful. Instead of being good at screening out and pricing risk accurately, health plans are going to need to be good at managing and improving the lives of those people they cover. And with the individual market growing in the next 5-10 years, health insurers will have to change their perspective from being a wholesaler (selling to employers) to that of a retailer (selling to individuals). This means a greater emphasis on the customer service experience which will bring changes in how they interact with their members through websites, written correspondence and phone calls. It also means that a company's brand will continue to grow in importance. Who do I think will successfully make this transition? I will discuss this in future posts.

The Senate House Compromise

There have been numerous articles written about the differences between the Senate and House bills. Many policy analysts agree that the Senate version will dominate in the final bill. One change I would like to see is the effective date of many of the provisions which should be earlier than 2014. Also, I think the penalties for not getting coverage need to be more severe as they are presently in the House bill. This will lessen the chance of adverse selection for health insurers. Right now health insurance lobbyists are busy fighting the premium tax. It will be interesting to see how effective they are in getting this lowered or eliminated.