Washington Health Benefit Exchange Consumer Choice

Transcription

1 Washington Health Benefit Exchange Consumer Choice Advisory Committee Meeting March 3, 2015 Christine Gibert, Senior Policy Analyst

2 Consumer Choice - Background In 2012, the Exchange Board passed the following Exchange Objectives: Increase access to affordable health plans Organize a transparent and accountable insurance market to facilitate consumer choice Provide an efficient, accurate, and consumer-friendly eligibility determination Enhance health plan competition on value price, access, quality, services, and innovation 2

3 Consumer Choice Tools Concept: Offer consumers tools to help them narrow down the field of QHP options to find plans better suited to their needs Why offer choice tools? Help consumers to narrow down the number of desirable plans Consumers decide for themselves what criteria are most important for choosing a plan offering the best fit E.g., quality ratings, premium price, cost-sharing structure Consumers have the choice of narrowing their field of plan options or considering all available plans in their area Help consumers find a plan that best addresses their health needs 3

4 Consumer Choice Tools Different Approaches Choice tools offer a variety of mechanisms to help consumers drill down to the best plan For example, tools can: Provide consumers with a customizable choice architecture platform that they can tailor to their concept of best value Allow consumer to compare plans by quality metrics Allow consumers to compare network information Support an enhanced shopping experience to facilitate choice 4

5 Consumer Choice Tools Unknowns Data issues Different tools may use state-specific data or national average data, or both How to integrate state-specific data into choice tools Cost to implement and maintain tools Level of resources/effort required to set up and maintain All tools are currently in development Not available for implementation in Washington before

6 Choice Tools Individually-Tailored Choice Architecture Allows consumers to define what value means to them Picwell predictive analytics tool Analyzes up to 900,000 variables affecting plan selection E.g., prescription medication use, risk tolerance, utilization patterns, quality preferences Allows consumers to invest as much time and identify as many or few areas of interest as they desire Presents the highest recommended plans to participants based on individual circumstances 6

7 Choice Tools Individually-Tailored Choice Architecture Consumers Checkbook Marketplace Health Plan Comparison Tool 50 federal agencies already use Consumers Checkbook choice tools Piloted in Illinois Exchange in 2014 Allows consumers to customize their plan search using total estimated cost, quality, doctor availability, health condition-specific benefits, and other metrics RWJF Plan Choice Challenge Contest to develop app to help consumers compare cost sharing features of plans Uses individuals health information and claims experience data to estimate total health spending and direct consumers to best-fit plans Demos of winning apps will be available in February

8 Choice Tools Quality Integrate Quality Rating System into shopping experience Federal Quality Rating System scoring E.g., sort health plans by their overall star ratings Rating System E.g., filter options to only show health plans with Diabetes Care Composite scores of or Integrate Community Checkup data into shopping experience Partner with Washington Health Alliance to provide quality information on local providers Potentially leverage HPF s Provider/Clinic Search functionality 8

9 Choice Tools Network Information RWJF and HHS Provider Network Challenge Contest to develop a tool to allow consumers to dig deeper into plan network information, including: Search for conveniently located providers Identify providers taking new patients Access patient reviews of providers Enhance Filter and Sort functions to include network information Some state exchanges already offer filtering by network, e.g, CA, NY Choose a plan and then interact with the provider directory of that plan 9

10 Choice Tools Enhance Shopping Environment to Facilitate Decision-Making Incorporation of Health Insurance Literacy tools Link consumers directly to enhanced health insurance literacy tools as they go through the shopping experience Shopping Cart feature Allow consumers to save and compare their favorite plans in their shopping cart after narrowing down QHPs using a variety of metrics Enhance current Plan Wizard and Sort and Filter tools E.g., add questions related to deductibles or anticipated utilization to the Plan Wizard 10

11 Next Steps Gather feedback from committees and stakeholder groups Board discussions in March Continue to learn about choice tools in other contexts Investigate ongoing costs associated with tools currently being used and in development 11

12 Washington Health Benefit Exchange Appendix

13 PAST POLICY COMMITTEE DISCUSSION Helping consumers to identify what value means to them and which plans offer the best fit E.g., quality, cost, accessibility The importance of educating consumers Promotion of health literacy Providing clarity and information on complex concepts Empowerment of consumers and an individualized process Transparency Especially with respect to cost Types of tools Visuals, enhanced filtering and sorting, real-time assistance, guidance on what plan basics to look for while shopping 13

14 COMMITTEE FEEDBACK ADVISORY AND HEALTH EQUITY TAC Focus on value Definition should be consumer-driven Solicit direct consumer and IPA/broker feedback Simplify the consumer experience New tools should provide straightforward information and be easy to use Consumer education is needed Support for increased health literacy efforts Understanding costs is a primary area of confusion Mixed reactions to whether these tools could drive innovation and improve consumer experience Take the time necessary to implement it right 14

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