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Private health insurance exchanges poised for 'Hypergrowth'

Brian Eastwood | Oct. 1, 2014
Public health insurance exchanges removed nearly 10 million American adults from the ranks of the uninsured. However, the sites were plagued with problems -- and the second year of sign-ups may bring additional headaches. That leads some to suggest that private exchanges may have a brighter future if they get the technology right.

More options mean more complexity, of course but that's the value proposition for the private health insurance exchange, Accenture says. The exchanges that want to get it right have much to do, particularly when it comes to data exception management, reconciliation, data exchange, integration with employer payroll systems, and real-time calculations of an employee's pre- and post-tax earnings.

"Mature exchanges," meanwhile, will consolidate bills across all carriers (health, dental, vision, life and even pet insurance) and reconcile the balance with what employees pay through the private health insurance exchange. This is no doubt a challenge, but Birhanzel says it will be a differentiator especially as firms allocate a set amount for employees to spend and not all of that need be put toward health insurance. "People, generally speaking, in an employer-sponsored space haven't had these kinds of choices before. They need to have tools to make as much of an informed decision as possible."

Scalability Will Mean Success for Private HIX
In the end, the private health exchanges that succeed will be the ones able to scale, especially during open enrollment periods (unlike the inaugural launch). "Scale" and "size" may not necessarily correlate, either small, focused exchanges, such as Washington, D.C.'s Industree Exchange for bars and restaurants, may well better serve their customers than larger exchanges trying to be everything to everyone.

"The private health insurance exchanges that make the right moves in the next 18-24 months will be the ones who are better positioned to achieve sustainable growth as this robust market matures," the Accenture report concludes. "Getting the front end right will draw in customers, and getting the back end right will retain them."


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