Private Exchanges See Surging Enrollment

CrowdTotal enrollment in private exchanges is expected to surpass state and federally funded exchanges by 2018, reaching 40 million, according to a report by Accenture. Three-times as many people are enrolled in private exchanges for 2014 as Accenture forecasted last year. Three million people now get employer health benefits through a private exchange.

“Private exchanges are experiencing hyper growth and will significantly change the role consumers have in personalizing their own employer health benefits…Private exchanges have an unprecedented opportunity to differentiate and prove the value of this new model over traditional self-managed plans,” said Rich Birhanzel, managing director, Accenture Health Administration Services.

The rapid growth of private exchanges has expanded benefit choices, but also presented employees with financial trade-offs. Twenty-five percent of those enrolled in private exchanges purchased less health coverage (measured in actuarial value) than they had previously. Those choices may have been to decrease monthly premiums, but they add out-of-pocket costs for patients with higher deductibles. This benefit trade-off also increases the reimbursement that hospitals and doctors need to collect directly from patients. By 2018, out-of-pocket collections from patients with employer-sponsored plans will increase 7% or an additional $3.7 billion. This also adds to the difficulties that health providers face with patient collections. The American Hospital Association estimates that U.S. hospitals provided more than $45 billion in uncompensated care in 2012. For more information, visit

Last Updated 08/10/2022

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