Enrollment in private exchanges likely to grow

Enrollment in private health insurance exchanges is likely to match enrollment in public exchanges by 2017 and may exceed it in 2018, an Accenture study found. Many employers favor private exchanges because they offer defined contribution plans and opportunities to customize supplemental offerings such as dental, life and disability products, Accenture’s Richard Birhanzel said. HealthLeaders Media (8/15)

Medicare Advantage Enrollment Continues to Grow

The Affordable Care Act (ACA) reduced federal payments to Medicare Advantage plans to bring them more in line with payments under traditional Medicare. Despite predictions that enrollment would drop, enrollment in Medicare Advantage plans has actually climbed from 11.1 million in 2010 to 14.4 million in 2013 – a 30% increase, according to a report by the Kaiser Family Foundation.

Enrollment continues to grow across counties and high and low payment quartiles,  which suggests that the market offers enough choice to attract enrollees even if some plans become less competitive under the ACA. However, the analysis did not examine cost sharing or benefits, and it is unclear how much the plans have changed cost sharing or extra benefits since 2012.

The Congressional Budget Office expects enrollment to continue to increase in 2015 and future years. But, the CMS Office of the Actuary expects enrollment to decrease after 2014.

Since payment reductions have not yet been fully phased in, it remains to be seen how companies will respond. Also, quality-based bonus payments have partly offset the payment reductions. There could be some shakeout in the market, over the next few years, as payment reductions are implemented and benchmarks move closer to  for traditional Medicare spending. To remain viable, some plans will have to become more efficient or modify the extra benefits they provide. HMOs seem to have an advantage over other model types. For more information, visit www.kff.org.

Consumer Driven Plans Continue to Grow

Ten percent of the population was enrolled in a consumer driven health plan (CDHP) in 2012, up from 7% in 2011. Enrollment in HDHPs remained at 16%, according to a study by the Employee Benefits Research Institute (EBRI). Fifteen percent of 21- to 64-year olds with private insurance were in a CDHP or an HDHP that was eligible for an HSA. When their children were counted, about 25 million people with private insurance,were in a CDHP or an HSA-eligible plan  — representing about 14.6% of the market.

CDHP enrollees were more likely to evaluate provider cost information compared to traditional plan enrollees. They were also more likely to look outside their health plan for information about their doctors’ costs and quality. CDHP enrollees were also more likely to participate in wellness programs, such as health-risk assessments, health-promotion programs, and biometric screenings. In addition, financial incentives mattered more to CDHP enrollees than to traditional-plan enrollees.

Compared to those in traditional plans, adults in a CDHP were much more likely to say they were in excellent or very good health, much more likely to exercise, and much  less likely to smoke. CDHP and HDHP enrollees were also more likely to be highly educated. For more information, visit www.ebri.org.

Last Updated 09/22/2021

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