Purchase |

Consumers Spend Little Time Choosing Health Plans

October 23, 2015 By Jay Baldauf

With open enrollment for 2016 underway, 59% of consumers say they will spend less than 30 minutes selecting a plan, according to an October HealthMine survey. “Consumers are treating an increasingly complex and costly purchase with inertia. With rising out-of-pocket costs, narrowing networks, and growing prevalence of chronic disease, not doing your due diligence on healthcare coverage could be hazardous to your health—and to your pocketbook,” said Bryce Williams, CEO and president of HealthMine.

The most important factors in selecting a health plan are monthly premiums and out-of-pocket costs. However, 76% of consumers don’t know what they spent in total out-of-pocket on drugs in the past year. And 67% don’t know what they spent out-of-pocket for doctor visits and labs. In addition, 42% don’t understand their total spend on monthly premiums.

Even though 85% of respondents say they have a good idea of needed services in the coming year, 36% find their plan somewhat or very confusing. Of those, 58% are most perplexed about which services are covered by their plan. Another 46% are confused about costs. Twenty-eight percent don’t know how to get the most from their wellness program. Sixty-six percent of consumers don’t plan to make any changes to their health plan in this enrollment period. Forty percent say that there has been no recent change to their plan’s quality and value. Another 35% say their plan is getting better.

UnitedHealth and Anthem Look to Purchase Smaller Carriers

June 28, 2015 By Jay Baldauf

TheStreet.com reports that UnitedHealth, Anthem, Aetna, Humana, and Cigna are involved in a buzz of merger and acquisition activity, as the health insurance industry is responding to the aftershocks of the Affordable Care Act.

Fitch Ratings reports that a combination of any of the five largest U.S. health insurers could accelerate further merger and acquisition activity in the managed care sector. Just one mega M&A deal could lead to similar responses by competing firms seeking to shore up competitive disadvantages in scale and product lines. Fitch sees the M&A potential in the health insurance sector as a direct response to anticipated market conditions in a post-Affordable Care Act (ACA) world. Rumors of health insurance M&A activity among the five largest publicly traded health insurers in the U.S. have accelerated in recent weeks.

Fitch says that the ACA, would add to health insurers’ membership volumes, but reduce member margins. This margin pressure would be exacerbated by the government’s challenging fiscal condition, employers’ on-going desire to reduce health care costs, and a heightened need to invest heavily in technology.

As a result, Fitch believes that size and scale are quite important to health insurers’ competitive positions and financial results. In addition, the importance of product line (i.e. individual, group, Medicare, Medicaid) diversification will increase in response to the government’s increasing role in the market, the aging U.S. population and employers’ desires to reduce health care costs