Changing the Game of Healthcare: Health Insurers

What do the 2016 presidential elections and the Affordable Care Act (ACA) have in common? They both have left American voters feeling neglected and misrepresented by the current choices. We’ve recently seen major health insurers like Aetna, Humana, and United Healthcare opting out of providing care through the ACA. By leaving the exchange, they are abandoning not only Obamacare but also the diverse individuals and communities throughout America that have found coverage through the exchange.

Just like a presidential candidate today couldn’t sweep the polls with the Reagan Coalition of The 1980s, these mega-insurers opting out of health exchanges are destined to fall behind the times. However, such changes open the door for insurers who are ready and willing to embrace the cultural and linguistic needs of all Americans in want of coverage. Health insurers that choose to stay in the ACA, providing low-cost and efficient coverage, are serving the needs of Americans today while positioning themselves for the demographic changes of tomorrow.

What does the future of the Health Insurance Exchange look like?

Well, this future belongs to the insurers who stay, the insurers who:

  • Care about serving individual members
  • Are adaptable to the new populations served through the exchanges
  • Have a long-term view on health and financial benefits
  • Want to position their company for growth

There are many benefits for health insurers who pursue these values by staying in the exchange. Despite the early difficulties of the exchange, the long-term positive outcomes will greatly benefit the health of America’s people and policies. As we all know, Obamacare is not without its imperfections, but we can’t forget that the exchange is still developing. According to The Washington Times, Obama stated in a recent letter to health insurers,

‘“We know that this progress has not been without challenges. Most new enterprises have growing pains and opportunities for improvement…The Marketplace, while strong, is no exception. Time and experience will help drive that improvement, as will constructive policy changes.”’

These constructive changes can already be seen in three concrete ways: 

  1. Obamacare Realizes Goals
  2. Long-term Investments…without Mega-Insurers!
  3. Major Opportunities for Customer-Centric Insurers

With the 4th open-enrollment period set to begin this fall, now is the time to discover these benefits for health insurers. Let’s start by taking a look at what Obamacare has achieved.The primary goal of Obamacare is to lower the rate of uninsured people in the United States. Obamacare achieves this in two ways

  1. Imposing an individual mandate requiring individuals to purchase health insurance or face a penalty known as the shared responsibility payment (SRP) if they remain uninsured
  2. Offering financial incentives to lower-income Americans

The successful execution of this goal can be seen through how many Americans, especially from low-income populations, are getting access to health insurance. According to new federal data, 2015 was the first year that more than 90% of Americans had health insurance.

Amidst the confusion of mega-insurers leaving, re-entering, and negotiating exchanges, many have predicted that the ACA is and will continue to be a positive investment. Nick Bagley, an assistant professor at the University of Michigan Law School whose work focuses on the Affordable Care Act, was quoted in a recent VOX article saying,

“It’s important to step back and think about what would be happening right now if there was no Affordable Care Act, premiums would be much higher now than they are under any kind of reasonable estimate.”

Despite the fluctuations of the marketplace, the ACA is positioned to be a lasting financial and medical win for the USA. In an article entitled, “The Surprising Way Obamacare Could Save the Healthcare System a Lot of Money,” writer Sean Williams explores a study published in JAMA Internal Medicine that demonstrates significant improvement in self-reported health for low-income adults in states that have benefited from Medicare expansion. Williams writes,

“It may be costing the federal government money right now to cover preventive care visits and possible medications for low-income adults. However, over time, that preventive care will catch many chronic or even lethal medical conditions before they become a costly burden on the healthcare system.”

Given that 5% of the population is accountable for half of healthcare costs, targeting specific populations and providing more expansive care through Obamacare is an investment in future savings. Just as health exchanges are a viable route to lasting, improved health benefits, customer-centric care will result in the most concrete benefits.

Valuing individual needs is at the core of the ACA and Obamacare. At Avantpage, we strive to be a customer-centric company and believe that dedicated health insurers also support this business approach. According to Investopedia, Customer-centric can be defined as,

“A specific approach to doing business that focuses on the customer. Client centric businesses ensure that the customer is at the center of a business’s philosophy, operations or ideas. These businesses believe that their clients are the only reason that they exist and use every means at their disposal to keep the client happy and satisfied.”

Healthcare reform and the exit of mega-insurers is paving the way for health insurance providers who value individual attention and care. Moreover, health insurers that take this customer-centric approach see incredible results communicating with patients in each patient’s own language.

Communicating in patients’ native languages leads to better health, healthier patients, and lower medical costs for the patients and their insurers. When patients, doctors, and medical staff have the ability to communicate, either through well-translated documents or the use of an interpreter, patients receive better medical care. Yet, many healthcare professionals still are hesitant to invest in language services.

With the LEP (Limited English Proficient) population at over 25 million and growing, it’s imperative that customer-centric health insurers offer accurate and clearly translated documents to patients. The overarching goal of Obamacare is to create more inclusive and affordable healthcare for all, and this approach gives health insurers the opportunity to take a stance as customer-centric, inclusive providers. Ultimately, this type of involvement and care will lead to healthier patients which leads to universally lower healthcare costs and results in a stronger, more loyal customer base in the marketplace.

Health insurers looking responsibly to the future, centered on the interests and needs of the American people, can hope to provide the most value, financially and in regards to individual care, through the ACA exchanges. As a new enrollment period begins, the door will be opened to insurers looking to serve the new multi-ethnic, multilingual populations of the USA.