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Actuarial Value
Consumer Research in Massachusetts
Health
Insurance
Exchanges
• Objectives
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Gain Insight into Consumer Perceptions of AV and Medal Categories
Better Understand Role of AV Categories in Purchasing Behavior
Identify Potential Consumer Segmentation in Purchasing by AV
Inform Consumer Outreach and Communication
Share Information with Health Plans
• Methodology
– Qualitative
– 4 Focus Groups; 47 Individual, Non-Group Consumers
• Timing
– February 2007
1
Actuarial Value
Consumer Research in Massachusetts
Health
Insurance
Exchanges
Highlights
• AV Confusing; “Technical;” Requires Examples
• Medal Categories
– Helpful “Directionally”
– Created Perception of Value (Price to Coverage Benefits)
– Incomplete – Other Needs (e.g. network, price, reputation)
• Importance of Decision Support Tools
– “What Are My Real Costs”
– Value (“What Plan is Right for Me?”)
• Initial Segmentation
– “Hand-Holders;” “Independents;” “Analyzers”
• Communication Preferences
2
– Easy & Simple Explanations with Examples
– On-Line w/ Video Explanation & Call Center Support
Company Confidential
Actuarial Value
Application to Health Plans
Health
Insurance
Exchanges
• Gold – Base Line AV – 92%
– Benefits Prescribed to Health Plans
• Silver – 75% - 83%
• Bronze – 60% - 65%
• Established Plan Design Flexibility – Silver & Bronze
– Design Flexibility within AV Range
• 2 Silver Plans; 1 Bronze Plan
• 27 Plan Designs (including Young Adult Plans)
• Influence on Decision to Standardize Benefit Plans
– Member Complaints About Confusion with Choices
– Plan Flexibility within Tiers Added to Perceived Complexity
– Qualitative/Quantitative Research Suggested Benefits of
Standardization
3
• 27 Plan Designs → 9 (including YAP)
Company Confidential