By Jeff Lin, Senior Vice President of Product Management at InstaMed
Centers for Medicare & Medicaid Services (CMS) released the final enrollment numbers for Open Enrollment 2016. In just three months, 12.7 million individuals enrolled in a health plan through the public and private exchanges this year which is an increase of one million over the previous year. Now in its third year, Open Enrollment presents particular challenges for the healthcare industry with this annual flood of new consumers, including:
- 90% of consumers have purchased the Bronze and Silver plans which have higher overall patient responsibility. (CMS)
- The amount a consumer must pay before a health plan covers any portion has increased 67%. (The Kaiser Family Foundation)
- The average health plan premium is expected to increase by 7.5%. (Healthcare.gov)
As demonstrated by these statistics, consumers have a rapidly growing role in healthcare which is under particular scrutiny during an Open Enrollment period. However, consumers, especially new participants, are still confused and frustrated by the process of managing their healthcare finances.
Adapting to the New Metal Plans and Higher Payments
The trend of high out-of-pocket costs has been spurred on by the introduction of the “metal plans” in Open Enrollment. The most popular plans are the Silver and Bronze plans that offer the lowest premiums yet have the highest out-of-pocket expenses.
Despite selecting a metal plan, these consumers do not necessarily understand the most common healthcare payment terms such as premium, deductible, coinsurance, or co-payment. This lack of understanding results in frustration, confusion, and a poor experience – often without any payment made. Consumers need to know how much they owe and how to pay. Healthcare organizations can eliminate consumer confusion and dissatisfaction with a simple and secure payment experience and clear patient communications. [Read more…]
