Resnick Unplugged:

The Affordable Care Act’s new Marketplaces (aka Exchanges) are open for business. They are the cornerstone of Obamacare. Millions of Americans, many uninsured and many with pre-existing conditions that previously excluded them from coverage are shopping and purchasing health insurance. And, the skies haven’t darkened, locusts haven’t descended to earth, and we’re not calling each other Comrade!

With coverage effective as early as January 1, 2014, these Marketplaces will be open for enrollment through March 31, 2014. Education and guidance remain a priority. Consumers need to know how ACA affects them. They need answers to help make the right choice: determine what it means to their individual situation; figure-out their options, and; understand what they need to do, and when and where do they need to do it.

So what’s next? It is absolutely critical payers and providers help consumers manage through this massive makeover of our healthcare financing and delivery system. After all, if we ask customers to make upfront benefit and medical choices and ask them to stay involved throughout care delivery, they need to be supported and educated about how to make economical, personal decisions for the benefits and services they need.

Well-crafted communications that remove intimidation and confusion that typically greets healthcare consumers can boost confidence in making these new individual healthcare decisions. Be assured, if you’re not aggressively front of your customers, your competitors will be! Whether you call them members or patients they’re all customers and putting them the center of everything your organization does will produce success. So it’s time to figure-out what’s working, what’s not…and why:

How are consumers interacting with your organization today? What needs to change?
What insights and intelligence are informing your consumer strategies?
What are you doing to deepen existing relationships throughout the customer lifecycle?
Is prospect and customer outreach leveraging multiple communication channels?
Is there an “open door” for every customer who wants to shop and buy from you?
Is there C-Suite support for a cross-organization, loyalty-driven customer experience?

The nation is in the midst of a transformation extraordinaire…the retailization of healthcare with the emergence of value-based healthcare shoppers. Add to the mix new competitive pressures shaping markets such as outcomes based payment, integrated patient experience, and fast-paced consolidation. The stakes are huge for payers and providers who want their fair share of the billions of dollars set to flow through tomorrow’s healthcare system.

Will ACA be successful, who knows. Some critics say administrative and technological glitches will cause ACA to implode. Other detractors claim the program is unsustainable once “low hanging fruit” of subsidy eligibles are harvested combined with healthy people gaming the mandate penalty by only entering the system at their time of greatest medical need. Still more naysayers question consumers’ abilities to shop for healthcare based on benefit levels, price, provider network, and plan sponsor quality via Web-based Exchanges or through anointed Navigators.

On the other hand there are 48 million Americans without health insurance (more than ¼ of the State of Texas). Today, 20 million people under age 65 purchase some form of health insurance directly. Pundits expect 7 million consumers to enroll through Marketplaces the first year with as much as $23 billion paid out in subsidies. In an era of the “always-on” consumer ACA stalwarts remind us not to underestimate Americans’ ability to manage a healthcare budget, comparison shop, and purchase what’s right for them…particularly when it means access to health insurance, many for the first time. They want to know (and will find out) what they are buying, is it right for them, who they’re buying it from, and why it costs what it does…most of all, what’s in it for them!

In terms of future efforts to repeal the Affordable Care Act, time works against those on that largely political mission. As more and more uninsured Americans gain access to subsidized health insurance benefits Obamacare repeal efforts turn what was a partisan battle over a law that was not fully enacted into a test of political will of taking money and health services away from voters once they’ve entered this new system.

The bottom-line is simple: every participant in the healthcare value chain interacting with consumers during their ACA journey will have to prove their value in the most meaningful, relevant terms. Watchwords moving forward are consumer education, multi-channel outreach, behavior modification, and superior customer experience.

ACA RESOURCE CENTER

Boomers - http://goo.gl/bxJqa7

COBRA - http://goo.gl/jKBeFA

HIX Private - http://goo.gl/cTXbJW

HIX Public - http://goo.gl/g049xr

Payers - http://goo.gl/4k4kTd

Providers - http://goo.gl/uKNTZW

Politics - http://goo.gl/1wpqlk

Retirees - http://goo.gl/EgBC86

State Map - http://goo.gl/q13I3q

States Rates - http://goo.gl/V5OmTL

Subsidies - http://goo.gl/it1yMP