Healthcare reforms and consumer purchasing trends

Contributor: Don Canning

Another interesting trend is how the new US Healthcare reforms mandate new consumer exchanges that can affect consumer purchasing trends.   Recent publications indicate that consumers will evaluate healthcare options independently from employers’ sponsored insurance (ESI) plans.  These trends indicate;

• A shift away from ESI’s towards exchanges for choice, convenience and affordability.
• Many will evaluate ESI’s against new exchanges as well as most lower-income and part time workers will engage public or private exchanges.

As employers and payers embrace reform mandates, new private and public healthcare exchanges will emerge changing the relationship between employers and ESI membership.  New exchanges will offer opportunities for workers to acquire healthcare services outside the workplace driving a new sense of independence and consumerization of purchasing trends.

As the US healthcare reform becomes more ingrained in day-to-day payer operations, industry analysts predict a shift away from traditional ESI’s plans to what is perceived to be a more flexible and lower cost alternative.  These new reforms offer public or private exchanges that can be a growth boom for the proactive payers that lead the industry to new business models.  Savvy executives are now planning to offer new competitive member exchange plans to millions of lower income or part-time workers.

Rethinking process excellence is good news for some payers and bad for others lacking the operational efficiency to accommodate exchanges at cost effective rates.  Moreover, reform mandates require full operational transparency across processing and audits, leaving many payers exposed before regulators.

For more information about healthcare; Rethink Process Excellence to Visualize New Programs

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